Sathi Das

clinical psychologist
Speech plus

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Goals of Therapy:
• Boosting of empowerment of the afflicted and their families.

• Patients are become able to tackle their illness in as optimal a

way as possible.

• Develop a basic comprehension of the background of illness and

the treatment options which are currently available.

• Without the establishment of a differential understanding of the

illness and resulting insight, compliance and improvement in
coping, long-term and successful cooperation with professional
auxiliary systems is doomed to remain suboptimal.

• Develops self-help potential within the affected person

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• “From dependent to self-contained theraputic method”

• Psychoeducation is a specific form of education. It is aimed at

helping persons with a mental illness or anyone with an interest
in mental illness, to access the facts about a broad range of
mental illnesses in a clear and concise manner. It is also a way
of accessing and learning strategies to deal with mental illness
and its effects

• Within the Anglo-American realm, psychoeducation fulfilled

less the function of an independent, self-contained therapeutic
method and was viewed more as a combination of several
therapeutic elements contained within a complex psychosocial
intervention (Goldstein et al.1978).
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Cont….
• The working group “Psychoeducation of patients with
schizophrenia” has formulated following definition:
The term psychoeducation comprises systemic,
didactic psychotheraputic interventions, which are adequatefor
informing patient and their relatives about the illness and its
treatment, facilitating both an understanding and personally
responsible handling of the illness and supporting those afflicted
in coping with the disorder.

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HISTORY OF THE CONCEPT…
• Psychoeducation was originally conceived as a composite of
numerous therapeutic elements within a complex family therapy
intervention.

• Since the mid 1980s, psychoeducation in German-speaking

countries has evolved into an independent therapeutic program
with a focus on the didactically skillful communication of key
information within the framework of a cognitive-behavioral
approach.

• The term was first employed by Anderson et al.(1980) and used

to describe a behavioral therapeutic concept consisting of 4
elements:

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Cont…..
Briefing the patients & their relatives
about their illness
Problem-solving training,
Communication training
Self-assertiveness training

• Patients and their relatives should be empowered to understand

and accept the illness and cope with it in a successful manner.

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Cont…….
• According to Aubin (2000), psychoeducation is a process that
involves two stages.

• First, a health care professional informs the patient and their

caregivers about the illness. This involves explaining symptoms,
illness patterns, treatment options, preventive measures and
prognosis.

• Secondly, the patient informs the professional about their

symptoms, beliefs and causation, factors that improve or worsen
symptoms, fears and the effect of illness on their daily
functioning.
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What it is not

Psychoeducation is not a treatment. It is

designed to be part of an overall treatment plan. For example,
knowledge of one's illness is crucial for individuals and their
support network to be able to design their own relapse prevention
plans and strategies.

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Why use Psychoeducation?

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Main Goals 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”

 “Cotherapists”—strengthening the role of relatives

 Optimal combination of professional therapeutic methods and

empowerment
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Continue…..
 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

(Bauml et al. 2006)

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Theory underline Psychoeducation

• Biopsychosocial
and
• Medical model of mental disorders

• It is cheaper & easier to evaluate

• Requires only empathy, communication skills and an exhaustive

knowledge of the illness & its management

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Models of Psychoeducation
The various psychoeducational models can be categorized into four
approaches (Zipple and Spaniol, 1997).

Informational Model

Skills Training Model

Supportive Model

Comprehensive Model
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• Multi-family groups-An effective and highly efficient way
to impart basic information to families (McFarlane et
al.1995).It may reduce the sense of isolation and stigma that
often accompany psychosis.

• Individual Education

• Videotapes or Pamphlets

• e-Therapy and Telecounselling

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1. Assessment : this focuses on a host of factors that may
influence the outcome of the disease in a given patient,
namely,

• The comorbid disorders present or likely to recur

• The characteristics likely to contribute to illness management
skills, and
• Exploring the patient’s views about his / her illness and its
treatment, like:
– Belief about the causes of their suffering
– Reason behind an unsuccessful treatment
– Nature of treatment setting in the past 15
Cont……
• Determining patient’s past experiences in collaborative decision
about treatment.

2. Implementation : Education regarding requirement and

practicalities of treatment. It is concerned with what can be
expected from the treatment and how the family members are
expected to respond or act.

• Resolution of any discrepancy between patient’s expectations

and preferences.

