Table 1 Content of psycho educational program

1

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

·Assessment of family needs.

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

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

·Completion of Brief Psychiatric Rating Scale and Family Burden scale by participants.

2

To understand schizophrenia, its symptoms and treatments, and its effects on patients and families

·Presentation of a patient with a DSM-IV diagnosis of schizophrenia with clinically stable status. The patient describes his experiences and offer insights. The instructor offers explanations of the symptoms and behaviors, and of their effects on the family.

·Discussion of the etiology and treatments

·Question-answer and group discussion.

3

To recognize the effect of medications and compliance.

·A review of the previous session.

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

·Emphasis on the importance of drug compliance and maintenance.

·Question-answer and group discussion.

4

To orient caregivers to the warning signs of relapse and relapse prevention

·A review of the previous session.

·Discussion about warning signs of relapse.

·Explanation of the family role in relapse prevention.

·Exploration of family intervention when the relapse has occurred.

·Question-answer and group discussion.

5-6

To improve communication skills in the family

·A review of the previous session.

·Discussion of the importance of effective communication skills in the family and the role of environmental stress as a risk factor for schizophrenia relapse.

·Discussion of skills for effective communication between family members.

·Question-answer and group discussions.

7

To manage the patient’s symptom and skills in coping with them

·A review of the previous session.

·Discussion of effective communication skills with patients when they have symptoms.

·Discussion of token economy and negative reinforcement for managing patients’ symptoms.

·Explanation of skills for coping with some of the patients’ symptoms.

·Question-answer and group discussion.

8

To understand effective way to express emotion

·A review of the previous session.

·Exploring intense emotions towards the patient.

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

·Discussion of how to cope with the patient’s negative emotions.

·Question-answer and group discussion.

9

To orient caregivers to stress management in the family

·A review of the previous session.

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

·Discussion of ways to reduce stress.

·Question-answer and group discussion.

10

To orient caregivers to relaxation methods

·A review and summary of the contents of past sessions.

·Practicing relaxation methods during sessions.

·Conclusion.