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Psychoeducation
Kinds of Psychoeducation Selected AbstractsA Delphi survey of the views of adult male patients with personality disorders on psychoeducation and social problem-solving therapyCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 5 2007Mary McMurran Background,Psychoeducation and social problem-solving therapy are treatment components that work well in tandem for offenders with personality disorders, hence it is worthwhile to maintain and improve their effectiveness. Aim,The aim was to seek patients' views of these therapies to contribute to their development. Method,A Delphi survey was conducted with all 12 male inpatients of a personality disorder hospital treatment unit. Results,Round 1 produced 30 statements for psychoeducation and 59 for social problem-solving therapy to be rated in Round 2. There was consensus at a level of 70% for all items. Both psychoeducation and social problem-solving therapies were viewed as useful by these patients. The men also suggested improvements in psychoeducation, including minimizing the delay between assessment and feedback, provision of reference material, preparation for the work and support afterwards. Areas identified for improvement in social problem-solving therapy included more frequent review of progress, greater consistency of delivery, eliciting problems more effectively, providing reference material, supporting patients in group work, and the development of an advanced therapy. Discussion,A Delphi approach to evaluation of therapies with the people receiving them is not only feasible but seems to offer a practical way of making useful clinical adjustments to the work. Further research with larger samples might usefully focus on whether such an approach enhances treatment compliance. Copyright © 2007 John Wiley & Sons, Ltd. [source] The manualization of a treatment programme for personality disorderCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2005Mary McMurran Background The advantages of manualized psychological treatments include: the promotion of evidence-based practice, the enhancement of treatment integrity, the facilitation of staff training, and the potential replicability of treatment. Argument The manualization of a multi-component, multidisciplinary treatment programme for male personality-disordered offenders is described. The background to this development is explained and the treatment setting is described briefly, followed by a description of the eight treatment manuals: (1) the treatment overview, (2) Psychoeducation focusing on personality disorder diagnosis and core beliefs, (3) Trust and Self-awareness group exercises, (4) Stop & Think! - a social problem-solving intervention, (5) Controlling Angry Aggression, (6) Controlling Substance Use, (7) Criminal Thinking/Belief Therapy, and (8) Skills for Living - a social skills manual. Conclusions In addition to the original aims of manualization, this exercise has clarified the treatment programme, included less highly trained staff in the delivery of therapy and permitted the evaluation of treatment modules, thus contributing to the incremental evaluation of the overall programme. These manuals may usefully be shared with other practitioners in the field. Copyright © 2005 Whurr Publishers Ltd. [source] A review of empirically supported psychological therapies for mood disorders in adultsDEPRESSION AND ANXIETY, Issue 10 2010Steven D. Hollon Ph.D. Abstract Background: The mood disorders are prevalent and problematic. We review randomized controlled psychotherapy trials to find those that are empirically supported with respect to acute symptom reduction and the prevention of subsequent relapse and recurrence. Methods: We searched the PsycINFO and PubMed databases and the reference sections of chapters and journal articles to identify appropriate articles. Results: One hundred twenty-five studies were found evaluating treatment efficacy for the various mood disorders. With respect to the treatment of major depressive disorder (MDD), interpersonal psychotherapy (IPT), cognitive behavior therapy (CBT), and behavior therapy (BT) are efficacious and specific and brief dynamic therapy (BDT) and emotion-focused therapy (EFT) are possibly efficacious. CBT is efficacious and specific, mindfulness-based cognitive therapy (MBCT) efficacious, and BDT and EFT possibly efficacious in the prevention of relapse/recurrence following treatment termination and IPT and CBT are each possibly efficacious in the prevention of relapse/recurrence if continued or maintained. IPT is possibly efficacious in the treatment of dysthymic disorder. With respect to bipolar disorder (BD), CBT and family-focused therapy (FFT) are efficacious and interpersonal social rhythm therapy (IPSRT) possibly efficacious as adjuncts to medication in the treatment of depression. Psychoeducation (PE) is efficacious in the prevention of mania/hypomania (and possibly depression) and FFT is efficacious and IPSRT and CBT possibly efficacious in preventing bipolar episodes. Conclusions: The newer psychological interventions are as efficacious as and more enduring than medications in the treatment of MDD and may enhance the efficacy of medications in the treatment of BD. