Table 1 The contents of the psycho-educational program

Pre Session

To orient caregivers to the program, to create a trusting relationship between the caregivers and instructors

· Overview of the program and introduction of the instructors and members to each other.

· Discussion of the importance of orientation to patient behaviors and symptoms

· Completion of Zarit Burden Interview (ZBI) questionnaire by participants.

· Assessment of family needs.

1

To understand the disorder, its symptoms and treatments, and its effects on patients and families

· Case presentation. The instructor offers explanations of the symptoms and behaviors, and their effects on the family.

· Discussion of the etiology and treatments

· Question-answer and group discussion.

2

To recognize the effect of medications and compliance, and to orient caregivers to the warning signs of relapse and relapse prevention

· A review of the previous session.

· Discussion of positive and negative effects of drugs and problems related to side effects.

· Emphasis on the importance of drug compliance.

· Discussion about the warning signs of relapse.

· Explanation of the family role in relapse prevention.

· Question-answer and group discussion.

3

To manage the patient’s symptoms, to gain skills in coping with the patient’s symptoms, and to understand effective ways to express emotion and improve communication skills.

· A review of the previous session.

· Discussion of the importance of effective communication skills in the family and with the patients when they have symptoms.

· Explanation of skills for coping with some of the patients’ symptoms, and cognitive and behavioral techniques for managing patients’ symptoms

· Exploring intense emotions towards the patient.

· Discussion of expressing emotion and the emotional environment in the family.

· Discussion of how to cope with the patient’s negative emotions (for example, suicide behavior in mood disorder patients).

· Question-answer and group discussion.

4

To orient caregivers to stress management and relaxation for the family

· A review of the previous session.

· Introduction of the importance of stress management in the family.

· Discussion of ways to reduce stress.

· Practicing relaxation methods during the session.

· Question-answer and group discussion.

· Conclusion