AI-Supported CBT-Based Psychoeducation for Caregivers of Individuals With Schizophrenia

Schizophrenia is a severe mental disorder that affects an individual's thoughts, perceptions, emotions, behaviors, and cognitive processes and may cause substantial difficulties in social and occupational functioning. Although the nature and severity of symptoms vary among individuals, schizophrenia generally requires long-term treatment, follow-up, rehabilitation, and psychosocial support. Because of its chronic course, risk of relapse, and adverse effects on daily living skills, individuals with schizophrenia often require extensive care and support from family members. Family caregivers assume important responsibilities, including meeting daily living needs, monitoring medication use and symptoms, maintaining healthcare appointments, supporting treatment adherence, managing crises, and promoting independent living skills and social functioning Long-term caregiving responsibilities may negatively affect caregivers' physical and psychological health, social relationships, employment, and financial circumstances. Previous studies have shown that family caregivers of individuals with schizophrenia experience substantial caregiver burden, burnout, financial difficulties, health problems, social stigma, and concerns about the patient's future . These findings indicate that caregiver burden is a multidimensional problem involving physical, psychological, social, and economic factors. Caregivers may also experience intense emotions such as fear, sadness, anger, guilt, helplessness, and hopelessness . Suppressing these emotions or being unable to express them appropriately may further increase caregiver burden. Therefore, interventions for caregivers should not be limited to providing information about schizophrenia and caregiving. They should also help caregivers recognize their thoughts and emotions, express their feelings appropriately, and cope more effectively with caregiving-related challenges. Psychoeducation is a structured psychosocial intervention designed to improve patients' and family members' knowledge of illness, treatment, and caregiving while developing skills related to stress management, effective communication, problem-solving, recognition of relapse warning signs, and crisis management . Family members are regarded as active partners in the treatment and caregiving process rather than passive recipients of information . Evidence suggests that family-based psychoeducational interventions may reduce caregiver burden, improve caregivers' knowledge and psychological outcomes, and contribute to reducing the risk of relapse among individuals with schizophrenia . Incorporating a cognitive behavioral approach into psychoeducation may help caregivers identify dysfunctional automatic thoughts, understand the relationships among their thoughts, emotions, and behaviors, and develop more realistic and adaptive responses . A previous experimental study conducted with caregivers of individuals with schizophrenia demonstrated that a cognitive behavioral therapy-based stress management program reduced caregivers' stress symptoms and caregiving burden and improved their problem-focused and emotion-focused coping skills . Artificial intelligence may enhance this process by facilitating caregivers' interaction with psychoeducational content and supporting the application and reinforcement of acquired knowledge and skills. Generative artificial intelligence can create new text, explanations, examples, and feedback based on user-provided input and previously learned data patterns . In mental healthcare, generative artificial intelligence has the potential to strengthen text-based support programs and provide personalized and interactive support . It may also facilitate the interactive delivery of structured psychoeducational content and improve user engagement . Research on artificial intelligence-supported education and mental health interventions has increased in recent years. Studies involving artificial intelligence-based conversational agents have indicated that users can interact with these systems, complete the programs, and acquire the intended skills. However, inconsistent findings regarding psychosocial outcomes indicate that these interventions should be evaluated not only in terms of engagement and completion rates but also according to their effects on targeted clinical and psychosocial outcomes . Digital interventions developed for family caregivers of individuals experiencing psychosis have generally been perceived as acceptable, accessible, flexible, and useful, with psychoeducation identified as one of their central components. Nevertheless, some randomized controlled studies have found no significant superiority of digital psychoeducation, peer-support, or telehealth programs over comparison conditions in caregiver well-being or caregiver burden . These findings suggest that merely providing digital content may be insufficient and that active user engagement and professional support may influence intervention effectiveness. Existing research has generally examined psychoeducation, cognitive behavioral interventions, digital health applications, and artificial intelligence-supported education separately or in populations other than caregivers of individuals with schizophrenia. Furthermore, expressed emotion examined in some digital interventions for caregivers of individuals with psychosis differs conceptually from caregivers' ability to recognize and appropriately express their own emotions . Based on the reviewed literature, no study has simultaneously evaluated the effects of a professionally supervised, artificial intelligence-supported psychoeducation program based on a cognitive behavioral approach on caregiver burden and emotional expressivity among caregivers of individuals with schizophrenia. In this study, a six-week artificial intelligence-supported psychoeducation program based on a cognitive behavioral approach will be developed for caregivers of individuals with schizophrenia. The standardized core content will be developed based on current scientific evidence and evaluated according to the opinions of relevant experts. The program will consist of the following six modules.