L/O/G/O

Presented by:Deepti Bhatta

Bsc. Nursing

4th year

PSYCHOEDUCATIONPSYCHOEDUCATION

CONTENTS:CONTENTS:

IntroductionHistorical backgroundDefinitionElements of psychoeducationGoals of psychoeducationBenefitsPrinciples

Contd…Contd…OutcomesTypes of psychoeducationApproaches for psychoducationContraindicationsResearch conducted

INTRODUCTIONINTRODUCTION

• Psychoeducation is an important component of any psychotherapy program.

• Psychoeducation, as the name suggests, is education about a certain situation or condition that causes psychological stress

CONTD…CONTD…• This is not necessarily psychotherapy as it

does not exclusively deal with psychological or mental illness’ but rather any condition you or a relative or a friend is experiencing.

• For example breast cancer is not a mental illness however a person with breast cancer may feel anxious, disheartened and scared about their condition and therefore it is said that the cancer is bringing about psychological stressors.

CONTD….CONTD….

• Frequently psychoeducational training involves individuals with schizophrenia, clinical depression,anxiety disorders, psychotic illnesses, eating disorders, and personality disorders, as well as patient training courses in the context of the treatment of physical illnesses.

HISTORICAL BACKGROUNDHISTORICAL BACKGROUND

• The concept of psychoeducation was first noted in the medical literature, in an article by John E. Donley "Psychotherapy and re-education" in The Journal of Abnormal Psychology, published in 1911

• The popularization and development of the term psychoeducation into its current form is widely attributed to the American researcher C.M. Anderson in 1980 in the context of the treatment of schizophrenia

DEFINITIONDEFINITION• Psycho education has been defined as “the

education of a person with a psychiatric disorder in subject areas that serve the goals of treatment and rehabilitation.” According to the American Psychiatric Association (APA)

• Psychoeducation includes cognitive, behavioral, and supportive therapeutic elements

CONTD…CONTD…

• Psychoeducation is usually implemented by a psychologist or anybody who is an expert in the specific condition the individual is experiencing and who has experience in psychotherapies such as nurses, social workers, occupational therapists, psychologists and physicians

Elements of Psycho-education:Elements of Psycho-education:• briefing the patient about their illness• problem solving training• communication training • self-assertiveness training

Goals of Psycho-educationGoals of Psycho-education• Ensuring patients' and their relatives'

attainment of “basic competence• Facilitating an informed and self-

responsible handling of the illness• Deepening the patients' role as an “expert”• “Co-therapists”—strengthening the role of

relatives• Optimal combination of professional

therapeutic methods and empowerment

Contd…Contd…• Improving insight into illness and

improvement of compliance• Promoting relapse prevention• Engaging in crisis management and

suicide prevention• Supporting healthy components• Economizing informational and

educational activities

BENEFITS BENEFITS • Every person will feel more relaxed and in

control of their condition if they have a greater level of understanding

• People who are educated about their condition are more likely to actively participate in their self-management and relapse prevention

• Brings about positive social and self-esteem changes which all add to the individual's self-efficacy

Contd…Contd…

• Can reduce social stigma, promote awareness, prevent emergencies and reduce relapse.

• Enable fewer hospital days• Increase medication adherence,

increased satisfaction with mental health services, and improved quality of life.

Effective PsychoeducationEffective Psychoeducation• Education is interactive• Use multiple teaching aids • Connote consumer as the “expert”• Elicit relatives’ experience and

understanding • Avoid conflict and confrontation• Education is a long-term process • Evaluate understanding• Review materials as often as possible

OUTCOMES OF PSYCHOEDUCATIONOUTCOMES OF PSYCHOEDUCATION• Information transfer (symptomatology of

the disturbance, causes, treatment concepts, etc.)

• Emotional discharge (understanding to promote, exchange of experiences with others concerning, contacts, etc.)

• Support of  medication or psychotherapeutic treatment, as cooperation is promoted between the mental health professional and patient (compliance, adherence).

Contd…Contd…

• Assistance to self-help (e.g. training, as crisis situations are promptly recognized and what steps should be taken to be able to help the patient)

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TYPES OF PSYCHOEDUCATIONTYPES OF PSYCHOEDUCATION

GROUP PSYCHOEUCATIONGROUP PSYCHOEUCATION

• Group psychoeducation can be very effective for a number of reasons

• People feel that they have the support of the group as well as the feeling they are “not alone” which decreases the amount of stress in the situation

• majority of common questions will be dealt with predominantly through discussion

Contd…Contd…

• In a group situation experiences are shared with each others. This way everyone gains a perspective of how other people deal with their situations which adds to the overall learning experience.

• Group psychoeducation can also be implemented in schools as a preventative measure

• Some of the issues discussed in classroom or small group sessions are:

Teenage pregnancy Social competency

• Eating disorders, body image and healthy eating

• Anger management and bullying

INDIVIDUAL PSYCHOEDUCATIONINDIVIDUAL PSYCHOEDUCATION• Individual psychoeducation can be more

specific and focused and can cover information and content that is more relevant for an individual situation.

• If group situations tend to make patient or family feel anxious and threatened then individual psychotherapy with the safety and confidentiality of a one on one interaction with a therapist or doctor may be more suitable.

Family PsychoeducationFamily Psychoeducation

• Education about a condition is relevant not only to the individual with the problem, but also the people who share their life. Therefore psychoeducation programs for the whole family are commonly used; this can reduce stress at home and encourage better relationships between the family members.

