Culturally-Adapted Family Intervention Study (CaFI)
Culturally-adapted family intervention for African and Caribbean people diagnosed with psychosis, and their families.
Are you a Black and Mixed heritage person diagnosed with schizophrenia or psychosis, or their relative?
We are currently recruiting participants living in specific parts of England for a study. The study will see if a new kind of talking therapy helps Black and Mixed heritage people diagnosed with schizophrenia or psychosis and their families.
Find out more about the study, if you are eligible to take part, and how to sign up.
Access key information if you have already signed up to the study, or want to find out more about it.
Taking part in the CaFI study
We are looking for eligible people to join our study to see whether Culturally-adapted Family Intervention (CaFI) is effective for Black and Mixed heritage people diagnosed with schizophrenia or psychosis and their families.
CaFI was designed together with service users, their families, community members, and health professionals for people from African-Caribbean backgrounds diagnosed with psychosis.
We are offering CaFI to 202 families of Caribbean and Sub-Saharan African origin across the north-west, Midlands, south-east and London as part of a randomised controlled trial (RCT).
We will compare their results with 202 families who do not receive CaFI to see if CaFI is at least as good as usual care.
Participants randomised to receive CaFI will receive talking therapy over ten sessions.
You can take part in the study if you meet our eligibility criteria. You may be referred to us by your clinical team, or you can get in touch with us to express an interest in joining the study.
Information about who can take part in our study and what’s involved.
Access downloadable resources, explore useful links or watch a video.
Read about the study’s background and our plans during the project.
Other ways to get involved
There are lots of other ways to get involved in the CaFI trial, whether you are a service user, family member or community member or other.
- Working as a therapist on the study.
- Supporting service users during Therapy as a Family Support Member.
- Becoming a member of our Research Advisory Group (RAG).
- Volunteering on the CaFI study to build your research knowledge and skills.
We meet with communities regularly by organising events and workshops to give everyone opportunities to learn about CaFI.
These events are opportunities for you to let us know what you think about the project and share any ideas you may have.
If you would like to get involved, please get in touch.
You can also see more information on patient and public involvement and engagement (PPIE) with the CaFI study.
CaFI:Digital will help reduce the impact of COVID-19 restrictions on the trial.
Originally, as with other FI models, CaFI was designed to be delivered in person. CaFI will now be delivered face-to-face/in person, or via CaFI:Digital – a bespoke online platform that we have developed to increase patient choice and flexibility.
If family units opt to receive CaFI:Digital, the therapy sessions will be delivered via Microsoft Teams. Therapists will direct family units to resources located on the purpose-built, secure CaFI:Digital website.
Meet the research team
Our research team makes up of research and healthcare experts from all over the country.
Professor Dawn Edge (Chief Investigator): Professor of Mental Health & Inclusivity, Division of Psychology & Mental Health, at The University of Manchester. Prof Edge will lead the project, overseeing all aspects including setting up, data collection and analysis, dissemination, ethics and governance. She supervises the Trial Manager and Research Assistants (RAs) and oversee coordination across all sites.
Josanne Holloway (Principal Investigator): Clinical Lead, Greater Manchester Mental Health NHS Foundation. Dr Holloway will facilitate access to services via clinical PI and community forensic services.
Professor Kathryn Abel: Professor of Psychiatry & Director of the Centre for Women’s Mental Health. Kathryn provides expertise in schizophrenia, trial design and senior oversight of the trial.
Dr Lesley-Anne Carter: Lecturer at The University of Manchester. Dr Carter provides expertise in trial design and statistics.
Professor Katherine Berry: Professor of Clinical Psychology and HCPC registered Consultant Clinical Psychologist. Katherine Berry is a professor and clinical psychologist who is based at The University of Manchester, UK. Her main area of expertise is attachment theory and therapeutic relationships in people experiencing psychosis. She currently works on the Manchester clinical psychology training programme and as a clinical psychologist in mental health rehabilitation.
Dr Richard Drake: Senior Lecturer/ Honorary Consultant Psychiatrist, at the University of Manchester. Dr Drake contributes expertise in trial design and evaluating psychosocial intervention in schizophrenia, including expertise in culturally-adaptation.
Professor Anthony Morrison: Professor of Clinical Psychology at the University of Manchester. In addition to expertise in trial design, Anthony facilitates service access and contribute expertise in trialling psychological interventions.
Mr Paul Wilson: Senior Research Fellow at Alliance Manchester Business School and the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Greater Manchester (NIHR CLAHRC GM).
Professor Linda Davies: Professor of Health Economics Research at The University of Manchester. Linda has experience in the economic evaluation of interventions for people with mental health problems and provides expertise in health economics.
Mr Kieran Blaikie: Kieran will work as a Junior Statistician to conduct statistical analyses under Dr Carter’s supervision and guidance.
