Psychoeducation Principles and Reflections
Psychoeducation is a broad term within psychiatric rehabilitation practice. As the Bond and Anderson article (2015) assert, the practice of psychoeducation can include just the individual with mental illness, just the family and/or caregivers, or a combination of the three. Additionally, psychoeducation can be done with groups or with individuals.
There are many models, but in general, the content ranges from providing information about medication, to information about mental illness, and managing life and symptoms (Bond & Anderson, 2015). The article cited above conducted a meta-analysis of many different psychoeducation programs, and concluded that in general, groups of people who went through a program together tended to have better outcomes (e.g., fewer symptoms, fewer relapses) than if the individual practitioner conducted psychoeducation with an individual patient (Bond & Anderson, 2015).
The second article available on Blackboard detailed a qualitative study done in Wales, UK. Poole, Smith, and Simpson (2015) interviewed people with bipolar disorder who had been a part of a psychoeducation program. Their reflections have important implications for the design of psychoeducation programs, and include:
- Mood (i.e., symptoms) affected their level of involvement -- some felt apathy, some didn't want to socialize, other who were feeling symptoms of mania found it difficult to concentrate, and felt irritable.
- Timing of sessions affected level of involvement -- afternoon sessions were appropriate for people with day jobs, but other members of the groups didn't want to go out for the group on cold dark evenings in the winter.
- Community settings were preferred to hospital settings for the group meetings, and the participants felt that the setting should be "neutral, sociable, and central." Hospitals were not seen as neutral settings, and in fact, participants said that hospitals triggered negative memories.
- Sessions were skipped for any number of reasons : the topic wasn't interesting, the person didn't feel like socializing, the person lacked energy to leave the house -- others had crises or lacked transportation. Others dropped out of the program all together, because group facilitators allowed some members to rant, members felt like the facilitators were condescending, and some felt too much pressure to talk.
- Specific strategies for symptom management, and practice exercises were helpful.
- Extensive information on medication was also important to participants.
Given the information from these two articles, how might YOU design a psychoeducation group? Who would you include and why? (people with MI, families, caregivers, or a combination)? Would your group be homogenous -- meaning only for people with bipolar or families of people with bipolar? or would you conduct psychoeducation about MI in general? How long would each meeting be, how often would the group(s) meet, and would this be a time-limited program, or would it be ongoing? What content would you include and why? If you had to choose one thing that must be part of psychoeducation, what might that be?
Answer these questions. Then ask a question of at least 2 of your classmates posts. Respond to the questions as appropriate.
If I was to design a psychoeducation group it would include individuals with mental illness and their caregivers/family members and any other major supports in their lives. I think the group should be more than just for individuals and families of people with bipolar. The information should be more general but also should have scheduled times or meetings when the information can be more specific to one person or a group of people. It should be ongoing, meetings should be frequent enough that individuals can get the information they need as soon as they need it and the meeting would go as long as there are questions and concerns to answer. While difficult to work around everyone's schedule it should be important to make sure those who are in need of the information should have a time available to them. If the information is irrelevant to some members than there is no real reason for showing up. I would include information from all aspects of mental illness: medication, therapy, self-medication, support, recovery, etc. There is a wide range of information and interventions available and the one thing that I would make sure is part of psychoeducation is the knowledge of the positive outcomes, the fact that things do get better, and that the individual and families are not alone.
ReplyDeleteHi Kylie, you mentioned that “if the information is irrelevant to some members than there is no real reason for showing up,” if that were the case would you then make another group for a different time slot to accommodate the needs of those individuals?
DeleteMegan, yes I would absolutely! I think things like this has to be more direct and personal and relevant to the individual to really make an impact.
DeleteYou mentioned that "meetings should be frequent enough that individuals can get the information they need as soon as they need it", would you have enough meeting times so that an individual could come to perhaps two or more meetings a week if they needed?
DeleteI would do my best. They could always come to a meeting and stay for more personal questions at the end. Anyway I could work things out to get needs met I would absolutely!
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ReplyDeleteIf I were to design a psychoeducation group it would include the individual with the mental illness and they would be able to choose whoever they want to be in the group with them. My group would be available for most all kinds of mental illness. Certain days and times would be reserved for a certain type of mental illness, that way everyone would be able to be a part of the group if they wanted to. Each group would meet two to three times a week depending on the week, for an hour or so, for as long as they wish to come. My sessions would include information about the mental illnesses, such as: symptoms, strategies for symptom management, practice exercises, medication, etc. If I had to choose one thing that must be part of psychoeducation, it would be a positive attitude. If the individual doesn't have a positive attitude about the situation they are in, then they will never be able to fully overcome that certain situation.
