Open research questions in Family Caregiving in Mental Illness

What the literature leaves open

• Although mindfulness-based stress reduction (MBSR) and narrative nursing have shown individual efficacy, the combined effect of MBSR and narrative nursing on treatment compliance and negative emotions in patients with schizophrenia is still insufficient.

  Effects of mindfulness-based stress reduction combined with narrative nursing on treatment adherence and negative emotions with schizophrenia · 2026 · DOI

• The research process was characterised by significant limitations. Difficulty in obtaining data is one of the reasons why studies on kinship foster care are not as popular as research on institutional care. The main limitation of the research process was obtaining consent to participate in the study due to the grandparents’ concerns over the dissolution of foster care by the court. Out of the 189 families meeting the eligi- Archives of Psychiatry and Psychotherapy, 2025; 4: 21–30 bility criteria, only 78 decided to participate in the study. The research tools looked into health, social background and a range of psychosocial competencies determining good care of the child in kinship foster care. Despite the interviewer’s extensive explanations, this factor had a significant effect on raising unjustified concerns in some foster families that the survey might make them “look bad” and as a result they might lose the foster care of their grandchildren. Another limitation was the relatively long data collection process resulting from the large size of the research tools used and the age of the respondents. Household and care-related responsibilities, fatigue and disease burden sometimes made it necessary to meet with one foster family on several different occasions. REFERENCES 1. Colton M., Wiliams M. Światowe kierunki w opiece zastępczej, [w:] Z.W. Stelmaszuk (red.), Współczesne kierunki w opiece nad dzieckiem. Wybór tekstów, Warszawa 1999, s. 230. 2. Racław M. Zinstrumentalizowane rodzicielstwo. Rodziny zastępcze – między usługą a odruchem serca. Perspektywa socjologiczna, Toruń 2017, s.132. 3. Oldham J. M., Morris L. B. Twój psychologiczny autoportret, Czarna Owca, Warszawa 1997, s. 28 4. Hall C.S., Lindzey G., Campbell J. B. Teorie osobowości, Wydawnictwo Naukowe PWN, Warszawa 2010, s. 31 5. Antonovsky A. The sense of coherence as a determinant of health. W: J. Matarazzo, S. Weiss, J. Herd, N. Miller (red.). Behavioral Health: A handbook of health enhancement and disease prevention. New York: Wiley 1984, s. 1-15. 6. Reykowski J, 1977, Osobowość jako centralny system regulacji i integracji czynności człowieka W: T Tomaszewski (red), Psychologia Warszawa, Wydawnictwo Naukowe PWN 1977, s. 762–825 7. Fromm E. Mieć czy być? Poznań: Dom Wydawniczy Rebis 1997. 8. Kasser T, Ryan MR. Further examining the American dream: Differential correlates of intrinsic and extrinsic goals. Person. Soc. Psychol. Bull. 1996; 22: 280–287. 9. Richins ML, Dawson S. A consumer values orientation for materialism and its measurement: scale development and validation. J. Consum. Res. 1992; 19 (3): 303–316. 10. Belk RW. Materialism: Trait aspects of living in the material world. J. Consum. Res. 1985; 12 (3): 265–280. 11. Ryan L, Dziurawiec S. Materialism and its relationship to life satisfaction. Soc. Indicators Res. 2001; 55 (2): 185–197. 30 Marta Giezek et al. 12.

  Personality traits and the sense of coherence in relation to personal values indicated by kinship foster carers aged 60+ providing care for their biological grandchildren · 2026 · DOI

• Moreover, the applicability of sibling+ dynamics to other family constellations remains unclear, including the circumstances of role shifts, their occurrence beyond parental illness or absence, and their long-term consequences. Compared to other family relationships, sibling ties remain comparatively under-researched, with the literature disproportionately 74 focused on white, middle-class U.

  Siblings+? Dynamic role transformations in sibling relationships among children of parents with mental illness · 2026 · DOI

• Family psychoeducation has shown benefits in several psychiatric conditions, yet its effects on relatives of adults with MDD remain insufficiently documented.