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] The evolution of family interventions for schizophrenia.JOURNAL OF FAMILY THERAPY, Issue 1 2006A tribute to Gianfranco Cecchin Family intervention for schizophrenia has informed the whole history of family therapy, although in different fashions. This presentation will deal with the main phases of such intervention, outlining the characteristic features of each one. We can roughly divide the history of family intervention for schizophrenia into four phases: Phase 1 , Conjoint family therapy (1955,1965). Family interventions were aimed at modifying family communication patterns, implying the possibility of a definitive resolution of psychopathology. Phase 2 , Antipsychiatry (1965,1975). This, rather than a treatment model, was a philosophy of psychiatry, which considered schizophrenia as an epiphenomenon of the distortions of Western society. Family treatment was aimed at promoting the awareness of such a dynamic. Phase 3 , Milan systemic therapy (1975,1985). The systemic model was aimed at helping people with schizophrenia to recognize their position within their families (and other significant systems), giving all family members a new sense of their relationships to each other. Phase 4 , Psychoeducation (1985,2005). In most psychoeducational models, schizophrenia was conceived of as a biologically determined disorder. Psychoeducation was a way of helping the not diagnosed family members to cope with problems brought about by the illness, eliciting consensus towards psychiatric treatments such as medication and rehabilitation. A fifth phase of family intervention for schizophrenia is probably developing right now. If this is happening it should probably be an integrative phase, in which different approaches to family dynamics might be bridged and blended, in order to give more effective help to all members of families with schizophrenia. [source] Psychoeducation for Survivors of TraumaPERSPECTIVES IN PSYCHIATRIC CARE, Issue 3 2007Bethany J. Phoenix RN PURPOSE.,Education about the persistent effects of trauma helps survivors better understand their own stress responses, and knowledge of coping strategies provides a sense of control over these responses. Trauma education for providers can minimize negative countertransference and prevent vicarious traumatization. CONCLUSIONS.,This article discusses content areas to be covered in psychoeducation with survivors of acute traumatic events and prolonged trauma and abuse, and reviews resources for trauma psychoeducation with clients and healthcare providers. PRACTICE IMPLICATIONS.,Advanced practice psychiatric nurses may provide psychoeducation to people who suffer from complex psychological and behavioral disturbances related to severe and persistent abuse or trauma, especially early in life. [source] Psychoeducation in dementia: Results of a survey of all psychiatric institutions in Germany, Austria and SwitzerlandPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 6 2008Christine Rummel-Kluge md No abstract is available for this article. [source] Psychoeducation in bipolar patients with comorbid personality disordersBIPOLAR DISORDERS, Issue 4 2004Francesc Colom Background:, The co-occurrence of personality and bipolar disorders is quite common. Bipolar patients with personality disorders have been described as having poorer outcome than ,pure' bipolar patients. However, from a combined-approach point of view, a little has been done to improve the course of these patients. Psychoeducation has shown its efficacy in the prevention of relapses in the bipolar population but, to date, no data is available on its efficacy in the management of bipolar patients with personality disorders. Method:, The present study shows a subanalysis from a single-blind randomized prospective clinical trial on the efficacy of group psychoeducation in bipolar I patients. Bipolar patients fulfilling DSM-IV criteria for any personality disorder were randomized to either psychoeducational treatment or a non-structured intervention. There were 22 patients in the control group and 15 in the psychoeducation group. All patients received naturalistic pharmacological treatment as well. The follow-up phase comprised 2 years where all patients continued receiving naturalistic treatment without psychological intervention and were assessed monthly for several outcome measures. Results:, At the end of the follow-up phase (2 years), a 100% of control group patients fulfilled criteria for recurrence versus a 67% in the psychoeducation group (p < 0.005). Patients included in the psychoeducation group had a higher time-to-relapse and a significantly lower mean number of total, manic and depressive relapses. No significant differences regarding the number of patients who required hospitalization were found but the mean duration of days spent in the hospitalization room was significantly higher for the patients included in the control group. Conclusion:, Psychoeducation may be a useful intervention for bipolar patients with comorbid personality disorders. Further studies should address the efficacy of specifically tailored interventions for this common type of patients. [source] Has number of previous episodes any effect on response to group psychoeducation in bipolar patients?ACTA NEUROPSYCHIATRICA, Issue 2 2010A 5-year follow-up post hoc analysis Colom F, Reinares M, Pacchiarotti I, Popovic D, Mazzarini L, Martínez-Arán A, Torrent C, Rosa A, Palomino-Otiniano R, Franco C, Bonnin CM, Vieta E. Has number of previous episodes any effect on response to group psychoeducation in bipolar patients? A 5-year follow-up post hoc analysis. Objective: One of the main utilities of staging in bipolar disorder is enhancing the formulation of pharmacological and non-pharmacological