Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Pilot Study of a Video-Based Educational Program to Reduce Family Violence for Parents of Adult Children with Schizophrenia

  • 37 Accesses


This pilot study evaluated a video-based educational program for improving communication skills and reducing family violence between parents and their adult children with schizophrenia. We used a one group pretest-posttest design. The program included a main 90-min video and six stories, each 20–30 min long. We made assessments at baseline and program completion (three months after baseline). Sixty-six parent participants completed the intervention. The average frequency of acts of family violence significantly decreased from 11.4 (SD = 26.2) at pretest to 5.1 (SD = 13.2) at posttest (p = 0.016). Our findings showed significant improvements regarding expressed emotion, psychological distress, family empowerment, and hope, demonstrating preliminary positive results for this video-based educational program. The program was shown to be feasible for support/educational groups of family members of adults with mental disorders to deliver and may also be useful for practitioner-led educational groups for families in public health centers or medical settings to offer.

This is a preview of subscription content, log in to check access.


  1. 1.

    Japan Ministry of Health Labour and Welfare, Heisei 28 nen seikatsuno shidurasanado nikansuru chosa [2016 National survey for children and adults with disabilities living in the community], 2018.

  2. 2.

    Japan Ministry of Health Labour and Welfare, Kanja chosa 2014 [Patients survey 2014], 2014.

  3. 3.

    Kageyama M, et al. Rate of family violence among patients with schizophrenia in Japan. Asia Pac J Public Health. 2015;27(6):652–60.

  4. 4.

    Kageyama M, et al. Factors related to physical violence experienced by parents of persons with schizophrenia in Japan. Psychiatry Res. 2016;243:439–45.

  5. 5.

    Butzlaff L, Hooley J. Expressed emotion and psychiatric relapse. Arch Gen Psychiatry. 1998;55(6):547–52.

  6. 6.

    Kageyama M, Solomon P. Characteristics of parents with high expressed emotion and related factors: a study of parents of adults with schizophrenia. J Nerv Ment Dis. Dec. 2018;206(12):955–61.

  7. 7.

    Mueser KT, Glynn SM. Behavioral family therapy for psychiatric disorders. Oakland: New Harbinger Publications, Inc.; 1999.

  8. 8.

    Pharoah F, Mari JJ, Rathbone J, Wong W. Family intervention for schizophrenia. Cochrane Database Syst Rev. 2010;12:CD000088.

  9. 9.

    Zhao S, Sampson S, Xia J, Jayaram MB. Psychoeducation (brief) for people with serious mental illness. Cochrane Database Syst Rev. 2015;4:CD010823.

  10. 10.

    Sun GC, Hsu MC. Effects of nurse-led child- and parent-focused violence intervention on mentally ill adult patients and victimized parents: a randomized controlled trial. Int J Nurs Stud. 2016;60(1):79–90.

  11. 11.

    Minna-net, “Shogaisya jiritushien chosakenkyu purojekuto hokokusho [a report of research project for independent living of people with disabilities 2009],” Tokyo, 2010.

  12. 12.

    Minna-net, Heisei 29 nendo nihon zaidan josei jigyo hokokusyo [Project report supported by the Nippon Foundation 2017], Tokyo, 2018.

  13. 13.

    Minna-net, “Heisei 24 nendo kazokukai zenkokuchosa [2012 National survey for family groups],” 2013.

  14. 14.

    Kageyama M, Yokoyama K, Horiai Y. Perceptions of stages of family violence and their perceived solutions in persons with schizophrenia. The Open Nursing Journal. 2019;13(1):156–67.

  15. 15.

    Dixon LB, Lucksted A, Medoff DR, Burland J, Stewart B, Lehman AF, et al. Outcomes of a randomized study of a peer-taught family-to-family education program for mental illness. Psychiatr Serv. 2011;62(6):591–7.

  16. 16.

    Home Office, “Information for Local Areas on the change to the Definition of Domestic Violence and Abuse Produced in partnership with 2 Information for Local Areas on the change to the Definition of Domestic Violence and Abuse,” no. March, 2013.

  17. 17.

    Fujita H, Shimodera S, Izumoto Y, Tanaka S, Kii M, Mino Y, et al. Family attitude scale: measurement of criticism in the relatives of patients with schizophrenia in Japan. Psychiatry Res. 2002;110(3):273–80.

