© Springer International Publishing Switzerland 2015Ingrid Söderback (ed.)International Handbook of Occupational Therapy Interventions10.1007/978-3-319-08141-0_34
34. Psychoeducational Groups
Homewood Health Centre, Kitchener, 20 Crestwood Pl., N1E 4M3 Guelph, ON, Canada
University of British Columbia, 862 Bayview Ave., V4M 2R4 Tsawassen, BC, Canada
Clients attending psychoeducational groups report that in addition to skills learned and social benefits, the activities reinforce content, assist in establishing healthy milieus, encourage involvement in the group, and assist with the recollection of the topic discussed (Cowls and Hale, Can J Occup Ther 72(3):176–182, 2005).
KeywordsMental healthPsychoeducational groupsRehabilitation
I valued a lot of the exercises. They were all good introductions to the topic and they also got you involved.
The therapeutic value of group work has long been supported by a variety of disciplines, predominantly psychology, psychiatry, social work, nursing, and rehabilitation. Groups in mental health settings aid in promotion of hope, universality (“I am not alone with my problems”), and mutual support (Yalom 1995). Psychoeducational groups often bring together people with similar illness states or health-related concerns. Effective learning can occur in group settings through individuals sharing concerns and strategies used to overcome them. This is much more powerful than didactic relaying of information (Anderson 2001).
Psychoeducational groups provide a structured, supportive, and interactive environment in which clients may learn about their illness and effective coping strategies to help manage symptoms and improve functioning (Brown 2011; Pitschel-Walz et.al. (2013). Leaders of the group guide or facilitate learning through offering current and up-to-date information (Brown 2011).
Psychoeducation has its roots as a family-focused intervention. It is considered an evidence-based approach and a useful adjunct to medication wherever possible in the treatment and prevention of mental health issues (Colom et al. 2003). It is used with mental health clients interested in learning new ways of coping and problem solving. Skills learned can assist people to improve functioning in their personal and work lives. Topics addressed in psychoeducation vary and can include stress management, self-esteem , recognizing and managing symptoms of illness, strategies to stay well, and conflict resolution.
Psychoeducational groups can help to prevent relapses with mental health conditions by skill teaching and information they provide. Recent mental health reviews emphasize the importance or recovery principles and self-management to promote recovery (Lloyd and Williams 2010). These groups can assist in maintaining wellness and can remediate recurring problems by improving the knowledge of illness and coping skills and by establishing routines to restore abilities. Clients have stated that they benefit from review and repetition of information (Brown 2011; Cowls and Hale 2005).
Candidates for the Intervention and Epidemiology
Psychoeducational groups are reportedly effective with a variety of Axis I diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; 2013), such as schizophrenia , mood disorders, anxiety disorders , eating disorders, and concurrent disorders of mental health and addiction.
The above disorders may begin in adolescence, in the case of eating disorders and anxiety disorders, and range through to adulthood. The diagnosis of schizophrenia generally varies in onset from 18 to 25 years of age. Aside from eating disorders, whereas 90 % are female, most illnesses mentioned affect the lives of both genders.
Psychoeducational groups have wide applicability within mental health from adolescences to older adulthood. It has often been believed that significant cognitive limitations are exclusion criteria for participation in psychoeducational groups. However, in a recent study by Pitschel-Walz et al. (2013), it was suggested that clients with borderline intellect are capable of integrating in and benefiting from psychoeducational groups, and therefore should not be excluded.
A review of the literature and clinical experience shows that psychoeducational groups are used in both inpatient and outpatient settings. Although benefits have been identified in both, it can be argued that inpatients may have greater difficulty attending to, understanding, and incorporating information gained in groups into their daily life (Cowls and Hale 2005; Sibitz et al. 2007).
Sibitz et al. (2007) found that clinical stability may be the most important prerequisite for benefiting from psychoeducational groups . One study by Duman et al. (2010) found that when providing short and well-structured psychoeducational groups, inpatients did show significant increases in their knowledge about their illness and discharge readiness.
The Role of the Occupational Therapist in Applying the Intervention
Although a variety of health-care professionals conduct psychoeducational groups , occupational therapists (OTs) bring a unique focus and method of group facilitation. When involved in a group, OTs practice as facilitators, empowering the client to direct and carry a large portion of group discussion. However, psychoeducational groups by definition do require structure. The OTs develop the structured content of these groups while incorporating two distinct factors: activity and link to occupational performance (participating in a task for self-care, productivity, or leisure).
Brown (2011) suggests that the psychoeducational group facilitator must possess a deep understanding of the group subject. She says that the facilitator is responsible for creating an environment that fosters hope, new learning, emotional expression, self-awareness, and an opportunity to practice new learning.
Recent literature suggests that OTs need to reconnect with their roots in activities. It has been stated “activity is valuable and should be promoted in order to deliver best practice for occupational therapy in mental health” (Cowls and Hale 2005, p. 178). Within a psychoeducational group, activities may serve many purposes such as an icebreaker, to illustrate a point, enhance self-reflection, increase participation, or to terminate a session (Brown 2011; Cowls and Hale 2005).
Principles for Practice
Attending a psychoeducational group should not be uniformly recommended for everyone.
An occupationally based assessment helps individuals to identify goals they define as central and important in their life. One such standardized assessment is the Canadian Occupational Performance Measure (COPM; Law et al. 1998). Once occupational issues in self-care, productivity (work), or leisure have been established, goals can then be generated in partnership with the client.
The content of psychoeducational groups can be discussed to ensure that they are relevant to the clients and could assist in the recovery of identified occupations. The assessment process is a key to developing rapport and collaborating with the client who attends a group. Setting individual goals and objectives allows each client to have a sense of control which can lead to greater buy in and contribution (Brown 2011). The results of these assessments serve as a guide for recovery and assist the client in integrating the skills from groups to their occupational goals .
If a client is reluctant to attend psychoeducational groups or uncertain of their benefits, a trial offer to try a group should be encouraged before ruling it out. Ultimately, the decision rests with the clients. Nothing will take this process further, however, than creating a collaborative, respectful working partnership. A regular review of goals and adapting them to each client’s needs and abilities is central to occupational therapy practice.
Two other important principles in terms of effective group process relate to group composition and readiness to attend to the content of the psychoeducational group. People attending groups should be at comparable points in their recovery. This promotes optimal group dynamics.
Readiness to attend these groups is often dependent on where clients are in understanding, accepting, and dealing with their illness and life circumstances (Cowls and Hale 2005).
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