treatment strategies. Hence, it is essential to ascertain whether the number of previous episodes influences treatment response. Hereby, we present a 5-year post hoc study on the efficacy of group psychoeducation for bipolar disorders according to the number of previous episodes. Methods: For this subanalysis, we have compared the 5-year outcome of 120 euthymic psychoeducated versus non-psychoeducated bipolar patients according to the number of previous episodes at study entry. Results: Patients with more than seven episodes at study entry did not show any significant improvement with psychoeducation according to time to recurrence. Patients with more than 14 episodes did not benefit from psychoeducation in terms of a reduction of time spent ill. Patients with 7 or 8 episodes showed a benefit in terms of fewer days spent in hypomania, depression, mixed episodes or any episodes but not mania, while patients with 9,14 episodes showed a benefit in terms of fewer days spent in hypomania and depression but not in mixed states or mania. Only patients who presented up to 6 episodes showed reduction in time spent in any episode polarity. Conclusion: The number of previous episodes clearly worsens response to psychoeducation, perhaps in a more subtle way than that observed with other psychological therapies. Psychoeducation should be delivered as soon as possible in the illness course, supporting the idea of early intervention. [source] Switching atypical antipsychotics: a reviewACTA NEUROPSYCHIATRICA, Issue 6 2004Pierre Chue Background:, Atypical antipsychotics are increasingly used in the treatment of diverse psychiatric disorders; however, there is little information on the ,why, when, and how' of switching between the different atypical antipsychotics currently available. Objective:, To review the data on switching and atypical antipsychotics. Methods:, A literature search was initially conducted using the key words followed by a search of relevant articles including conference abstracts; relevant pharmaceutical companies were also contacted. Results:, Clinical trial data are limited in terms of parameters measured, and case reports describe specific problems. Few studies are based on real world populations of psychiatric patients over the long-term. Careful patient and drug selections matched to a carefully supervised and appropriate cross titration based upon the pharmacodynamic and pharmacokinetic properties of all of the drugs involved is important to avoid potential complications such as re-emergence or worsening of psychosis and withdrawal, rebound, and emergent phenomena including new or uncovered side-effects. Psychoeducation and involvement of patients and caregivers in the process are also necessary for a successful switch. Conclusion:, Despite the prevalence of switching in real world clinical practice, there is a paucity of data to guide clinicians with respect to effective and safe strategies. There are no criteria defining a successful switch. With the increasing range and formulations of atypical antipsychotics available, there is a rationale for their early use to avoid the practical problems associated with switching from conventional antipsychotics as well as the opportunity to maintain patients on an optimal atypical antipsychotic monotherapy. [source] A Delphi survey of the views of adult male patients with personality disorders on psychoeducation and social problem-solving therapyCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 5 2007Mary McMurran Background,Psychoeducation and social problem-solving therapy are treatment components that work well in tandem for offenders with personality disorders, hence it is worthwhile to maintain and improve their effectiveness. Aim,The aim was to seek patients' views of these therapies to contribute to their development. Method,A Delphi survey was conducted with all 12 male inpatients of a personality disorder hospital treatment unit. Results,Round 1 produced 30 statements for psychoeducation and 59 for social problem-solving therapy to be rated in Round 2. There was consensus at a level of 70% for all items. Both psychoeducation and social problem-solving therapies were viewed as useful by these patients. The men also suggested improvements in psychoeducation, including minimizing the delay between assessment and feedback, provision of reference material, preparation for the work and support afterwards. Areas identified for improvement in social problem-solving therapy included more frequent review of progress, greater consistency of delivery, eliciting problems more effectively, providing reference material, supporting patients in group work, and the development of an advanced therapy. Discussion,A Delphi approach to evaluation of therapies with the people receiving them is not only feasible but seems to offer a practical way of making useful clinical adjustments to the work. Further research with larger samples might usefully focus on whether such an approach enhances treatment compliance. Copyright © 2007 John Wiley & Sons, Ltd. [source] Group cognitive-behavioural therapy vs. group psychoeducation: which is better?ACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2006Om Prakash Jhirwal No abstract is available for this article. [source] Dissonance-based eating disorder prevention program: A preliminary dismantling investigationINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 1 2006Megan Roehrig MA Abstract Objective A dissonance-based program aimed at reducing thin-ideal internalization