Tom Price: Tom works as a Research Assistant. His role includes introducing the study to service users, their families and to professionals. He recruits participants into the trial and collects data through interviews and questionnaires.
Shenitta Anderson: Shenitta works as a research assistant alongside clinical teams, service users, local community groups, researchers to aid recruitment and date collection. Shenitta was awarded a first-class honours degree in Psychology and is passionate about understanding the barriers that service users face in access and treatment in mental health services.
Sonalia Kaur: Sonalia works as a Research Assistant and Co-Therapist handling quantitative data and delivering family intervention alongside clinical psychologists. She has experience in clinical settings delivering assessments and is passionate about giving back to the community. Sonalia has an undergraduate degree in Psychology and a master’s in Clinical and Health Psychology from The University of Manchester.
Kings College London
Dr Claire Henderson (Principal Investigator): Dr Henderson is a Honorary Consultant Psychiatrist, Senior Clinical Adviser, Joint Academic Lead for the Quality Improvement and Implementation Science Clinical Academic Group, King’s Health Partners. Her role in this project is to provide expertise in trial design. Her areas of expertise are in the evaluation of complex interventions in mental health and in evaluation of interventions to reduce mental health related stigma and discrimination.
Dr Shubulade Smith CBE: Consultant Psychiatrist at the Kings College London. She was appointed a CBE in 2019 for services to forensic psychiatric intensive care. Dr Smith’s role in this project is to provide expertise in transcultural and forensic psychiatry, and mental health policy.
Dr Louisa Codjoe: Psychologist at the Kings College London. Dr Codjoe’s role in this project is to provide expertise in transcultural psychology.
Bethany Thompson: Bethany works as a Research Assistant. She is responsible for participant recruitment, data collection and qualitative data analysis at the London site.
Isis Harvey: Isis works as a research assistant. Her main responsibilities are participant recruitment and assisting with data collection.
Barnet, Enfield and Haringey
Dr Ilyas Mirza (Principal Investigator): Dr Mirza is a highly experienced Consultant Adult Psychiatrist with more than 20 years of experience working in the NHS and private sector. He is a Fellow of the Royal College of Psychiatrists and holds a research doctorate from the University of London. He works in a collaborative way to achieve outcomes identified as a priority for his patients.
Lauren Otchelio: Lauren works as a Research Assistant. She is responsible for participant recruitment, data collection and qualitative data analysis.
Jessica Rapley: Jessica works as a Research Assistant. She is responsible for participant recruitment, data collection and qualitative data analysis.
Birmingham and Solihull
Dr Carl Harris (Principal Investigator): Dr Harris is a clinical and community psychologist with more than 30 years’ experience of working in mental health services and with communities in the city. Dr Harris has a special interest in community psychology, which sees the people, systems, and services around the person as crucial to their development and wellbeing.
Ayesha Alam: Ayesha works as a Research Assistant. She is responsible for participant recruitment, data collection and qualitative data analysis.
Nottingham (a reserve site)
Professor Gillian Doody: Dean of Medical Education at the University of Nottingham. Gillian will contribute expertise in psychosis and medical education. Her experience as member of the Aetiology and Epidemiology of Schizophrenia and Other Psychoses (AESOP) team will be invaluable. She will be site lead for Nottingham.
Professor Shanaya Rathod (Principal Investigator): Visiting Professor, University of Portsmouth. Shanaya’s role is to provide expertise in cultural adaptation and to be the site lead for Southern Health Care (Southampton).
Yvonne Billa: Yvonne works as a Research Assistant with Southern Health NHS Foundation Trust in Hampshire. She is responsible for participant recruitment, data collection and qualitative data analysis at the Southampton site.
Bristol (reserve site)
Dr Jonathan Evans: Consultant Senior Lecturer, Centre for Academic Mental Health, School of Population Health Sciences, Bristol Medical School, at the University of Bristol. As site lead in Bristol, Dr Evans will provide expertise in psychosis and liaison with clinical services.
Reverend Paul Grey: Independent Service User Consultant and ‘expert by experience’. Rev Grey will provide invaluable insight from the service user perspective.
Ms Sonia Lindsay: Carer Consultant and ‘expert by experience’. A member of the RAG in our CaFI feasibility study, Ms Lindsay will provide expertise from the carer perspective.
Mrs Michelle Ayavoro: Community Member and activist. A member of the RAG in our CaFI feasibility study, she will be a community-focused Independent Consultant on this project.
Dr Nicholas Jon Kennedy: Consultant Psychiatrist, Birmingham & Solihull Mental Health NHS Foundation Trust. Dr Kennedy’s role will be to provide expertise in transcultural psychiatry and Clinical PI for Birmingham.
