Research That Matters (January 17 - 20, 2008)

Background and purpose: Family factors are a primary interest for social work given the importance the family has for ethnic minority populations typically underrepresented in the literature. A critical need is to test family factors (e.g. pressures, resources, overall functioning, amount of family contact) on consumer clinical and psychosocial functioning. Consumer psychosocial functioning is a particularly vital outcome given that most consumers spend more time in the community and given the dearth of research on family contextual factors impacting it.

The study's aims were to test what family factors influence critical comments; and what family factors are directly and/or indirectly associated with improved psychosocial functioning, a novel area of focus in the schizophrenia family literature.

Methods: The sample (94 dyads of consumer and family member) was taken from the first wave of a longitudinal study assessing a family psychoeducation program designed for African-American consumers and their families. Measures of clinical functioning (symptoms) and psychosocial functioning were administered to consumers. Measures of family functioning were administered to the families. The data analysis tested two models using advanced statistical methodology not often used in the family mental health literature. Structural equation modeling permitted concurrently testing family contextual factors on consumer functioning thus testing in one study what has been done in the past across numerous, separate studies.

Results: The study revealed two striking findings regarding what family factors impacted consumer functioning. First, more family criticism predicted poorer consumer clinical functioning replicating with a larger sample what was found in the EE literature for African-Americans. Second, more family contact and less family dysfunction predicted improved consumer psychosocial functioning. Contextual factors such as fewer family resources and greater family pressures were associated with more family dysfunction. Thus family factors both directly and indirectly effected psychosocial functioning although amount of family contact had the greatest positive impact of all the family factors. This suggests that contact with families was crucial, in and of itself, to consumer well-being in the community even given that other family factors had a direct and indirect effect. Also, latent constructs used in the models demonstrated the criteria of identifiably for measurement models increasing confidence in the validity of the results.

Implications: The study identifies how family contextual factors directly and indirectly impact consumer functioning. Of note is that the results for consumer psychosocial functioning is a novel finding within the schizophrenia literature. This study advances knowledge by identifying two specific family contextual processes that impact two major areas of consumer functioning; by expanding the lens of analysis by concurrently testing family factors on consumer functioning in one study that in the past was done across numerous separate studies; and by identifying key areas for intervention that target both the consumer and family to ensure a holistic, evidenced based approach in social work practice with similar communities. These findings fill a critical need in the literature by identifying family contextual factors that impact consumer functioning, a top priority for social work research and practice.