has been found to significantly decrease levels of bulimic symptoms in young adult and adolescent females. Because this program is multifaceted, containing psychoeducation, counterattitudinal advocacy, and behavioral exposure components, the current study sought to investigate the mechanisms involved in symptom reduction. Method The current study compared the original treatment program with a dismantled version of the full package, which consisted solely of the specific dissonance component (i.e., the counterattitudinal advocacy procedure). Seventy-eight women were randomly assigned to either the full treatment condition or the counterattitudinal advocacy condition. Results Findings suggest that both interventions significantly reduced established risk factors for eating pathology as well as bulimic symptoms at termination and at 1-month follow-up. Conclusion Both treatments appear to be equally effective at reducing eating pathology in at-risk college women. Limitations of the study are discussed, and directions for future research are offered. © 2005 by Wiley Periodicals, Inc. [source] Behavioral treatment of substance abuse in schizophreniaJOURNAL OF CLINICAL PSYCHOLOGY, Issue 8 2009Wendy N. Tenhula Abstract Co-occurring substance use disorders are highly prevalent among individuals with schizophrenia and other serious and persistent mental illnesses (SPMI) and are associated with clinically significant consequences. A multifaceted behavioral treatment called Behavioral Treatment for Substance Abuse in Serious and Persistent Mental Illness (BTSAS) can reduce substance abuse in persons with SPMI. The key treatment strategies in BTSAS include a urinalysis contingency, short-term goal setting, training in drug refusal skills, psychoeducation about the impact of drug use, and relapse prevention training. A case example illustrating the application of BTSAS is presented and relevant clinical issues are discussed. © 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65: 1,11, 2009. [source] Meditation with yoga, group therapy with hypnosis, and psychoeducation for long-term depressed mood: a randomized pilot trialJOURNAL OF CLINICAL PSYCHOLOGY, Issue 7 2008Lisa D. Butler Abstract This randomized pilot study investigated the effects of meditation with yoga (and psychoeducation) versus group therapy with hypnosis (and psychoeducation) versus psychoeducation alone on diagnostic status and symptom levels among 46 individuals with long-term depressive disorders. Results indicate that significantly more meditation group participants experienced a remission than did controls at 9-month follow-up. Eight hypnosis group participants also experienced a remission, but the difference from controls was not statistically significant. Three control participants, but no meditation or hypnosis participants, developed a new depressive episode during the study, though this difference did not reach statistical significance in any case. Although all groups reported some reduction in symptom levels, they did not differ significantly in that outcome. Overall, these results suggest that these two interventions show promise for treating low- to moderate-level depression. © 2008 Wiley Periodicals, Inc. J Clin Psychol 64(7): 1,15, 2008. [source] Family-focused treatment for bipolar disorder in adults and youthJOURNAL OF CLINICAL PSYCHOLOGY, Issue 5 2007Chad D. Morris Levels of familial expressed emotion during an acute episode are consistently associated with rates of recurrence among bipolar patients. This article briefly reviews the evidence for expressed emotion (EE) as a prognostic indicator and then illustrates family-focused treatment (FFT) with adults and adolescents suffering from bipolar disorder. FFT is a time-limited, modularized treatment consisting of psychoeducation, communication enhancement training, and problem-solving skills. Controlled trials indicate that FFT is an efficacious adjunct to pharmacotherapy for patients with bipolar disorder. We describe its recent application to early onset bipolar patients and include a clinical vignette. © 2007 Wiley Periodicals, Inc. J Clin Psychol: In Session 63: 433,445, 2007. [source] Effects of psychoeducation for offenders in a community correctional facilityJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 5 2004Albert K. Liau The present study provided a randomized outcome evaluation of the psychoeducational component of the EQUIP program. The psychoeducational curriculum was implemented in a community correctional facility for adult felony offenders. The psychoeducational curriculum is designed to remedy offenders' delays in moral judgment maturity, social cognitive distortions, and social skill deficiencies. The participants were 316 felony offenders, 71% male, aged 18 to 61 years. Relative to a control group, participants who received portions of the curriculum reported fewer serious institutional violations. Female, but not male participants, who received the curriculum were less likely to recidivate than those in the control group at six months. Reductions in mediating factors,cognitive distortion for males and social skills for females,were associated with fewer serious institutional violations. Levels of substance abuse, exposure to violence, and number of serious violations were found to predict recidivism at six months. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 543,558, 2004. [source] Integrating family therapy in adolescent depression: an ethical stanceJOURNAL OF FAMILY THERAPY, Issue 3 2009Glenn Larner Adolescent depression, particularly where suicidal behaviour is involved, is a complex and pressing mental health problem and demanding for families, therapists and services alike. This article reviews the evidence-based literature for adolescent depression including family therapy approaches. It suggests an integrative treatment approach that includes individual psychological treatment like CBT, medication where required and a family therapy intervention is supported by the literature. The focus of the latter is psychoeducation, building resilience and hope, enhancing communication, reducing relational conflict between parents and adolescents and addressing attachment and relationship issues. A systemic framework for integrating family therapy in the evidence- based treatment of adolescent depression is described. This is based on an ethic of hospitality towards different languages of therapy, which is illustrated by a detailed example from family therapy practice. [source] Understanding families in their own context: schizophrenia and structural family therapy in BeijingJOURNAL OF FAMILY THERAPY, Issue 3 2002Lawrence Hsin Yang Evidence from a number of family intervention strategies demonstrates a beneficial impact on the course of schizophrenia. It appears that different family interventions have generic features that aid the patient to avoid relapse and improve functioning. A significant challenge for researchers is to modify these generic strategies to be sensitive to different cultural groups in order to ensure their effectiveness. Chinese culture, with its distinct cultural norms governing family interaction and intense stigma towards the mentally ill, would seem to raise a particular challenge. This paper offers an account of an eclectic model of structural family therapy that incorporates psychoeducation and behavioural treatments for schizophrenia as a theoretical guide to working in a cross,cultural context. A Beijing family, consisting of parents and their daughter with schizophrenia, were seen for sixteen months during a trial of family intervention in China. Through structural family concepts, China's sociocultural context of treatment resource constraints, population policy and stigma are examined and the impact of the illness on family organization is explored. [source] Symptom comparison across multiple solicitation methods among Burundians with traumatic event histories,JOURNAL OF TRAUMATIC STRESS, Issue 2 2008Peter D. Yeomans Debate continues over whether posttraumatic stress disorder (PTSD) symptoms are more biologically based and therefore relatively universal or are more culturally constructed. This study aimed to describe traumatic stress reactions in a Burundian sample and to investigate the influences of the solicitation method (open-ended questions and standardized measures) and psychoeducation (as a process of acculturation) on symptoms reported. Standardized measures showed that distress was manifested in somatization, anxiety, and depression, and less so in specific PTSD symptoms. Content analysis of open-ended questions revealed frequent material complaints. Prior exposure to Western ideas about trauma was predictive of more severe PTSD symptoms. The implications of the findings are discussed in terms of how methodological and cultural factors may influence posttraumatic reactions in nonindustrialized settings. [source] (631) Chronic Pain Treatment Meta-Analyses: A Mathematical and Qualitative ReviewPAIN MEDICINE, Issue 2 2000Article first published online: 25 DEC 200 Authors: Fishbain DA, University of Miami Comprehensive Pain Center; Rosomoff H, University of Miami Comprehensive Pain Center; Cutler RB, University of Miami Comprehensive Pain Center; Steele-Rosomoff R, University of Miami Comprehensive Pain Center Aim of Investigation: To critically review chronic pain treatment meta-analyses according to defined criteria. Methods: An extensive literature search yielded 22 meta-analyses dealing with pain. The following inclusion criteria were applied to these studies: (1) nonsurgical pain treatment outcome only, including nerve blocks; (2) chronic pain treatment outcome only; (3) nonmalignant pain only and; (4) study data presenting an effect size which enabled the calculation of a confidence interval (CI). These inclusion criteria selected 16 studies from the original group. These remaining meta-analyses were then divided into 3 categories: (1) General pain facility treatment (n = 4); (2) Headache treatment (n = 5) and; (3) Specific treatment types, eg, manipulation, psychoeducational, antidepressant, etc. (n = 7). Within each meta-analysis the data was subdivided according to type of pain, treatment type and outcome variable. The CI was then calculated for each of these subdivisions within each meta-analysis. The quality of the 16 meta-analyses was also investigated according to 20 meta-analysis criteria previously presented in the literature. Results: (1) Overall, the pain facility treatment meta-analyses were remarkably consistent in demonstrating that pain facility treatment is effective for most treatment outcome variables. (2) Within pain facility treatments, biofeedback, cognitive therapy, operant conditioning, and package treatment were demonstrated to be efficacious. (3) Within the headache treatment meta-analyses, both relaxation/biofeedback and various medications were demonstrated to be efficacious. (4) Within the specific isolated treatments group, psychoeducation, antidepressants, capsaicin and spinal manipulation