  Who Benefits from Family Psychoeducation for Relatives of Adults with Major Depressive Disorder? Findings from a Randomized Controlled Trial · 2026 · DOI

• 根據是項統計調查的樣本設計，在統 1.9 計調查期間，只能搜集已抽選的住戶內有關成 員的資料。就住院情況這課題而言，在訪問期 間實在難以接觸當時正入住醫院的受訪者。因 此，「住院病人」在是項統計調查被定義為在統 計前 12 個月內曾入住醫院但在訪問時已出院的 人士。儘管如此，這系列統計調查的經驗顯示， 與行政記錄得出的類似統計數字相比，從統計 調查所得的住院病人的數目及入院次數存在相 當的低估情況。須強調的是，就住院情況而言， 這系列的統計調查的目的是搜集有關統計期內 曾入住醫院的人士的社會經濟特徵、開支模 式、享有醫療福利的情況及受醫療保險保障的 情況等資料，而非估計該期間住院病人的總數 及其總入院次數。因此，數據使用者對相關數 字須小心闡析。 during fieldwork According to the sample design of the 1.9 survey, information could only be collected from members that could be identified in the sampled households period. the Regarding the topic on hospitalisation, there were inherent difficulties to contact respondents who were staying in hospitals during the fieldwork period. In light of this, “in-patients” in this survey refer to persons who had been admitted into hospitals during the 12 months before enumeration but had already been discharged at the time of enumeration. Notwithstanding this, experience of this series of surveys conducted so far revealed that there existed rather significant under-reporting in the number of in-patients and hospital admissions in the surveys when compared with similar statistics derived from administrative records. It should be emphasised that with respect to hospitalisation, the objective of this series of surveys was to collect information on the socio-economic characteristics, the expenditure profile and the entitlement to medical benefits and coverage of medical insurance of those persons ever admitted into hospitals during the reference period before enumeration rather than to estimate the total number of in-patients and hospital admissions during the same reference period. Data users are reminded to interpret the related figures with care. 1.10 就器官捐贈的課題而言，有相當數目的 受訪者可能由於有關課題敏感而拒絕提供相關 資料。本報告載列的有關統計數字（如適用） 已撇除那些拒絕就器官捐贈這課題提供意見的 人士。 1.10 For the topic on organ donation, a considerable number of respondents refused to provide related information probably due to the sensitive nature of the topic. Relevant statistics (where applicable) presented in this report are compiled by excluding persons who refused to provide views on the topic of organ donation.

  An e-Coaching Intervention for Family Carers to Enhance Well-Being and Resilience Through Self-Help Strategies: Protocol for a Randomized Controlled Trial. · 2026 · DOI

• The study focused on service providers who were identified as offering outpatient and community-based mental health services to MHCUs and informal caregivers. As a result, the study excluded health professionals from the two hospitals that offer 72-hour mental health services and this limited the extent of the evidence gathered. Conducting interviews in the participants’ workplace was ideal; however, the interviews were constantly interrupted as some needed to be paused to allow the participants to attend to their work, which interrupted the flow and depth of information shared by the participants. The focus groups with the CHWs was larger than the commonly recommended size. Although measures were put in place to support equal participation, a group of this size may still have limited the depth of individual contributions or influenced how freely some participants engaged. Lastly, the CHW focus group was conducted in Xitsonga and subsequently translated into English by a language specialist, which may have introduced subtle shifts in meaning affecting the interpretation of the data.

  Service providers’ perspectives on strategies to reduce caregiver burden among informal carers of people living with mental health conditions in rural South Africa: A qualitative descriptive study · 2026 · DOI

• Data availability statement While this longitudinal study provides valuable insights into the experiences of FCs of persons living with AD during the COVID-19 pandemic, some limitations should be considered when interpreting the findings. Most psychosocial variables were assessed using self-report measures, which may introduce common-method bias and inflate asso- ciations due to shared measurement variance or social desirability. Future research should incorporate additional objective or multi-informant data where feasible. The sample consisted exclusively of Portuguese family caregivers from Northern Portugal, which may limit generalizability, as caregiving norms, access to support, and coping processes, such as for- giveness, are culturally embedded. Moreover, although data were The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

  Quality of life and burden during the COVID-19 pandemic: a longitudinal study with family caregivers of persons living with Alzheimer’s disease · 2026 · DOI

• • Replication of the study with a larger sample. • Similar studies in different settings and populations. • Comparative studies using different teaching methods. Con(cid:193)ict(cid:3)of(cid:3)Interest The(cid:3) author(cid:3) declares(cid:3) no(cid:3) con(cid:193)ict(cid:3) of(cid:3) interest(cid:3) in(cid:3) the preparation of this article.

