The Effects of a Mindfulness-Based Family Psychoeducation Intervention for the Caregivers of Young Adults with First-Episode Psychosis: A Randomized Controlled Trial

Zoe Jiwen ZHANG, Herman Hay Ming LO*, Siu Man NG, Winnie W. S. MAK, Samuel Yeung Shan WONG, Karen S. Y. HUNG, Cola Siu Lin LO, Jessica Oi Yin WONG, Simon S. Y. LUI, Edmund LIN, Clara Man Wah SIU, Eric Wai Ching YAN, Sunny Ho Wan CHAN, Annie YIP, Man Fai POON, Gloria Oi Chi WONG, Jonathan Wai Hung MAK, Hillman Shiu Wah TAM, Iris Huen Hung TSE, Bobby Fook Hin LEUNG

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)peer-review

8 Citations (Scopus)


Objective: In this study, we investigated the effects of a mindfulness-based family psychoeducation (MBFPE) program on the mental-health outcomes of both caregivers and young adults with first-episode psychosis with an onset in the past three years through a multi-site randomized controlled trial. We also studied the outcomes of three potential mediating effects of interpersonal mindfulness, expressed emotions, and non-attachment on the program. Method: We randomly assigned 65 caregivers of young adults with psychosis to MBFPE (n = 33) or an ordinary family psychoeducation (FPE) program (n = 32); among them, 18 young adults in recovery also participated in the evaluation of outcomes. Results: Intent-to-treat analyses were conducted. No significant time × group interaction effects of MBFPE and FPE programs were found in any of the caregivers’ outcomes. However, the young adults with psychosis reported higher levels of recovery after the MBFPE program than after the ordinary FPE program (F = 8.268, p = 0.012, d = 1.484). They also reported a larger reduction in over-involvement of their caregivers (F = 4.846, p = 0.044, d = 1.136), showing that MBFPE had a superior effect to FPE in promoting recovery and reducing over-involvement. Conclusions: A brief psychoeducation program may not reduce the burden on or improve the mental-health outcome of caregivers of individuals with recent-onset psychosis. However, integrating mindfulness into a conventional family psychoeducation program may reduce the expressed emotions of caregivers, especially over-involvement. Further studies should explore how psychoeducation programs can reduce the impact of psychosis on family through sustainable effects in terms of reducing their burden and expressed emotions, using a rigorous study and adequate sample size.
Original languageEnglish
Article number1018
JournalInternational Journal of Environmental Research and Public Health
Issue number2
Early online date3 Jan 2023
Publication statusPublished - 3 Jan 2023

Bibliographical note

The authors want to thank the caregivers who agreed to take part in this study. Their generosity in sharing their photographs and lived experience helped us better understand the challenges they face and how mental-health professionals might better respond to their needs. Special thanks to Castle Peak Hospital and Kowloon Hospital (Hospital Authority) and Baptist Oi Kwan Social Services for their collaborative effort in recruiting caregivers for this project.

Funding Information:
This project was supported by financial funding from the General Research Fund of the Research Grants Council in Hong Kong (Reference No. 15604118), awarded to the corresponding author.

Publisher Copyright:
© 2023 by the authors.


  • mindfulness-based intervention
  • family psychoeducation
  • caregivers
  • first-episode psychosis
  • Young Adult
  • Psychotic Disorders/therapy
  • Humans
  • Mental Health
  • Mindfulness
  • Caregivers/psychology
  • Psychosocial Support Systems
  • randomized controlled trial


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