psychoeducation for people with mental illness

1. Mr. Siba karmi
M. Phil in PSW
Dept. of Psychiatric Social Work
CIP, Ranchi
PSYCHOEDUCATION IN
PSYCHIATRIC DISORDERS

2. HISTORY OF PSYCHOEDCATION
 The roots of the psychoeducational orientation can be found in the humanitarian
writings of the early to mid 1800's by individuals such as Pestalozzi, Itard, and
Howe, among others. However, it was the “mental hygiene” movement in the early
1900's that strengthened and promoted this humanistic approach for the treatment
of those who experience psychological and behavioural disorders.
 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.

3. Contd…
 The Psycho Educational model is a humanistic approach to change the
behavioural patterns, values, interpretation of events, and life outlook of
individuals, who are not adjusting well to their environment(s) (e.g. home,
school, workplace, hospital etc).
 Inappropriate behavior is viewed as a person’s maladaptive attempt to cope with
the demands of that environment.
 Appropriate behaviors are developed by helping the individual to recognize the
need for change, and then helping that person to display better behavior choices.
 For example “teacher” is helping a “student” to more accurately understand
oneself and problems , the futility of the present pattern of behaving, and the
need to adopt prosocial alternative responses.

4. THEORIES OF PSYCHOEDUCATION
 Ecological systems theory
 Cognitive behavioural theory
 Learning theory
 Group practice model
 Stress and coping model
 Social support model
 Narrative model

5. WHAT IS PSYCHOEDUCATION
Psycho education is a systematic , structured and didactic
information on the illness and its treatment and includes
integrating emotional aspects in order to enable patients as well
as family members to cope with illness (Bauml et al.).

6. SYMPTOMS CLUSTERS
POSITIVE NEGATIVE
Hallucinations Few feelings
Delusions Lack of drive
IMPAIRMENTS
Work
Relationships
Self-care
COGNITIVE MOOD
Memory Depression
Problem solving Hopelessness

7. TYPES OF PSYCHOEDUCATION

8. Individual 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.

9. Group psychoeducation
 It 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.
 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.
 Some of the issues discussed in group sessions (10-12 members same
disorder ) are about disorders, healthy eating, Anger management and
sleeping, Mental hygiene etc.

10. Family 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
and reduce high expressed emotion.
 Information and education to the family.
 Enhance family coping skills.
 Improve communication & problem solving skills.
 Prevention of relapse.
 Concurrent use of psychopharmacology.

11. Pyschoeducation for peer
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.

12. SOCIAL PSYCHOEDUCATION
The influence of social stigma as well as social support and the
importance of recognizing 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. Advocate
the community about illness, and engage on awareness
programme. Reduce stigma and inclusion of the patient in the
community.

13. MODEL S OF PSYCHOEDUCATION
 Information model
 Skill training model
 Supportive model
 Comprehensive model
 Multi family group therapy model
 Behavioural family management model
 Family focused treatment.
 Peer to peer psycho education model
 Problem solving model.
 Communication model (Deficit and functional model)

14. Components of psychoeducation
 Illness awareness: it aims to increase patient’s insight,
illness acceptance and decrease the stigma and humiliation
felt by patient .
 Adherence enhancement: considering the fact that the
most important cause of relapse in patients is non adherence
and common reasons of non adherence are incorrect
information, fear of side effects and dependency, lack of
information about illness and the necessity of treatment.

15. Contd…
 Detection of early warning signs and symptoms:
recognizing the early warning signs can help patients to
prevent full blown episode and subsequent probable
hospitalization.
 Substance misuse avoidance: considering that substance
and drug misuse can worsen the course of disorders.
 Life style regularity: regular habits and stress
management. Educate the patients to regulate.

16. STAGES OF PSYCHOEDUCATION
According to SAMHSA org.
1. Beginning stage
2. Conceptual stage
3. Working stage
4. Evaluation stage
5. Termination stage

17. PSYCHOEDUCATION FOR PSYCHOTIC
DISORDERS
According to psychoeducational programme project of dept. of
Psychiatry, university hospital of Olomouc in 2010 explains about six
sessions for psychotic disorders and the duration of each session is 45
minutes.
1. Session
 Introduction
 Rapport establish (Othmer)
 Purpose of psychoeducation.
 what is psychosis?
2. Session
 Types and prevalence of psychotic disorder.
 Signs and symptoms of psychosis. ( negative, positive, cognitive ,
affective and social)

18. Contd...
 Circle of various hallucinations, delusions, abulia and social
isolation.
3. Session :
 Causes of psychosis
 Biological causes
 Vulnerability of stress.
 Maintenance factors of trigger of relapse
 Early warning sign of relapse.
4. Session :
 Myths about antipsychotic medication
 Mechanism of medication.
 Side effect of medication.

