The perspective and experiences of significant others on electroconvulsive therapy

TL;DR

This study explores how family and close friends of people receiving electroconvulsive therapy (ECT) experience the treatment process and the challenges they face.

Contribution

The study uniquely highlights the role of hope in ECT decision-making and emphasizes the need for structured support and transparent communication for significant others.

Findings

Significant others experience emotional distress before ECT and feel a sense of responsibility and hope when deciding to proceed.

Transparent communication from psychiatrists and structured support systems are valued by significant others during ECT.

Stigma and logistical challenges remain barriers for significant others during and after ECT treatment.

Abstract

Electroconvulsive therapy (ECT) is an essential but often controversial treatment in psychiatry. While existing research focuses on patient outcomes, the perspectives of significant others (SOs) remain underexplored. They play, nevertheless, a crucial role in decision-making, treatment adherence, and post-treatment evaluation. To better understand their perceptions, challenges, and support needs, this study aims to explore the lived experiences of SOs and ECT.

A qualitative phenomenological approach was employed using semi-structured interviews with nine SOs of patients who underwent ECT. Thematic analysis was conducted using Braun and Clarke’s framework, and data were analyzed using the NVivo software.

Before ECT, SOs experienced a significant emotional burden, describing their lives as unlivable due to the patients’ severe illness. The decision to start ECT was marked by feelings of responsibility and fear but also driven by hope. During ECT, SOs closely monitored treatment effects and side effects, balancing improvements against challenges such as memory loss and fatigue. The psychiatrist played a central role in shaping perceptions and instilling hope. During the maintenance phase, SOs faced logistical challenges and stigma but aimed to integrate ECT into daily life while supporting patient autonomy.

This study highlights the complex role of SOs in ECT. Unlike previous studies that have focused on caregiver burden, it emphasizes the role of hope in decision-making and treatment adherence. SOs value transparent communication from psychiatrists and seek structured support systems to navigate practical and emotional challenges. Stigma remains a significant barrier to open discussion and social integration.