  18. 18.

    Furukawa TA, Kawakami N, Saitoh M, Ono Y, Nakane Y, Nakamura Y, et al. The performance of the Japanese version of the K6 and K10 in the world mental health survey Japan. Int J Methods Psychiatr Res. 2008;17(3):152–8.

  19. 19.

    Kageyama M, Nakamura Y, Kobayashi S, Yokoyama K. Validity and reliability of the family empowerment scale for caregivers of adults with mental health issues. J Psychiatr Ment Health Nurs. 2016;23(8):521–31.

  20. 20.

    Koren PE, DeChillo N, Friesen BJ. Measuring empowerment in families whose children have emotional disabilities: a brief questionnaire. Rehabil Psychol. 1992;37(4):305–21.

  21. 21.

    Yuko HIRANO, Mayumi SAKITA, Yoshihiko YAMAZAKI, Kaoru KAWAI, Miho SATO. The Herth Hope index (HHI) and related factors in the Japanese general urban population. Japanese Journal of Health and Human Ecology. 2007;73(1):31–43.

  22. 22.

    Yamaki C, Yamazaki Y. “Herth Hope index (HHI) nihongoban sakuseino torikumi [development of Herth Hope index (HHI) Japanese version],” in KAKENHI report 14201021. Tokyo; 2003. p. 147–9.

  23. 23.

    Kageyama M, Solomon P, Yokoyama K. Psychological distress and violence towards parents of patients with schizophrenia. Arch Psychiatr Nurs. 2016;30(5):614–9.

  24. 24.

    Ninomiya S, et al. Seishinsyogaisyano kazokupia gakusyu puroguramuga kazokuno enpawamentoni ataeru koka [the effect of ‘Omotenashi-family experiences learning program’ on the empowerment of fmaily members]. Seishin Igaku. 2016;58(3):199–207.

  25. 25.

    Monahan J, et al. Rethinking risk assessment: the MacArthur study of mental disorder and violence [Boryokuno risuku asesumento: Seishinsyogaito boryokuni kansuru MacArthur kenkyu kara]. Oxford: Oxford University Press, Inc.; 2001.

  26. 26.

    Copeland DA, Heilemann MV. Choosing ‘the best of the hells’: mothers face housing dilemmas for their adult children with mental illness and a history of violence. Qual Health Res. 2011;21(4):520–33.

  27. 27.

    Hsu MC, Tu CH. Adult patients with schizophrenia using violence towards their parents: a phenomenological study of views and experiences of violence in parent-child dyads. J Adv Nurs. 2014;70(2):336–49.

  28. 28.

    Kageyama M, Yokoyama K, Nakamura Y, Kobayashi S, Fujii C. The coping process of Japanese parents who experience violence from adult children with schizophrenia. Arch Psychiatr Nurs. 2018.

  29. 29.

    Kageyama M, Solomon P, Yokoyama K, Nakamura Y, Kobayashi S, Fujii C. Violence towards family caregivers by their relative with schizophrenia in Japan. Psychiatry Q. 2018;89(2):329–40.

  30. 30.

    Kirkpatrick H. A narrative framework for understanding experiences of people with severe mental illnesses. Arch Psychiatr Nurs. 2008;22(2):61–8.

  31. 31.

    Kajitani K, et al. Chokinyuin togoshichosyo nokazoku no seishintekikenkodo [mental health status of family members of paitients undergoing long-term hospitalization for schizophrenia]. Seishin Igaku. 2008;50(2):169–72.

Download references


We wish to thank all research participants for their time and care in participating to our research project. All authors designed the research project. MK and KY conducted intervention program. All authors approved the final draft.


Masako Kageyama has received financial support for the research from the Mitsubishi Foundation, 2017–2019 (No.29311) for the research. For the remaining author none were declared.

Author information

Correspondence to Masako Kageyama.

Ethics declarations

Conflict of Interest

The authors declare that they haves no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kageyama, M., Yokoyama, K., Horiai, Y. et al. Pilot Study of a Video-Based Educational Program to Reduce Family Violence for Parents of Adult Children with Schizophrenia. Psychiatr Q (2020). https://doi.org/10.1007/s11126-020-09717-6

Download citation


  • Family caregivers
  • Family intervention
  • Family violence
  • Schizophrenia
  • Japan