  Effectiveness of Psychoeducation on Knowledge of Extrapyramidal Symptoms among Caregivers · 2026 · DOI

• A strength of this review is the inclusion of 76 studies exclusively from LMICs, providing the necessary depth and contextual focus to inform global policy. The use of thematic synthesis allowed us to move beyond descriptive summaries to generate high-level, analytical themes of commitment, burden, and resilience. Furthermore, the inclusion of a multidisciplinary research team ensured that our interpretations remained deeply grounded in the realities of caregiving rather than relying solely on clinical or systemic lenses. However, several limitations must be acknowledged. First, grouping vastly diverse nations under the broad economic designation of “LMICs” inherently masks significant intra- and inter-regional differences in culture, religion, family structures, and health system infrastructures. While our synthesis identified common, cross-cutting themes, local adaptation and cultural tailoring remain essential before applying these findings to specific intervention designs. Second, as noted in our quality appraisal, many of the primary studies lacked explicit researcher reflexivity. The failure of primary authors to interrogate their own theoretical or cultural positioning may have influenced the depth and framing of the original data we extracted. Third, the dominant qualitative narrative in the primary literature is heavily deficit-focused. Because research questions frequently center on “burden” and “challenges,” the positive dimensions of caregiving are likely underrepresented in this synthesis. Finally, the literature search for this review concluded in February 2025. While this represents a comprehensive synthesis of the qualitative literature up to that point, studies published in the subsequent months are not reflected in this analysis; however, given the large volume of included studies (n=76), thematic saturation was robustly achieved.

  Experiences, needs, and priorities of family caregivers of people with severe mental health conditions in low and middle-income countries: a systematic review of qualitative studies · 2026 · DOI

• Our study focused on investigating posting and response patterns through individual posts rather than examining long-term com- munity participation. Future work could investigate how remote supporters engage with these communities over time, including fac- tors influencing sustained engagement. Understanding long-term participation is particularly critical because our findings suggest re- mote supporters may not receive targeted support in these general communities, predominantly comprised of co-located caregivers. Further, it is important to engage directly with community mem- bers to understand their motivations, rather than relying only on the analysis of their posts. Additionally, our focus on Reddit, a public forum platform, repre- sents only one type of online space where remote supporters seek help. Future research could explore how patterns differ between public forums like Reddit and more private, closed groups such as Facebook Groups or Discord servers. The different affordances of these platforms, including community size, privacy levels and moderation approaches, may play a role in how remote supporters share their experiences and exchange support.

  Understanding Remote Mental Health Supporters' Help-Seeking in Online Communities · 2026 · DOI

• Several limitations should be considered when interpreting the crossthe present findings. First, sectional design precludes causal inference regarding the directionality of associations between cognitive–perceptual tendencies, caregiving stress, depressive symptoms, and quality of life. Second, although the sample size was appropriate for exploratory analyses, it limited statistical power and precluded the use of more complex analytic approaches, such as multivariable modeling or mediation analyses. Third, the hybrid control group comprised heterogeneous caregiving and somatic illness profiles, which may have introduced unmeasured variability despite the application of an a priori frequency-based matching strategy. Given this hybrid composition, observed betweengroup differences cannot be attributed specifically to schizophrenia caregiving per se. Instead, these contrasts should be interpreted as contextual comparisons between schizophrenia caregiving and a heterogeneous non- PsychiatryMEDICINE AND PHARMACY REPORTS psychiatric illness and caregiving context, reflecting differing constellations of chronic stress exposure rather than diagnosis-specific effects. Rather, these differences reflect comparisons between schizophrenia caregivers and a heterogeneous non-psychiatric comparison group exposed to varying forms of chronic illness, caregiving demands, and role-related stress. Consequently, the present findings should be interpreted cautiously and not as evidence of schizophrenia-specific caregiving effects. Importantly, no covariate-adjusted or sensitivity analyses were conducted; as a result, observed group differences and associations cannot be interpreted as independent of demographic or caregiving-related factors such as age, sex, caregiving duration, or co-residence. Fourth, the study relied primarily on self-report measures, which may be influenced by subjective reporting biases, coping-related response shift, and contextual factors associated with the COVID-19 period during data collection. Fifth, while the MoCA provides a brief screening of global cognitive functioning, it may lack sensitivity to detect subtle cognitive changes or stress-related attentional fluctuations in high-stress but otherwise nonclinical populations. Finally, as the Romanian version of the ESI has not yet undergone full psychometric validation, interpretations of its subscales should be considered preliminary pending future studies establishing its reliability and factorial structure. Although internal consistency was estimated in the present sample, full psychometric validation of the Romanian ESI—including factor structure, test–retest reliability, and construct validity—remains necessary. In addition, the absence of covariate-adjusted analyses limits the ability to disentangle the independent contribution of sociodemographic factors to observed group differences. Furthermore, subgroup comparisons based on median splits of continuous variables are inherently arbitrary and may reduce statistical power; in the present study, such stratified analyses were included solely to facilitate visualization of patterns observed in continuous associations and should be interpreted as illustrative rather than as evidence of discrete caregiver subgroups. long-term psychiatric care.