• Psychoeducation can be implemented for a number of families at the same time.

Contd…Contd…

• Benefits:1. Family information & education2. Enhance family coping skills3. Improve communication & problem

solving skills 4. Prevention of relapse5. Concurrent use of psychopharmacology

Psychoeducation for friends and care takersPsychoeducation for friends and care takers• For many people with mental illness,

especially adults, there is no family around to support them. Therefore psychoeducation programs for friends and caretakers have also been developed

Social psychoeducationSocial psychoeducation

• The influence of social stigma as well as social support and the importance of recognising the social support you have, this is called social psychoeducation.

• When people feel they have the support of the community they are more likely to manage the distress associated with their condition more effectively.

Contd…Contd…

• For adolescents and children, peer pressure issues may also be dealt with. For example it is very important that a diabetic child understands why they cannot have as much chocolate and lollies as their friends and also how and when to say no if their friends offer them food.

Approaches for psychoeducation (individual with disorder)Approaches for psychoeducation (individual with disorder)

• The structure of psychoeducation is determined by whether the program involves the individual with the disorder or only involves the family or peers

• The common topics that will be focused on are as follows:

Contd…Contd…• The medical aspects of the condition by

identifying and defining the diagnosis, the prognosis, the biology and psychology. How the condition may affect the future in terms of physical limits, how this will affect mind set and how to think positively.

• The stigma attached to the diagnosis, what can be done to combat and manage the stigma. The stigma associated with many physiological and psychological conditions can impact significantly on self-esteem and self-worth

Contd…Contd…

• Healthy lifestyle behaviours that will help to manage the condition.

• Stress management- why do need to manage our stress levels and how does high stress lead to the worsening of symptoms?

• Understanding self-esteem, self-image, self-efficacy

Contd…Contd…

• Treatment- For many disorders adherence to medication is a very important factor in managing the condition. The information will answer questions about the medication that includes: What it does? How does it work? What are the benefits? What are the side effects or adverse effects? When and how often it must be taken? Why it is important to it at certain intervals? What happens when the medication is not taken?

Contd…Contd…

• Another important aspect of treatment are the types of psychotherapies that are available and suitable to help the patient deal with the psychological effects of the condition and what is the cost, the effectiveness and the cost effectiveness of these psychotherapies?

• Financial assistance that is available to aid the patient.

Example:Example:• Many people feel despair and guilty when

they are responsible for their condition for example substance abuse or emphysema after years of cigarette smoking, however having a guilty, self-defeated attitude will not help combat the problem. Psychoeducation conveys the concept that what is in the past stays there, now is time to learn about your condition and what ways to best manage it for your future.

Without the patient presentWithout the patient present• When the individual with the condition (the

patient) is not present, that is when only the family, peers or caregivers are attending the program; the main focus of the psychoeducation is on how to manage while looking after the individual, understanding their situation and hardships, preventing any relapse and how to provide them with support.

• The common topics that will be focused on are as follows:

Contd….Contd….• Understanding the nature of the illness-

this includes information on the disorder as well as the psychological aspects involved. What is it like for the patient in terms of psychology and physiology? What are the realistic expectations that of the patient?

• The main symptoms of the disorder as well as the identification of the disorder are discussed.

Contd…Contd…• Indentifying trigger factors• Treatment• What to do in emergencies?• The financial, legal and social support that

is available for families, caretakers and schools to aid in caring and catering for the patient will also be discussed.

Contra-indication for psycho-educationContra-indication for psycho-education• massive formal thought disorders• manic elevated mood• hearing imperative voices• acute suicidality with generally reduced

stress resilience

Research done:Research done:

• A randomized trial on the efficacy of group psychoeducation in the prophylaxis of recurrences in bipolar patients whose disease is in remission.

• Source• Bipolar Disorders Program…IDIBAPS

Barcelona, Spain

• Abstract• Studies on individual psychotherapy

indicate that some interventions may reduce the number of recurrences in bipolar patients. However, there has been a lack of structured, well-designed, blinded, controlled studies demonstrating the efficacy of group psychoeducation to prevent recurrences in patients with bipolar I and II disorder.

• METHODS:• One hundred twenty bipolar I and II

outpatients in remission (Young Mania Rating Scale score <6, Hamilton Depression Rating Scale-17 score <8) for at least 6 months prior to inclusion in the study, who were receiving standard pharmacologic treatment, were included in a controlled trial.

Contd…Contd…

• Subjects were matched for age and sex and randomized to receive, in addition to standard psychiatric care, 21 sessions of group psychoeducation or 21 sessions of nonstructured group meetings. Subjects were assessed monthly during the 21-week treatment period and throughout the 2-year follow-up.

• RESULTS:• Group psychoeducation significantly

reduced the number of relapsed patients and the number of recurrences per patient, and increased the time to depressive, manic, hypomanic, and mixed recurrences. The number and length of hospitalizations per patient were also lower in patients who received psychoeducation.

• CONCLUSION:• Group psychoeducation is an efficacious

intervention to prevent recurrence in pharmacologically treated patients with bipolar I and II disorder.

References:References:• Stuart GW, Laraia MT. Principles &

practice of psychiatric nursing. 8th ed. Mosby Elsevier publication; 2008. p., 684-7

• Brand EF, Lakey B, Berman S. A preventative, psychoeducational approach to increase perceived social support. American journal of community psychology. 1995; 23(1): 117-135.

• URL:http://www.webmd.com/balance/psycheducation-6301 Retrieved on 23rd september 2013