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Psychoeducation in Mental Health

Introduction:

The term psychoeducation describes a range of individual, family, and group interventions that are focused on educating participants about a significant challenge in living, helping participants develop social and resource supports in managing the challenges of mental illness. Psychoeducation is an effective, adaptable intervention for helping individuals and their families develop knowledge of and coping skills for a variety of problems and challenges in living.

Objectives:

Upon completion of the module, students will be able to:

· understand the definition of psychoeducation and and its applications

· identify the various forms of psychoeducation

· identify the goals of psychoeducation

· understand the benefits of psychoeducation in mental health and how it benefits individuals and their families

Topic 2. Psychoeducation in Mental Health

Patient Education

Patient empowerment is critical for the successful management of any chronic disease and the cornerstone of empowerment is knowledge. Education must be tailored to the patient’s unique learning style and be geared to the patient’s ability to engage in the process. Information may be broken down to into parts and shared over time, across multiple sessions. There are some clear points that should be part of any teaching plan, and they are identified as the following:

Patient Education Points

· Diagnosis

· Establishment of a mental health illness/disorder

· Review of any common myths or incorrect beliefs about the illness/disorder

· Explanation of the common symptoms, attention to the patient’s unique symptoms

· Identification of “early warning signs” and a response plan to address these sigs

· Strategies to deal with symptoms

· Medication education

· Cautions to consider from the medications

· Impact of substance use on symptoms, prognosis, and medication effects

· Importance of support systems and education (example- expectations)

· Resources/supports

What is Psychoeducation?

Psychoeducation is a psychosocial treatment that has been well documented as an adjunct to pharmacological therapy. The term psychoeducation comprises systemic, didactic-psychotherapeutic interventions, which are adequate for informing patients and their relatives about the illness and its treatment, facilitating both an understanding and personally responsible handling of the illness and supporting those afflicted in coping with the disorder. The roots of psychoeducation are to be found in behavioral therapy, although current conceptions also include elements of client-centered therapy in various degrees. Within the framework of psychotherapy, psychoeducation refers to the components of treatment where active communication of information, exchange of information among those afflicted, and treatment of general aspects of the illness are prominent. Psychoeducation includes cognitive, behavioral, and supportive therapeutic elements. Education is a gradual process, and intended outcomes of psychoeducation fall on a continuum and build on one another.

The core psycho-educational principle is education has a role in emotional and behavioral change. With an improved understanding of the causes and effects of the problem, psycho-education broadens the person’s perception and interpretation of the problem, and this refined view positively influences the individual’s emotions and behavior. Consequently, improved awareness of causes and effects leads to improved self-efficacy (the person believing that he is able to manage the situation), and improved self-efficacy leads to better self-control. In other words, the person feels less helpless about the situation and more in control of himself or herself. Educating people about their own mental issues can be an effective way for them to get the facts and learn effective coping strategies so that they take the steps necessary in helping themselves. Psycho-education is not a treatment; in clinical settings, psycho-education is the first step of the overall treatment plan.

Psychoeducational approaches may use books, pamphlets, audiovisual materials, talks, workshops, etc.

Types of Psychoeducation

Psycho-education involves anything that teaches people about mental health issues. The types of psychoeducation are listed below:

· Individual Psychoeducation

Consumer psychoeducation is a direct service designed to help individuals with mental and substance use disorders manage their own recovery. The service supports development of personal strategies that lead to better understanding of mental and substance use disorders. Individuals then use the acquired information to create personal goals. A combination of motivational, educational, and cognitive-behavioral techniques helps consumers create their own definition of recovery, gain control over their lives, and move forward on their paths to recovery. Educational materials and interventions help consumers learn relapse prevention and recovery strategies, build social support, use medications effectively, cope with stress, and manage their symptoms.

· Group Psychoeducation

Psychoeducational groups offer an opportunity for group members to increase members knowledge and understanding of their illness and treatment, coping and management strategies, and skills needed to avoid relapse.

· Psychoeducation for Parents and Family

Family psychoeducation is a direct service that provides the relatives of adults and children who have (or are at risk of having) mental and substance use disorders with information about prevention, treatment, and recovery strategies for that disorder. The service aims to increase the family’s awareness about related risk factors, symptoms, treatment options, and other resources. The family is encouraged to guide the consumer in making good decisions about his or her own care, such as taking prescribed medications or maintaining engagement in needed services and supports.