  Stress-related cognitive–perceptual tendencies and their associations with psychological quality of life in informal Romanian schizophrenia caregivers: an exploratory ESI-based analysis · 2026 · DOI

• 539 This study aimed to provide an in-depth analysis of the experiences of a 540 specific subgroup of caregivers; therefore, the purposive sample strategy inherently GENDER IN SPOUSAL CAREGIVING 23 541 limits the generalizability of the findings to the under-study population (Palinkas et 542 al., 2015). Greece's sociocultural context, unique historical factors, and specific 543 gender norms shaped participants' experiences. Notably, all participants identified as 544 cisgender and heterosexual, further restricting generalizability to other gender 545 identities and sexual orientations. The sample primarily represented a working-class 546 demographic from one urban clinic, limiting applicability to diverse socioeconomic 547 backgrounds, rural settings, varied clinical contexts, and caregiving dynamics. 548 Nevertheless, this study provides a framework for examination in different 549 populations. Future research should expand on these findings to understand gender 550 stereotypes, caregiving experiences, and moral decision-making across a broader 551 spectrum of caregivers, encompassing diverse cultural, ethnic, and socioeconomic 552 backgrounds, gender and sexual orientations. Qualitative research findings, reliant on 553 subjective analysis and narrative descriptions, may be subject to multiple 554 interpretations influenced by researcher biases, participant responses, and translation 555 issues. Informants may provide unreliable data due to a desire to please or hidden 556 intentions, emotions, principles, or viewpoints (Tongco, 2007). Our research team 557 maintained rigor through reflexivity and transparent data collection, methods, and 558 analysis to mitigate these limitations.

  The experience of gender in spousal caregiving: A phenomenological psychological study (Greece). · 2024 · DOI

• To address this gap in research, we developed qualitative genogram analysis (QGA), a three‐step protocol for analyzing transcribed interviews using family systems theory, representing family systems relational concepts visually in genograms, and identifying common patterns of family dynamics that emerged from these visualizations across families.

  Qualitative genogram analysis: A methodology for theorizing family dynamics · 2023 · DOI

• The purpose of this narrative literature review is to discuss existing research regarding counseling and care partner training in PPA and to outline additional treatment considerations and future research needs in this understudied area.

  Counseling and Care Partner Training in Primary Progressive Aphasia · 2021 · DOI

• The effects of social support among persons utilizing medication assisted treatment (MAT) living in abstinence-based recovery homes is not clearly understood, and there is a need to identify social process components that engender social support for this population.

  Homophily Effects Among Oxford House Residents Utilizing Medication Assisted Treatment · 2020 · DOI

• Despite widespread recognition of the usefulness of a biopsychosocial approach in social work, there are limited studies exploring how social workers can use this approach to support the health and wellbeing of carers of young people with first episode psychosis (FEP).

  Health of Carers of Young People with Early Psychosis: A Biopsychosocial Approach · 2019 · DOI

• Although a robust body of literature exists about the scope of family caregiving, little is known specifically about the experiences and perspectives of family caregivers who support participant directed (PD) participants, particularly across the caregiving trajectory.

  “I’m just trying to cope for both of us”: Challenges and supports of family caregivers in participant-directed programs · 2018 · DOI

• CONCLUSIONS: Initial psychometrics suggest the CRS offers a reliable and valid assessment of multiple dimensions of the caregiving experience and warrants further research.

  Preliminary Evidence for the Validity and Reliability of the Caregiver Reaction Scale · 2016 · DOI

• Focusing on the understudied, increasing population of male Alzheimer's disease (AD) caregivers, the purpose of this study was to identify their likelihood of utilizing 3 coping strategies (task focused, emotion focused, and avoidance focused) and to examine the effects of each coping strategy on caregiving burden.

  Burden Among Male Alzheimer’s Caregivers · 2014 · DOI

• However, no studies have determined whether the burden of care is greater for those families with more than one ill member (multiplex) than for families with a single-affected individual (simplex), and whether psycho-educational programs should be adapted to meet the specific needs of multiplex families.