ReplyDeleteAs cliché as it sounds I totally agree with the positive attitude, like if you come in with a positive attitude it makes such a difference. But like I said before you also have to really want to make that change. We had a lot of the same idea, dividing the time to make sure the information is important to a specific group of people! I guess my question would be, would you offer classes for just the family/S.O. of the individual if they are looking for ways to support or care for the individual?
DeleteI love that you mentioned the importance of a positive attitude! I think that is a very important part of both the individual's recovery and group dynamics. My question would be, how would you handle the situation if a member showed up to group with a very negative attitude and just "rained on everyone's parade"?
DeleteKylie:
DeleteYes, I definitely would have a class for just family members looking for ways to help their loved one who may or may not want to come to a class for help. That way maybe the family members will become educated enough to help their loved one, instead of no one helping them.
Alexis:
That's a good question. I think at first I would try and emphasize the fact that a positive attitude goes a long way with recovery to the whole group so not to single one person out, but if that person's attitude doesn't change then I would talk to them after one of the sessions and try and help them individually. If it continued to not change and it began impacting the group then I would have to not allow them to come to the group anymore and refer them to a counselor maybe? I'm not completely sure!
Hey Kylie! I like when you said, "certain days and times would be reserved for a certain type of mental illness." I think it is important to note that you would do more open groups, but at times you would reserve group fro people who had similarities so people could really connect on a deeper level since they could be experiencing similar situations.
DeleteIf I was to design a psychoeducational group, it would include individuals with mental illness and whoever they would want with them (support group). Depending on what type of mental illness it would be, would depend on the day of scheduling and times available. All meetings will focus on general information about mental illness, but depending on the group, it would be focused more on that mental illness that time/day. I also believe that the group should have easy access to information given and therefore make it available through a site or make packets. I would even have a buddy system in the group. If one person doesn't know the information or have questions they can ask their group mate or receive other sources that will be given. Topics to be discussed: Coping, medication, resources, therapy, recovery, dealing with the negatives, and looking more towards the positives, and discuss overall the wide range of how to live with a mental illness.
ReplyDeleteI love the idea of a buddy system, kind of like AA when you have someone whose gone through it to lean on and help you... I don't know if that's exactly what you meant but it might be an idea. Do you think the information would be any less helpful if it came from someone who was not a professional?
DeleteI really liked your thoughts on how you would create your group. I like when you said, "all meetings will focus on general information about mental illness." I think it is important to keep a general focus and then if the time arises and is appropriate with the meeting, you can go deeper into any topics that you think is appropriate. You can not plan peoples emotions or talking points, so you can keep it simple, and then go deeper if you need to within each session.
DeleteI would create a psycho education group with a combination of people due to the research that there is more of a positive outcome from a combination group versus a single group. It helps family members, friends, caretakers, etc. be able to go through this together making a stronger bond and understanding versus if they went through solo. I would probably do more than one group if I could. One for homogenous group and one for the general public. I think if the public was just going into listen without having a level of understanding or personal attachment to a person who has bipolar than it would not make a strong group bond, rather an observation. I would ask what fits around the groups schedule with timing and time. I would prefer night time and for an hour. That gives plenty of time without taking too much time. I like doing it at the end of the night too because if something happened during the day or the person(s) had a bad day, it could give them some comfort of talking it out. The group would be continuously growing so each session could build off of the previous session. I would have the session marked down as general knowledge of the mental illness, but would divulge further into each session depending on the environment that was presented that day.
ReplyDeleteIf I was to design a psychoeducation group it would include the individuals with mental illness and they could choose to have family members/caregivers join them as well. The group would be for other mental illnesses too, not just bipolar disorder. There would be different meeting times/days available to tailor the group content more specifically on one mental illness. However, all meetings would include some of the same general information/content. Each meeting would be about an hour long and a variety of meeting times would be offered so that members could attend two meetings per a week. The group would be on-going, so members could continue to come as long as they would like. The sessions would include information about mental illnesses such as: medications, therapy, coping strategies, how to process negative emotions, strategies for symptom management, practice exercises, resources, supports, and recovery. I would want to focus on and encourage building peer relationships and support within the group. I think it is very important for people to know that they are not alone and others are going through similar things as them.
ReplyDeleteI agree with all your thoughts! Your statement: "I would want to focus on and encourage building peer relationships and support within the group." I was wondering how you would go about that, and what would you do if your plans weren't exactly working out how you imagined them to?
DeleteI like how you say, "they could choose." You connected all our other work in the class with this post and I definitely appreciate it. Giving people the power is the most important part of a treatment and group and really helps to build trust and empower the individual.
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