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Psychoeducation refers to the education offered to people with a mental health condition. 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. Family members are also included. A goal is for the consumer to understand and be better able to deal with the presented illness. Also, the patient's own strengths, resources and coping skills are reinforced, in order to understand that relapse is a part of their recovery, and contribute to their own health and wellness on a long-term basis. The theory is, with better knowledge the consumer has of their illness, the better the consumer can live with their condition.
Introduction to psychoeducation
Since it is often difficult for the patient and their family members to accept the patient's diagnosis, psychoeducation also has the function of contributing to the destigmatization of psychological disturbances and to diminish barriers to treatment. Through an improved view of the causes and the effects of the illness, psychoeducation frequently broadens the patient's view of their illness and this increased understanding can positively affect the patient. The relapse risk is in this way lowered; patients and family members, who are more well-informed about the disease, feel less helpless. Important elements in psychoeducation are:
- 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 a medication or psychotherapeutic treatment, as cooperation is promoted between the mental health professional and patient (compliance, adherence).
- 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).
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. It wasn't until 30 years later that the first use of the word psychoeducation appeared in the medical literature in title of the book The psychoeducational clinic by Brian E. Tomlinson. New York, NY, US: MacMillan Co. This book was published in 1941. In French, the first instance of the term psychoéducation is in the thesis "La stabilité du comportement" published in 1962.
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. Her research concentrated on educating relatives concerning the symptoms and the process of the schizophrenia. Also, her research focused on the stabilization of social authority and on the improvement in handling of the family members among themselves. Finally, C.M. Anderson's research included more effective stress management techniques. Psychoeducation in behavior therapy has its origin in the patient's relearning of emotional and social skills. In the last few years increasingly systematic group programs have been developed, in order to make the knowledge more understandable to patients and their families.
Single and group psychoeducation
Psychoeducation can take place in one-on-one discussion or in groups and by any qualified health educator as well as health professionals such as nurses, social workers, occupational therapists, psychologists and physicians. In the groups several patients are informed about their illnesses at once. Also, exchanges of experience between the concerned patients and mutual support play a role in the healing process.
Possible risks and side effects
Actually, nothing speaks against the participation in a psychoeducative group apart from the political implications of forcing people to accept the legitimacy of the medical model. Furthermore, acutely sick patients are frequently overtaxed with schizophrenic psychosis, and they suffer from substantial thinking, concentration and attention disturbances, at the beginning of their illness. Care should be taken not to overwhelm the patient with too much information. Besides positive effects of a therapeutic measure like psychoeducation, in principle, also other possible risks should be considered. The detailed knowledge of the illness, in particular regarding chances of recovery, therapy possibilities and the disease process, can make the patient and/or family member stressed. Therefore, one should draw an exact picture of the risks regarding the psychological condition of the patient. It should be considered how much the patient already understands, and how much knowledge the patient can take up and process in their current condition. The ability to concentrate should be considered as well as the maximum level of emotional stress that the patient can take. In the context of a psychoeducational program a selection of aspects and/or therapy possibilities can be considered and discussed with the patient. Otherwise, the patient may form an incomplete picture of their illness, and they may form ideas about treatment alternatives from a vantage point of incomplete information. However, the professional should also make a complete representation of the possibilities of treatment, and attention should be paid to not make excessive demands of the patient, that is, giving too much information at once
- Bäuml, Josef, et al. Psychoeducation: A Basic Psychotherapeutic Intervention for Patients With Schizophrenia and Their Families. Schizophrenia Bulletin. 2006 32 (Supplement 1): S1-S9
- Hogarty, GE, Anderson, CM, Reiss, D, et al. Family psychoeducation, social skills training and maintenance chemotherapy in the aftercare treatment of schizophrenia: II. Two-year effects of a controlled study on relapse and adjustment. Arch Gen Psychiatry 1991; 48:340–347.