CLINICAL OUTCOMES OF CULTURALLY ADAPTED PARENTING INTERVENTION FOR MOTHERS WITH SCHIZOPHRENIA IN LOW RESOURCE SETTINGS PILOT RANDOMIZED CONTROL TRIAL

Abstract

Schizophrenia is a severe psychiatric emergency associated with significantly impact functional and adversative outcomes in both mothers and their children. Mothers with schizophrenia encounters caregiving burden and challenges, which fade mother infant bonding, reduced parenting sensitivity, and limited social support. It increased developmental and psychological problems risk in their offspring. Despite the growing evidence for psychosocial interventions in psychosis, culturally appropriate parenting interventions for mothers with schizophrenia remain unexplored in Low- and Middle-Income Countries (LMICs). This paper aim assess the feasibility of schizophrenic symptoms reduction among mother through Learning Through Play Plus (LTP Plus), parenting intervention integrated with a culturally adapted Cognitive Behavioral therapy for psychosis (CaCBTp) in Karachi, Pakistan. A randomized controlled trial was conducted with 50 diagnosed schizophrenic mothers who has last born child aged birth to 36 months. Participants were randomly allocated to either the intervention group (LTP Plus) or treatment as usual (TAU), with 25 participants in each group. The intervention combined the Learning Through Play parenting program with culturally adapted CBT for psychosis and was delivered through weekly sessions by trained clinical psychologists. Participants were assessed at baseline and at third month follow-up post randomization using the Positive and Negative Syndrome Scale (PANSS). Descriptive statistics and independent and paired sample t-tests were used to analyze data on SPSS v23. At baseline, no significant differences were observed between the groups among the PANSS three subscales. At follow-up, the intervention group demonstrated significantly greater reductions in PANSS Positive (p < .001), negative (p < .001), but not significant changes were observed in the general psychopathology subscale, than the control group. The findings suggest that LTP Plus is a promising, culturally adapted psychosocial intervention for mothers with schizophrenia, can further needs to assessed on the implementation studies. Integrating parenting support with cognitive behavioral therapy may enhance maternal mental health and caregiving capacity in resource limited settings.