# Effect of a positive thinking skills training program on psychological adjustment among psychiatric patients’ caregivers

## TL;DR

A positive thinking training program significantly improved psychological adjustment in caregivers of psychiatric patients, with lasting effects three months after the program.

## Contribution

This study demonstrates the effectiveness of a positive thinking skills training program in improving psychological adjustment among psychiatric caregivers.

## Key findings

- The training program showed highly significant improvements in psychological adjustment immediately after the program.
- The positive effects were maintained three months after the program ended.
- The program had a large effect size, indicating strong practical significance.

## Abstract

Psychiatric disorders are becoming a major public health problem. The prolonged caregiving responsibilities for psychiatric patients can deplete the family’s energy, resulting in exhaustion and increased negative emotions, such as feelings of despair, guilt, depression, and helplessness, and a significant decrease in their psychological adjustment which requires adequate support and training.

The present study aims to explore the effect of a positive thinking skills training program on psychological adjustment among psychiatric patients’ caregivers.

A quasi-experimental research design (Non-Randomized Controlled Trial) was utilized in this study of one group (pre-, post-test, and follow-up after 3 months) in the psychiatric outpatient clinic at Port Said Psychiatric Health Hospital and Addiction Treatment. A purposive sample of 66 psychiatric patients’ caregivers. Eight sessions of positive thinking skills training were carried out in the form of small groups for four months. Two tools used for data collection consisted of Tool I: The Positive Thinking Scale, Tool II: The Psychological Adjustment Scale, in addition to the Personal and Clinical Data Sheet of the studied psychiatric patients’ caregivers.

The current study revealed that there were highly statistically ‎significant differences between the mean score of total psychological adjustment between pre-program and immediate post with mean difference ± Std. Error (23.51 ± 1.26) compared to the mean difference ± Std. Error in the pre-program and follow-up phase was (22.22 ± 1.20) While the mean difference ± Std. Error between the immediate post and follow-up phase was (1.29 ± 0.45) (p < 0.001) as determined by Cohen’s d test, there was a large effect of the training program on the immediate post and follow-up after 3 months.

The positive thinking skill training program had a positive significant effect in improving the total psychological adjustment score among studied psychiatric patients’ caregivers. The study recommended the application of the positive thinking skill training program by the health profession at Port Said Psychiatric Health Hospital and Addiction Treatment to ensure continuity of care for psychiatric patients’ caregivers.

The study was approved by the Research Ethics Committee (REC), Faculty of Nursing/ Port Said University, Egypt (code number: NUR 13/3/2022–11). The study also retrospectively registered under the following number: PACTR202507513786427 on 1 July 2025.

The online version contains supplementary material available at 10.1186/s12888-025-07276-3.