19. Contd…
5. session:
 self –help
 Life style regularities.
 Management of stress.
 Managing voices and delusion experiences .
 Time management and pleasure activities.
 Physical health.
6. Session :
 positives aspect of interpersonal relation.
 expressed emotion.
 Social skill training.
 Preparing for future

20. SOCIAL SKILL TRAINING MODEL
Anxiety and stress Antisocial
behaviour
Social isolation
Low self- confidence Cognitive
deficit
SOCIAL
SKILL
DEFICIT

21. PSYCHOEDUCATION FOR MOOD
DISORDERS ( Barcelona model)
Barcelona project: colom et al., 2003 conducted
psychoeducational session for out patients diagnosed with bipolar
I and II. Which held for six months and each session carried out
for 90 minutes. such as -
1. Introduction and establishment of rapport.
2. what is bipolar disorder?
3. Eatiology, the disorder's onset and out come.
4. Symptom of Mania and hypomania.
5. System of depression.
6. Course and outcome.
7. Treatment ( Biological, psychological and mood stabilizer).
8. Treatment of antipsychotic.

22. Contd…
9. Treatment of anti depression.
10. Plasma level of mood stabilizer.
11. Pregnancy and genetic advice.
12. Psychopharmacology VS Therapy
13. Risk factor associated with interruption of treatment.
14. Early warning sign and symptom.
15. Early detection of mania and Hypomania.
16. Early detection of depression .
17. New episode management .
18. Regularity of habit.
19. Stress control technique.
20. Problem solving strategies.
21. Summary of session and outdoor service.

23. PSYCHOEDUCATION FOR
NEUROTIC DISORDERS
 Explain what is neurotic disorder.
 Clarify myths and misconception about illness.
 Explain biological and psychological factors.
 Give information about signs and symptoms.
 Provide information about pharmacotherapy and other psychological
therapies.
 Side effect of pharmacotherapy and its management .
 Enable patient to detect early warning sign and symptoms.
 Thought stopping for OCD patient.

24. COLORADO MODEL OF
PSYCHOEDUCATION
 It was developed by American family foundation for post traumatic
stress disorder, Acute Stress, adjustment problem , sexual
harassment and mentally and physical torture and people with
disaster affected for recovery and empower them, for their
psychological problems. It comprises 10-12 sessions and duration
of each session is 45 minutes.
It has two tracks : 1. Psycho education and Moral support.
2. Recovery issues.

25. STAGES OF COLORADO MODEL
1. Establish safety: overview of cult recovery, critical thinking
and PTSD & triggers.
2. Remembrance and mourning: Anger and grief, inventing and
reinventing your self. (Through mapping up techniques).
3. Reconnection: Boundaries, recognition, repair, relationship and
intimacy.

26. PREDISCHARGE COUNSELLING AS PART
OF PSYCHOEDUCATIONAL MODEL
Predischarge counseling will be done through METHODS and IDEALS
approach.
 Medicine and drug
 Environment and Behavior modification
 Treatment process.
 Health education .
 Out patient service.
 Dieting.
 Signs and symptoms of disorder and social support .

27. Contd…
 Include (family members, caregiver and patient).
 Discuss (about illness and future direction).
 Education (about medication and drug).
 Assessment (of whole psychological intervention).
 Life style regularities.
 Socialization (in the community, Recuperative service center).

28. IMPORTANCE OF PSYCHOEDUCATION
 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.

29. Contd…
 Improving insight into illness improvement of compliance.
 Promoting relapse prevention.
 Engaging in crisis management and suicide prevention.
 Supporting healthy components .
 Economizing informational educational activities.

31. AFTER PSYCHOEDUCATION

32. REFERENCE
 Brendtro, L., Brokenleg, M., & VanBockern, S. (199 ). Reclaiming children
and youth at risk. National Educational Services.
 Curwin, R. & Mendler, A. (19 ). Discipline with dignity for challenging
youth. National Educational Services.
 Long, N.J., Morse, W.C., & Newman, R.G. (1996). Conflict in the classroom:
The education of at-risk and troubled students. Wadsworth.
 Long, N.J., Wood, M.M., & Fecser, F.A. (2001). Life space crisis intervention:
Talking with students in conflict.
 McIntyre, T. (1993 ). Classroom counseling. Reprinted at
http://www.behavioradvisor.com

33. Contd…
 McIntyre, T. (2005). The behavior survival guide for kids: How
to make good choices and stay out of trouble. Minneapolis: Free
Spirit Press.
 Colom F, Vieta E, Sa´nchez-Moreno J, et al Psychoeducation in
bipolar patients with comorbid personality disorders. Bipolar
Disord 2004; 6 : 294–298.
 Ba¨uml J, Pitschel-Walz G. Psychoedukation bei schizophrenen
Erkrankungen. Stuttgart, Germany: Schattauer; 2003. Article in
German. As cited in: J Ba¨uml, T Frobo¨se, S Kraemer, M.
Rentrop, and G. Pitschel-Walz. Psychoeducation: A basic
psychotherapeutic intervention for patients with schizophrenia
and their families. Schizophr Bull 2006; 32 (1) : S1-S9.

34. THANK YOU