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Objective: This study aimed to determine the effects of logotherapy-based psychoeducation applied to family members of individuals diagnosed with schizophrenia on meaning in life, hope, and depression, and to examine experiences related to the psychoeducation process.
Materials and Methods: Using a parallel convergent mixed methods design, the quantitative dimension of the study was designed as a randomized controlled trial, and the qualitative dimension was designed using a phenomenological method. The research was conducted between November 2023 and August 2025 with family members of individuals diagnosed with schizophrenia who were being followed up in the mental health and diseases outpatient clinics of a city hospital in Istanbul. A total of 40 family members were included in the study, 19 in the experimental group and 21 in the control group. Quantitative data were collected using the Demographic Information Form, Meaning in Life Scale, Herth Hope Scale, and Beck Depression Inventory, while qualitative data were collected using a Semi-Structured Interview Form. Pre-test measurements were performed on family members in both the experimental and control groups after randomization. Subsequently, individuals in the experimental group received an eight-session Logotherapy-Based Psychoeducation program individually online. Family members who completed the psychoeducation program underwent post-test measurements the following day, and qualitative data were collected through individual in-depth interviews. Family members in the control group received no intervention for eight weeks, after which post-test measurements were taken. Quantitative data were analyzed using the Wilcoxon signed-rank test, Mann Whitney U test, and t-test; qualitative data were analyzed using Colaizzi's phenomenological data analysis method.
The resources that will strengthen the family members who play a key role in the treatment of schizophrenia should also be activated. One of these resources that enable people to cope with the difficult events they experience is finding meaning in life. The meaning of life is a basic source of motivation for an individual to live despite everything. In this respect, meaning is a source that helps them maintain their mental balance. Another concept that is considered important in terms of protecting and strengthening the mental health of family members is hope. Hope is defined as setting a goal and taking action to achieve it, and looking for different ways when faced with difficulties. Hope gives caregivers the belief that they can cope with stressful experiences. Therefore, it is important to develop hope in family members of individuals with mental disorders. Today, different therapy methods are applied to protect and improve mental health. Recent studies have shown that logotherapy is an effective method in strengthening positive psychological factors and coping with negative emotions. Logotherapy adopts "Therapy through Meaning" as its basic method. The effectiveness of logotherapy on meaning and hope has been demonstrated in many different samples. No study has been found that focuses on meaning and hope in family members of schizophrenia patients. This research, conducted using a parallel convergent mixed methods design, aims to determine the effects of logotherapy-based psychoeducation applied to family members of individuals diagnosed with schizophrenia on meaning in life, hope, and depression, and to examine experiences related to the psychoeducation process.
Research hypotheses for the quantitative dimension of the study:
Research question for the qualitative dimension of the study:
What are the experiences of family members who participated in the Logotherapy-Based Psychoeducation Program during the psychoeducation process?
Research question for the mixed research method:
How are the quantitative findings of the study related to the qualitative findings obtained from the interviews, and how do they contribute to solving the research problem when considered together? The study consisted of two groups, an experimental group and a control group, selected through randomization. Each participant was scheduled for a pre-test date, and the Demographic Information Form, Meaning of Life Scale (MLS), Herth Hope Scale (HHS), and Beck Depression Inventory were administered online via Zoom. The following day, the psychoeducation program for family members in the experimental group began with individual online sessions. Eight individual online sessions were conducted with each family member. One day after the completion of the psychoeducation process for each participant, the MLS, HHS, and Beck Depression Inventory were administered again online. On the same day, individual in-depth interviews were conducted using a semi-structured interview form, and qualitative data were collected.
In the control group, each participant underwent individual online post-tests eight weeks after the pre-tests. Following the post-tests, participants in the control group were informed that they could participate in the psychoeducation program if they wished. Four participants from the control group received the psychoeducation program.
The logotherapy-based psychoeducational program was conducted individually via ZOOM in a total of eight sessions, with one meeting per week. Each session lasted 40-60 minutes. Key points to consider during the sessions were highlighted.
One day after the intervention was completed, participants were interviewed online again for final tests, and qualitative data were collected through one-hour in-depth interviews using a Semi-Structured Interview Form.
