Family support is a recommended practice in guidelines for Early Psychosis Intervention (EPI) programs worldwide and is included in the Ontario Early Psychosis Intervention Program Standards1. However, implementation is often a challenge due to time and resource constraints. Additionally, a lack of fit between delivered support and family needs and preferences can affect family uptake. The Pyramid of Family Care2 is a hierarchical framework of family support options based on the premise that many families require minimal support within the scope of most programs to provide, while a smaller portion requires more intensive support and the expertise of specialist providers. The Pyramid outlines five levels of family support of increasing intensity and specialization: 1 – Connection and assessment services, 2 – General education, 3 – Psycho-education, 4 – Consultation, and 5 – Family therapy.
Recent surveys of Ontario Early Psychosis Intervention (EPI) programs found variation in family support implementation in relation to the Standards. Additionally, programs varied in their approaches to delivery (e.g., through a dedicated family worker or a distributed role among staff alongside client care).
The present project responded to an Applied Health Research Question posed by the Early Psychosis Intervention Ontario Network (EPION) to learn more about family work delivery in relation to the Pyramid levels of care. It builds on a previous ARHQ project for EPION – a systematic literature review of the barriers and facilitators to implementing support for families of individuals experiencing early psychosis. The aim of both projects is to inform EPI program efforts to meet the Ontario EPI Program Standards.