were found to have efficacy, for a number of treatment outcome variables. (5) The quality of the meta-analyses was variable but acceptable, according to the meta-analysis criteria utilized. Conclusions: Overall the results of the reviewed meta-analyses indicate that most treatments are effective for most pain patients but that some treatments appear to be more effective than others. [source] Psychoeducation for Survivors of TraumaPERSPECTIVES IN PSYCHIATRIC CARE, Issue 3 2007Bethany J. Phoenix RN PURPOSE.,Education about the persistent effects of trauma helps survivors better understand their own stress responses, and knowledge of coping strategies provides a sense of control over these responses. Trauma education for providers can minimize negative countertransference and prevent vicarious traumatization. CONCLUSIONS.,This article discusses content areas to be covered in psychoeducation with survivors of acute traumatic events and prolonged trauma and abuse, and reviews resources for trauma psychoeducation with clients and healthcare providers. PRACTICE IMPLICATIONS.,Advanced practice psychiatric nurses may provide psychoeducation to people who suffer from complex psychological and behavioral disturbances related to severe and persistent abuse or trauma, especially early in life. [source] Effect of a family psychoeducational program on relatives of schizophrenia patientsPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 4 2008Satoko Sota Aims:, Family psychoeducational programs have been shown to be effective in terms of knowledge acquirement and relapse prevention, but few studies have looked at whether one mode of educational method is more effective than another. The aim of the present study was to compare several modes of educational approaches and to elucidate which mode of education is more effective. Methods:, A total of 110 relatives of 95 patients with schizophrenia received three types of family psychoeducational programs between January 1995 and September 2003: a small group with two sessions (P1), a large group with nine sessions (P2), and a large group with five sessions (P3). In addition to the demographic data, acquired knowledge was measured using the modified Knowledge About Schizophrenia Interview (KASI), family expressed emotion (EE), and relapse episodes. Results:, Overall there were significant increases in many KASI subcategory scores after the three programs, in mothers in particular. The change in KASI scores indicated that the low EE group was able to be highly educated and that the relatives of non-relapsers were more effectively educated. As for the mode of the family psychoeducational program, the P1 and P2 groups surpassed the P3 in terms of knowledge acquired. Conclusions:, Effects of family psychoeducation may depend not on the number of members or sessions but on the time spent on the program per member. [source] Direct effects of short-term psychoeducational intervention for relatives of patients with schizophrenia in JapanPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2006HAJIME YAMAGUCHI md Abstract, This study examined the direct effects of short-term psychoeducation on relatives of inpatients with schizophrenia, with the goal of introducing this type of support program into standard care. The subjects were 46 relatives of inpatients with schizophrenia who attended three or four sessions of psychoeducation. Levels of anxiety and subjective burden and distress were measured before and after sessions using self-administered rating scales. In addition, levels of expressed emotion were also measured. Results showed that both state and trait anxiety on the State-Trait Anxiety Inventory were significantly lower after psychoeducational intervention than before intervention. In addition, subjective burden and distress reported by the family significantly decreased on the subscales for family confusion resulting from a lack of knowledge of the illness and anxiety about the future, subjective burden and depression resulting from the patient's illness, and difficulties in the relatives' relationships with the patient. Comparison of high and low expressed emotion families showed that the intervention was almost equally effective for the two groups. However, its effectiveness with regard to the subjective burden and depression experienced by the families was significantly greater among high expressed emotion families. The present study confirmed that family psychoeducation during hospitalization, even for a short period, is effective for all families, whether high or low expressed emotion. Moreover, the results suggested that the intervention may have a greater effect on emotional factors in high expressed emotion families than in low expressed emotion families. [source] Where is help sought for depression or suicidal ideation in an elderly population living in a rural area of Japan?PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2004SHINJI SAKAMOTO phd Abstract, Although suicide is increasingly becoming a social problem in Japan, especially among the elderly, little early intervention or suicide prevention is done. A project was begun which, since 1999, has aimed to detect depression at an early stage as a suicide prevention measure in a model area of Town A, which had a high suicide rate. In order to promote early intervention and prevention in a community, it is important to know where residents seek help if they become depressed or have suicidal ideation. Therefore, in the present study, help-seeking behavior using