Since this research is a randomized controlled trial, the experimental process was conducted in accordance with the Consolidated Standards of Reporting Trials (CONSORT-SPI 2018) report.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Relatives of patients who underwent the application | Experimental | Individuals in this group will receive 8 sessions of psychoeducation focused on logotherapy. |
|
| relatives of patients in routine practice | No Intervention | Individuals in this arm will not be subjected to any additional intervention other than routine practices. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| logotherapy focused psychoeducation | Other | 8 sessions of online individual logotherapy focused psychoeducation program |
|
| Measure | Description | Time Frame |
|---|---|---|
| Finding meaning in life scale score | The meaning of life scale was developed by Steger and colleagues to determine the meaning people find in life and the meaning they seek. The adaptation study for Turkey was conducted by Akın and Taş. The meaning of life scale consists of 10 items on a 7-point Likert type. The scale consists of two subscales, namely current meaning and sought meaning. The total score on the scale varies between 7 and 70. High scores obtained from the scale indicate that the individual has a high level of meaning in life. The internal consistency reliability coefficients of the scale are .82 for the current meaning subscale and .87 for the sought meaning subscale. | first week and eighth week |
| Herth Hope Scale Scores | The Herth Hope Scale (HUÖ) was developed by Dr. Herth in 1991 to determine the hope levels of individuals and was adapted to Turkish by Aslan and colleagues. The scale is a four-point Likert type and consists of 30 items. The scale consists of the sub-dimensions "Future", "Positive readiness and expectation" and "Relationships between oneself and those around oneself". The total hope score varies between 0-90, and the total score for each sub-scale varies between 0-30. High scores obtained from the scale indicate a high level of hope. In the reliability study of the Turkish form of the scale, the Cronbach alpha coefficient was determined as 0.84. | first week and eighth week |
| Beck Depression Inventory Scores | Developed by Beck et al. (1961), the Turkish validity and reliability study was conducted by Hisli (1989) (Beck et al., 1961; Sahin, 1989). The scale, designed to measure physical, emotional, cognitive, and motivational components, is a four-point Likert-type scale. It consists of 21 questions and is rated from 0 to 3. The lowest possible score is 0, and the highest is 63. As the total score increases, the level of depression increases. In terms of severity, 0-9 indicates minimal, 10-16 mild, 17-29 moderate, and 30-63 severe depressive symptoms. Hisli found the Cronbach's alpha value of the scale to be 0.80. In this study, the Cronbach's alpha value was calculated as 0.86 for the pre-test and 0.86 for the post-test. | first week and eighth week |
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| Measure | Description | Time Frame |
|---|---|---|
| Personal İnformation Form | This form, created by the researcher by scanning the relevant literature, consists of 14 questions aimed at determining the sociodemographic and disease-related characteristics of the individual diagnosed with schizophrenia and his/her family member. | first week |
Participation Criteria
Exclusion Criteria
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Uskudar University | Ümraniye | Istanbul | 34768 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 5247330 | Result | Frankl VE. Logotherapy. Isr Ann Psychiatr Relat Discip. 1967;5(2):142-55. No abstract available. | |
| 39138762 | Result | Eskigulek Y, Kav S. Effect of logotherapy counseling program on chronic sorrow, dignity, and meaning in life of palliative care patients: a randomized controlled trial. Support Care Cancer. 2024 Aug 13;32(9):587. doi: 10.1007/s00520-024-08792-w. |
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The data analysis will be shared. Documents (surveys, examples from transcripts) will be shared if necessary. However, due to the confidentiality of personal information, participants' personal information cannot be shared.
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| ID | Term |
|---|---|
| D012559 | Schizophrenia |
| D003863 | Depression |
| ID | Term |
|---|---|
| D019967 | Schizophrenia Spectrum and Other Psychotic Disorders |
| D001523 | Mental Disorders |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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This research was conducted using a Parallel Convergent Mixed Methods Design to simultaneously evaluate the effectiveness of a logotherapy-based psychoeducation program through both statistical generalizations and an in-depth understanding of participants' psychoeducation experiences. The quantitative dimension of the study was designed as a randomized controlled trial (RCT) to examine the cause-and-effect relationship between the psychoeducation program and participant outcomes with a high level of evidential power. In the qualitative dimension, a phenomenological method was used to reveal the essence and shared meaning of participants' experiences during the psychoeducation program. The sample consisted of 40 family members of individuals diagnosed with schizophrenia, 19 in the experimental group and 21 in the control group.
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| Results of semi-structured qualitative form | The semi-structured interview form to be used for the qualitative interview will be created by the researcher in line with expert opinion while preparing the psychoeducation program. | tenth week |
| 37642347 | Result | Aydin R, Kabukcuoglu K. The effect of logotherapy-based, nurse-guided meaning attribution conversations on women diagnosed with gynecologic cancer: A Turkish pilot study. Women Health. 2023 Sep 14;63(8):599-614. doi: 10.1080/03630242.2023.2249123. Epub 2023 Aug 29. |
| 31469671 | Result | Sun FK, Hung CM, Yao Y, Fu CF, Tsai PJ, Chiang CY. The Effects of Logotherapy on Distress, Depression, and Demoralization in Breast Cancer and Gynecological Cancer Patients: A Preliminary Study. Cancer Nurs. 2021 Jan/Feb;44(1):53-61. doi: 10.1097/NCC.0000000000000740. |
| 29136682 | Result | Applebaum AJ, Buda KL, Schofield E, Farberov M, Teitelbaum ND, Evans K, Cowens-Alvarado R, Cannady RS. Exploring the cancer caregiver's journey through web-based Meaning-Centered Psychotherapy. Psychooncology. 2018 Mar;27(3):847-856. doi: 10.1002/pon.4583. Epub 2017 Dec 19. |
| 38461440 | Result | Yang X, Zhang P, Jing S, Cheng Y, Cavaletto A. Logotherapy-Based Interventions for Chinese Family Caregivers of Older Adults with Dementia Through Online Groups: A Mixed-Methods Study. J Gerontol Soc Work. 2024 Oct;67(7):865-880. doi: 10.1080/01634372.2024.2326689. Epub 2024 Mar 10. |