Dr Judith Richardson: Programme Director – Quality and Leadership, Health and Social Care, NICE. Dr Richardson will contribute expertise in Health Service Policy and service implementation.
Information for researchers and healthcare professionals
We have a number of outputs related to CaFI and other work available.
If you have difficulties with accessing any of these articles/reports, please contact the CaFI team (email@example.com) for further information.
CaFI Feasibility Pilot Study Report
The CaFI pilot study report can be found on the National Institute of Health Research Journal Library. The report outlines the methods and findings from the first CaFI study, which tested CaFI with families of Caribbean origin in Manchester. For example, the report discusses how CaFI was developed with families, how it was tested and how families and healthcare professionals found CaFI. The report is available to all for free of charge.
Culturally-adapted Knowledge About Psychosis Questionnaire
This article presents findings from a study that culturally-adapted a well-known questionnaire, Knowledge About Psychosis, to make it more relevant to people of African-Caribbean heritage. This study produced a reliable questionnaire, that can be used in research and healthcare settings. The article can be viewed on the publisher’s website.
Case examples from CaFI therapists
This article reports on 3 completely anonymous examples of families who took part in the CaFI feasibility pilot study. Their therapists reflect on how they worked with these families, and the strengths and weaknesses of CaFI as a ‘talking therapy’ for these families. The article can be accessed on the publisher’s website.
CaFI Feasibility Pilot Study Protocol
This paper outlines the methods and procedures used in the ‘CaFI-1’ (pilot) study. The article can be viewed on the publisher’s website.
Culturally-appropriate e-Learning Resource Study Protocol
This paper outlines the methods and procedures used in CaFI’s sister study, Culturally-appropriate Schizophrenia Psychological Education Resource, or CaSPER for short. CaSPER was developed and pilot tested together with families of Caribbean heritage in Manchester. It will be used as a resource in the current CaFI study. The CaSPER protocol paper can be found on the publisher’s website.
Psychology Across Cultures
This article explores how mental health interventions could be made more relevant, culturally-appropriate, and effective globally. The article can be viewed on the publisher’s website.
These links go to academic research articles relevant to CaFI’s work.
- Christine Barrowclough, Nicholas Tarrier (1992) Families of schizophrenic patients: Cognitive behavioural intervention (Google Books)
- Dinesh Bhugra, Kamaldeep Bhui (2018) African-Caribbeans and schizophrenia: contributing factors (Advances in Psychiatric Treatment)
- Kamaldeep Bhui et al (2018) Ethnic variations in pathways to and use of specialist mental health services in the UK Systematic review (British Journal of Psychiatry)
- Care Quality Commission (2011) Count me in 2010: Results of the 2010 national census of inpatients and patients on supervised community treatment in mental health and learning disability services in England and Wales (PDF)
- Department of Health (2005) Delivering Race Equality in Mental Health Care: an action plan for reform inside and outside services and the Government’s response to the Independent inquiry into the death of David Bennett (PDF)
- Department of Health (2014) Closing the Gap: Priorities for Essential Change in Mental Health (PDF)
- Department of Health (2014) No Health Without Mental Health: A Cross-Government Mental Health Outcomes Strategy for People of All Ages (GOV.UK)
- Paul Fearon et al (2006) Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP Study (Psychological Medicine)
- Centre for Mental Health (2002) Breaking the circles of fear: A review of the relationship between mental health services and African and Caribbean communities (PDF)
- Craig Morgan et al (2004) Negative pathways to psychiatric care and ethnicity: the bridge between social science and psychiatry (Social Science & Medicine)
- S Pilling et al (2002) Psychological treatments in schizophrenia: I. Meta-analysis of family intervention and cognitive behaviour therapy (Psychological Medicine)
- Rebecca Pinto et al (2008) Schizophrenia in black Caribbean’s living in the UK: an exploration of underlying causes of the high incidence rate (British Journal of General Practice)
- Fiona Pharoah et al (2010) Family intervention for schizophrenia (Cochrane Database Systematic Review)
- Mandy Sharpley et al (2018) Understanding the excess of psychosis among the African-Caribbean population in England: Review of current hypotheses (British Journal of Psychiatry)
- Centre for Mental Health (2006) Policy Paper 6: The costs of race inequality (PDF)
- The Schizophrenia Commission (2012) The abandoned illness (PDF)
- Dixon Chibanda et al (2015) The Friendship Bench programme: a cluster randomised control trial of a brief psychology intervention for common mental health disorders delivered by lay health workers in Zimbabwe (International Journal of Mental Health Systems)
There are a number of ways to get involved in this project, with a variety of roles on offer.
Whether you are a service user, a family member/carer, a community member, a health professional, a student or an academic, there is a part for you to play in this study.
If you would like to register your interest in getting involved with CaFI, or have any questions about the study, please contact the research team.
Alternatively, you can complete our online contact form.