case vignettes was investigated. Data from 230 residents (82 men, 148 women) in the model area of Town A, aged 65 or over, were analyzed in the present study. If participants were unable to answer by themselves due to physical condition, public health nurses read out each item and wrote in their answers. The relationship between help-seeking behavior and demographic variables, psychosocial variables, depressive symptoms and so forth, were examined. The results show that participation in mental health workshops facilitated consultation with specialists (e.g. primary care doctors and nurses). The expected effects of psychoeducation on the general public and specialists were considered. [source] Methodological issues in the recruitment of cancer pain patients and their caregiversRESEARCH IN NURSING & HEALTH, Issue 3 2006Sean Ransom Abstract Published pain management guidelines recommend that caregivers of cancer pain patients be provided pain management education, but little is known about the utility of providing such information. This study examined recruitment and retention of cancer pain patients and caregivers for a randomized clinical trial that provided psychoeducation and stress management training to caregivers. Of 397 patient/caregiver dyads screened, only 22 (5.5%) were study eligible, consented to participate, and completed the study. A variety of problems hampered successful participation, including a high proportion of non-cancer-related pain syndromes among patients, a high proportion of patients without caregivers, and participants' perception of study burden. Results suggest that researchers should recruit from a broad patient base and limit study burden on participants. © 2006 Wiley Periodicals, Inc. Res Nurs Health 29:190,198, 2006 [source] Interventions to reduce the burden of caregiving for an adult with dementia: A meta-analysis,RESEARCH IN NURSING & HEALTH, Issue 5 2001Gayle J. Acton Abstract Because of conflicting results, in order to clarify the state of the science it was necessary to do a systematic analysis of the literature on research testing the effect of interventions on the burden of persons caring for family members with dementia. The purpose of this study was to evaluate, using meta-analytic techniques, those intervention strategies (support group, education, psychoeducation, counseling, respite care, and multicomponent) designed to help caregivers cope with the burden of caregiving. Using meta-analytic methods developed by Glass, McGraw, and Smith (1981) and Hedges and Olkin (1985), 24 published research reports testing 27 treatments for caregivers of adults with dementia were synthesized. Overall, the analysis showed that collectively the interventions had no effect on caregiver burden. Only the category of multicomponent interventions significantly reduced caregiver burden. Burden may be too global an outcome to be affected consistently by intervention. Better and more precise measures are needed to evaluate the effects of caregiver interventions properly. © 2001 John Wiley & Sons, Inc. Res Nurs Health 24:349,360, 2001 [source] Prevention of relapse and interventions for enhancing medication adherence in schizophrenia: An East Asian perspectiveASIA-PACIFIC PSYCHIATRY, Issue 2 2010Salleh Mohd Razali MPM FAMM Abstract Introduction: Studies investigating the efficacy of interventions for improving treatment non-adherence in schizophrenia have generated contrasting findings. The present review examined psychosocial interventions for improving medication adherence and prevention of relapse among patients with schizophrenia in developing countries in the Asia-Pacific. Methods: The relevant literature and systematic review were identified by computerized searches using keywords, and hand-searched for other selected articles. Results: The reasons for poor medication adherence were complex and heterogenous. Psychoeducation programs alone are ineffective in achieving good medication adherence because they do not lead to attitudinal and behavioral changes. The greatest improvement in adherence was seen with interventions employing a combination of educational, behavioral and cognitive strategies. Unfortunately, few relevant studies from this region were found. There were some interventions related to psychoeducation and compliance therapy (CT) that were successfully conducted by nurses. Patients in developing countries generally had better family support, but strong stigma towards mental illness and interference by traditional healers led to poor treatment adherence. Lack of facilities and shortage of medical professionals aggravated the situation. Discussion: Intervention to improve treatment adherence and prevention of relapse among patients with schizophrenia should be incorporated into existing psychiatric services. Adherence to treatment in patients with schizophrenia could be improved if continuously supported and monitored by caregivers and treating doctors, to facilitate a change in the patient's attitude. Paramedical personnel, such as psychiatric nurses, could be actively involved in intervention programs because of the shortage of medical professionals in this region. [source] Psychological therapies in bipolar disorder: the effect of illness history on relapse prevention , a systematic reviewBIPOLAR DISORDERS, Issue 5 2009Dominic H Lam Objectives:, Despite some encouraging outcomes and shared components of psychological therapies specific to bipolar disorders, not all studies found conclusively that the addition of a psychosocial