• Personal cost-benefit analyses around specific treatment

decision.

• Conveying information about side-effects 16

Cont…..

3. Follow-up :Patient’s opinion about the outcome.

• Joint decision whether to continue as it is, adjust to current

intervention (Dose, timing and frequency) or change the
intervention.

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 Developmental disability
& the family
Family is the basic and primary unit of society which provides care, support &
facilities for the development of each child irrespective of child’s abilities &
disabilities.
According to Dale(1996), parents rarely expect their child’s disabling
conditions or life threatening illness.
The news about the child’s disability may be so difficult to take in that some
parents refuse to accept it for a while or may reject the person conveying the
news.
Fraser et al., (1998) noted that parents must mourn the loss of their desired
normal child before they can accept their real defective child. They go
through a number of stages ,which are as follows:
Shock Denial Sadness Adaptation

Reorganization

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Cont……

• Once parents become acclimated to the fact of their child’s

disability and determine to rear their child themselves, stress
unusually shifts to the day-to-day realities of caregiving.

• Some families adapt well, develop an effective routine, and

experience a high level of family functioning, whereas others
are devasted or destroyed.

• There is evidence that family stress increases as children with

mental retardation grow older (Bristol & Schopler, 1984) and
middle childhood may be a more stressful period than other
periods.
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 Psychoeducation on Autism & the family

• Four basic aims for autism treatment goals:

• 1) fostering social and communicative development;

• 2) enhancing learning and problem-solving;

• 3) decreasing behaviors that interfere with learning and access to

opportunities for ordinary experiences; and

• 4) helping families to cope with autism.

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• 1 in 68 American children as on the autism
spectrum–a ten-fold increase in prevalence
in 40 years.

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Psychoeducation on mr & their family
• Giving information about what is mental retardation

• What are the basic symptoms –Delays milestones

Deficits in memeory skills
Difficulty learning social rules
Difficulty in problem-solving skills
Delays in the develpoment of self-care
skills
Lack of social inhibitors
• Common misconceptions & facts about MR

• What causes mental retardation

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Cont……
• How to prevent it- Compensatory education (it aims at preventing
developmental defects that interfere with educational progress in
the disadvantaged preschool child)

• Special education (Provides a reasonable structure for educating

the retarded child, may discourage stigmatization & rejection of
the child).

• Sheltered workshop (Gives child to the opportunity to develop

work skills to a point where he can get a job)

• Parent counselling
• What are the common types of behaviour problems (Hyperactive,
inattentiveness, violent, destructive, self-injurious, sexually
inappropriate behaviors etc.) 24
Cont….
• What are the techniques for modifying problem behaviours-
Simple techniques & Advanced techniques

• Techniques for teaching new skills –shaping, imitation etc.

• How to handle maladptations in the family

• How to handle adverse social consequences

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Studies showing Efficacy of Psychoeducation on
both patient & their family………..
• Sovani (1993), Prema and Kodandaram (1998) and Shankar and
Menon (993) reported that interventions comprising educational
sessions were carried out in a group format and assessments
revealed a reduction in both negative attitudes to illness , as well
as caregiver distress and burden.

• Nag et al., (2010) was conducted a study on efficacy of

psychoeducation in primary caregivers of individuals with mental
retardation (14 mothers of mentally retarded children) .The result
showed significant reduction of caregivers’s level of stress and
change in use of coping strategies after the psychoeducational
intervention.
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Attention Deficit Hyperactivity Disorder
• ADHD is a chronic condition requiring access to
long-term treatment and support, sometimes over
many years. However, the level and type of support
needed can vary. The principal aims of treatment are
to promote the child's development and to
reduce secondary difficulties or disabilities .
• Written information should be given to the parents/ carers and
the child's school regarding diagnosis and assessment, support
and self-help, psychological treatment and the use and possible
side effects of drug treatment.
• Specific form of face to face sessions which can be offered
individually to parents and young people about how to control
the behaviour.
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Conclusion….
• When the patient party first comes in contact with a clinician,
they are in great distress.

• They expect cure for the problems and also an explanation about
exactly what is happening and why.

• Then the clinician provides them with plausible explanation of

the disease and also informs them with the treatment options
available and how to go about it.

• All these are likely to reduce EE and overall stress and caregiver
burden.

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THANK YOU

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