  Caregiver's Burden, Coping, and Psycho-Education in Indian Households with Single- and Multiple-Affected Members with Schizophrenia · 2014 · DOI

• Conclusions: While using a carefully considered creative reminiscence activity intervention for clients with dementia can cause a decrease in caregivers' perception of their own burden and an increase in their perceptions of the loved ones' quality of life, future research is needed to determine the subtle nuances in well-being of individuals with memory loss and their caregivers.

  The Effects of Creative Reminiscing on Individuals with Dementia and Their Caregivers: A Pilot Study · 2014 · DOI

• Current research highlights the individual patient's or family member's perspectives on chronic illness, but family systems nursing (FSN) studies are warranted.

  Living as a family in the midst of chronic illness · 2013 · DOI

• Since the previous review, several FPE programs for parents of children or youth with mood disorders have also been developed, with limited research showing more positive than null results.

  Recent Developments in Family Psychoeducation as an Evidence‐Based Practice · 2011 · DOI

• UNLABELLED: Family intervention in schizophrenia is known to reduce high expressed emotion (EE) burden in relatives, reduce patients' relapse and improve patient functioning; but these issues have not been studied in Iran.

  The Outcome of Family Interventions for the Mothers of Schizophrenia Patients in Iran · 2009 · DOI

• RESULTS: While the literature has examined and discussed the stressors associated with parenting a child with an illness, including the impact of illness on finances, family roles, and caregiver burden, few studies have examined single parents of children and adolescents with chronic illnesses and related stressors stemming from being a lone caregiver.

  Single Parents of Children with Chronic Illness: An Understudied Phenomenon · 2007 · DOI

Most-cited papers in Family Caregiving in Mental Illness

• Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020 · MMWR Morbidity and Mortality Weekly Report · 2020 · 2,252 citations
• Caregiver burden for informal caregivers of patients with dementia: A systematic review · International Nursing Review · 2015 · 692 citations
• Family Caregiving for Older Adults · Annual Review of Psychology · 2020 · 608 citations
• Initial Challenges of Caregiving During COVID-19: Caregiver Burden, Mental Health, and the Parent–Child Relationship · Child Psychiatry & Human Development · 2020 · 571 citations
• Coping as a Communal Process · Journal of Social and Personal Relationships · 1998 · 537 citations
• Systematic Review of Psychological Approaches to the Management of Neuropsychiatric Symptoms of Dementia · American Journal of Psychiatry · 2005 · 467 citations
• Collaborative care for depression in primary care · The British Journal of Psychiatry · 2006 · 317 citations
• Appraisal, coping, and social support as mediators of well-being in Black and White family caregivers of patients with Alzheimer's disease. · Journal of Consulting and Clinical Psychology · 1996 · 315 citations
• Brief Therapy: Focused Problem Resolution · Family Process · 1974 · 299 citations
• Hearing Their Voice: A Systematic Review of Dementia Family Caregivers’ Needs · The Gerontologist · 2016 · 260 citations

Most recent work

• Understanding Remote Mental Health Supporters' Help-Seeking in Online Communities · 2026
• Effects of Psychoeducation on Burden, Depression, and Anxiety in Informal Caregivers of Patients With Dementia: A Systematic Review of Randomized Controlled Trials · Western Journal of Nursing Research · 2026
• Family functioning following a brief, virtual emotion‐focused family therapy intervention for children's mental health · JCPP Advances · 2026
• Stress-related cognitive–perceptual tendencies and their associations with psychological quality of life in informal Romanian schizophrenia caregivers: an exploratory ESI-based analysis · Medicine and Pharmacy Reports · 2026
• Experiences, needs, and priorities of family caregivers of people with severe mental health conditions in low and middle-income countries: a systematic review of qualitative studies · Cambridge Prisms: Global Mental Health · 2026
• Perceptions of Psychiatric Mental Health Nurses Regarding the Needs of Family Members Caring for People Living With Mental Illness: A Qualitative Study in Lobatse, Botswana · Journal of Psychiatric and Mental Health Nursing · 2026
• How does the process of adjustment and coping manifest in informal caregivers after placing a loved one in long-term care, and what interventions can support their mental health? · Zenodo (CERN European Organization for Nuclear Research) · 2026
• Major mental disorders among family caregivers: a nation-wide register-based study · Scandinavian Journal of Primary Health Care · 2026
• How do family or spousal caregivers adjust and cope with the placement of a loved one into residential care facilities? · Open MIND · 2026
• Depression among married individuals: new evidence in Türkiye · Frontiers in Psychiatry · 2026

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