· Psychoeducation for Friends and Caretakers

The purpose of patient education/teaching (or psychoeducation) is to increase the friend’s and caretaker’s knowledge and understanding of their illness and treatment, coping and management strategies, and skills needed to avoid relapse.

· Social Psychoeducation

Social psychoeducation is a subtype of psychoeducation that deals specifically with the social aspects of a condition. These include perceived social support, peer pressure, social pressure and social stigma.

The Goals of Psychoeducation

Psychoeducation occurs in a range of contexts and may be conducted by a variety of professionals, each with a differing emphasis. The formulation of realistic and coherent therapeutic goals is of particular importance for all involved, patients, relatives, and professional auxiliaries. In general, however, four broad goals direct most psychoeducation efforts:

1. Information transfer (as when clients/patients and their families and caretakers learn about symptoms, causes, and treatment concepts)

2. Emotional discharge (a goal served as the patient/client or family ventilates frustrations during the sessions or exchanges with similar others their experiences concerning the problem)

3. Support of a medication or other treatment, as cooperation grows between professional and client/patient and adherence and compliance issues diminish

4. Assistance toward self-help (that is, training in aspects such as prompt recognition of crisis situations and knowledge of what steps should be taken)

Example Goals of Psychoeducation for Patient with Schizophrenia:

· Increase knowledge about the illness and treatment options

· Empower consumers and family members to make informed decisions

· Foster collaboration among consumers, family members, and professionals

· Alleviate suffering among family members

· Increased insight into illness

· Understand how medications work

· Understand the impact of medication adherence has on recovery

· Improve treatment adherence

· Improve physical health and wellness

· Manage stress and problems

· Reduce relapse and rehospitalization

· Recognize relapse and develop crisis and relapse prevention plans

· Foster recovery and community reintegration

· Understand the effects of substance use on mental health

Psychoeducation as a Multimodal Treatment Concept

Psychoeducation is not a means to rival continuative cognitive behavioral therapy or other forms of psychotherapy. On the contrary, psychoeducation is to be seen as a precursor and catalyst for subsequent complementary psychotherapeutic and psychosocial treatment strategies, such that patients and their relatives are in a position to discover the form of treatment which is optimal for their respective phase of illness.

Evidence for the Effectiveness of Consumer Psychoeducation

Consumer psychoeducation demonstrates consistent evidence for the following outcomes:

• Improved functioning

• Improved insight

• Reduced incidence of nonadherence

• Improved quality of life

• Higher satisfaction with services

Evidence for the Effectiveness of Family Psychoeducation

Family psychoeducation demonstrates consistent evidence for the following outcomes:

• Decreased relapse and rehospitalization rates

• Reduced burden on families

• Greater knowledge of the disorder and the mental health care system

• Improved ability to solve problems

• Better self-care

•Improved quality of life

Patient Tools

Office of Disease Prevention and Health Promotion (2021)

MyHealthfinder: https://health.gov/myhealthfinder/topics/everyday-healthy-living/mental-health-and-relationships

Read:

Friedman, M.R., Bowen, V.R., & Jones, E.G. (2003)

Chapter 7- pages 190-195

Perese (2012)- Chapter 7- pages 202- 203

Chapter 8-pages 221-222

Psychoeducation Articles:

Motlova, L.B., Balon, R., Beresin, E.V. et al. (2017). Psychoeducation as an opportunity for patients, psychiatrists, and psychiatric educators: why do we ignore it? Acad Psychiatry. 41, 447–451. Available at:

https://link.springer.com/content/pdf/10.1007/s40596-017-0728-y.pdf

Tsai, J., Huang, M. Rosenheck, R. & Wilkinson, S. (2020). A randomized control trial of video psychoeducation for electroconvulsive therapy in the United States. Psychiatric Services. 71(6), 562-569. Available at:

https://doi.org/10.1176/appi.ps.201900448

Videos on Psychoeducation: Psychoeducation and Recovery

References

Colom, F. & Vieta, E. (2006). Psychoeducation Manual for Bipolar Disorder. Cambridge University Press

Leffley, H. (2009). Family Psychoeducation for Serious Mental Illness. Oxford University Press

Lukens, P. & McFarlans, W. (2004). Psychoeducation as evidence-based practice: considerations for practice, research, and policy. Brief Treatment and Crisis Intervention, 4(3). btci-04-03-02 205..225 (easacommunity.org)

Sin, J., Jordan, C. D., Barley, E. A., Henderson, C., & Norman, I. (2015). Psychoeducation for siblings of people with severe mental illness. The Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD010540.pub2