intervention to pharmacological interventions improves outcomes. There was some tentative evidence from post hoc analyses that patients with more than 12 previous episodes did not benefit from psychoeducation or cognitive therapy. This paper presents a systematic review and meta-analysis which examines the overall efficacy of bipolar disorder-specific psychological therapies and the impact of the number of previous episodes on the efficacy of psychological therapies in relapse prevention. Methods:, Systematic literature searches of electronic databases and reference lists of existing reviews were carried out. The number of participants experiencing relapse in randomized, controlled studies was combined in a meta-analysis to determine the overall treatment effect in relapse prevention. Metaregression modeling was used to examine whether the number of previous episodes confounded the number of relapses experienced by participants by the end of treatment. Results:, Meta-analysis of relapse calculated an overall relative risk of 0.74 [95% confidence interval (CI): 0.64,0.85] with some heterogeneity present (I2 = 43.3%). Metaregression of six studies showed no relationship between number of episodes and number of relapses by endpoint. Conclusion:, Psychological therapy specifically designed for bipolar disorder is effective in preventing or delaying relapses in bipolar disorders, and there is no clear evidence that the number of previous episodes moderated the effect. [source] Psychoeducation in bipolar patients with comorbid personality disordersBIPOLAR DISORDERS, Issue 4 2004Francesc Colom Background:, The co-occurrence of personality and bipolar disorders is quite common. Bipolar patients with personality disorders have been described as having poorer outcome than ,pure' bipolar patients. However, from a combined-approach point of view, a little has been done to improve the course of these patients. Psychoeducation has shown its efficacy in the prevention of relapses in the bipolar population but, to date, no data is available on its efficacy in the management of bipolar patients with personality disorders. Method:, The present study shows a subanalysis from a single-blind randomized prospective clinical trial on the efficacy of group psychoeducation in bipolar I patients. Bipolar patients fulfilling DSM-IV criteria for any personality disorder were randomized to either psychoeducational treatment or a non-structured intervention. There were 22 patients in the control group and 15 in the psychoeducation group. All patients received naturalistic pharmacological treatment as well. The follow-up phase comprised 2 years where all patients continued receiving naturalistic treatment without psychological intervention and were assessed monthly for several outcome measures. Results:, At the end of the follow-up phase (2 years), a 100% of control group patients fulfilled criteria for recurrence versus a 67% in the psychoeducation group (p < 0.005). Patients included in the psychoeducation group had a higher time-to-relapse and a significantly lower mean number of total, manic and depressive relapses. No significant differences regarding the number of patients who required hospitalization were found but the mean duration of days spent in the hospitalization room was significantly higher for the patients included in the control group. Conclusion:, Psychoeducation may be a useful intervention for bipolar patients with comorbid personality disorders. Further studies should address the efficacy of specifically tailored interventions for this common type of patients. [source] Psychotherapy for bipolar depression: a phase-specific treatment strategy?BIPOLAR DISORDERS, Issue 1 2001Holly A Swartz Objectives: The depressive phase of bipolar disorder is particularly difficult to treat. Pharmacologic strategies for bipolar depression are often inadequate. We therefore review the literature on the role of psychotherapy as an adjunct to medication in the treatment of bipolar depression. Methods: With one exception, there are no descriptions of psychotherapies employed specifically for the treatment of bipolar depression. We therefore reviewed published reports of psychotherapy for bipolar disorder in general and extracted from these reports relevant data or impressions about the specific effects of the therapies on the depressive phase of the disorder. Results: Described psychosocial approaches to bipolar disorder include psychoeducation, group therapy, cognitive-behavioral therapy, couples therapy, family therapy, and interpersonal psychotherapy. Only cognitive-behavioral therapy has been tested in a pilot study for the treatment of bipolar depression specifically. Results from randomized controlled trials of family therapy and interpersonal and social rhythm therapy suggest that these treatments may be more efficacious in the treatment and prevention of depression relative to mania. Conclusions: A limited number of well-designed studies and preponderance of case reports limit definitive conclusions about the role of psychotherapy in the treatment of bipolar depression. However, converging reports suggest that cognitive-behavioral therapy, family therapy, and interpersonal and social rhythm therapy may be particularly useful for bipolar depression. We propose a novel approach to the treatment of bipolar disorder that includes the use of phase-specific sequenced psychotherapies delivered in variable patterns and linked to fluctuating mood states. [source] | |||||||||||||||||||||||||