Psychotherapeutic Potential of Psychoeducation in the Rehabilitation of Patients with Schizophrenia Spectrum Disorders

34

Abstract

Relevance. Having arisen in routine psychiatric practice to help a patient with schizophrenia spectrum disorders (SSDs), and then his relatives, in building understanding of the illness and ways of coping with it, psychoeducation not only approved the status of a stand-alone method of therapy, but also proved its effectiveness and expediency of use. Gradually, sдeveral models of psychoeducation emerged: informational, supportive, motivational, and a model of teaching skills to cope with illness. The aim. The article contains descriptions of these models, examples of programs and data on their effectiveness. Results. Psychoeducation in modern conditions has become a mandatory element of extensive treatment and rehabilitation programs for patients with SSDs; it is combined with other types of psychotherapeutic interventions, equipped with new and unexpected practices, and is actively developing. Conclusion. The article substantiates the conclusion that improving and developing program options and increasing their accessibility largely determines the effectiveness of mental health services and provides a personalized approach to patients with SSDs.

General Information

Keywords: psychoeducation, psychosocial rehabilitation, schizophrenia spectrum disorders (SSDs), psychotherapy

Journal rubric: Research Reviews

Article type: scientific article

DOI: https://doi.org/10.17759/cpp.2024320306

Received: 06.05.2024

Accepted:

For citation: Palin A.V. Psychotherapeutic Potential of Psychoeducation in the Rehabilitation of Patients with Schizophrenia Spectrum Disorders. Konsul'tativnaya psikhologiya i psikhoterapiya = Counseling Psychology and Psychotherapy, 2024. Vol. 32, no. 3, pp. 96–115. DOI: 10.17759/cpp.2024320306. (In Russ., аbstr. in Engl.)

References

  1. Burygina L.A. Sravnitel'naya effektivnost' medikamentoznogo i kompleksnogo medikamentozno-psihoobrazovatel'nogo podhodov pri okazanii ambulatornoj pomoshchi bol'nym paranoidal'noj shizofreniej s chastymi obostreniyami (recidivami): diss. … kand.med.nauk. M., 2013. 149 p.
  2. Karpenko O.A. Vliyanie psihoobrazovaniya na komplaentnost' pacientov s pervym psihoticheskim epizodom v usloviyah stacionara. ZHurnal nevrologii i psihiatrii im. S.S. Korsakova, 2020, vol. 120, № 6 (2), pp. 92-98. DOI: 10.17116/jnevro202012006292
  3. Karpenko O.A. Psihoobrazovanie pacientov s pervym psihoticheskim epizodom, gospitalizirovannyh po neotlozhnym pokazaniyam: diss. … kand.med.nauk. M., 2021. 163 p.
  4. Kuznecov S.YU. Metakognitivnyj trening u pacientov s paranoidnoj formoj shizofrenii i shizoaffektivnym rasstrojstvom v usloviyah dnevnogo stacionara: diss. ... kand.med.n. – Moskva, 2023. 211 p
  5. Movina L.G., Papsuev O.O., Golland E.V., Kuznecova O.G., Fursov B.B. O rabote otdeleniya vnebol'nichnoj psihosocial'noj reabilitacii, Social'naya i klinicheskaya psihiatriya, 2012, vol. 22, № 3, pp. 93-98.
  6. Palin A.V., Rychkova O.V. Rannie psihosocial'nye vmeshatel'stva u bol'nyh s shizofreniej – uslovie effektivnosti lechebno-reabilitacionnogo processa. Social'naya i klinicheskaya psihiatriya, 2020, vol. 30, № 2, pp. 96-103.
  7. Semenova N.D., Gurovich I.YA. Modul' formirovaniya motivacii k reabilitacii bol'nyh shizofrenieji rasstrojstvami shizofrenicheskogo spectra. Social'naya i klinicheskaya psihiatriya, 2014, vol. 24, № 4, pp. 31-36.
  8. Semenova N.D., Kuz'menko A.YU., Kostyuk G.P. Psihoobrazovanie: problemy i napravlenie issledovanij. Obozrenie psihiatrii i med. Psihologii, 2016, № 4, pp. 3-11.
  9. Takkueva E.V Ocenka effektivnosti integrativnoj programmy motivacionnogo treninga (IPMT) u bol'nyh shizofreniej, prohodyashchih lechenie v stacionare psihiatricheskoj bol'nicy, i u prozhivayushchih v PNI. Konsul'tativnaya psihologiya i psihoterapiya, 2023, vol. 31, № 1, pp. 31—57.
  10. Takkueva E.V., Holmogorova A.B., Palin A.V. Konsolidaciya dostizhenij organizacionnoj i klinicheskoj psihologii v reabilitacii bol'nyh shizofreniej: integrativnaya programma motivacionnogo treninga, Sovremennaya terapiya psihicheskih rasstrojstv, 2019, № 1, pp. 38—48.
  11. Holmogorova A.B., Rychkova O.V., O.D. Pugovkina O.D., Moskacheva M.A. Misheni i metody psihologicheskoj pomoshchi pacientam s rasstrojstvami shizofrenicheskogo i affektivnogo spektrov: metod. posobie /Sost. A.B. Holmogorova, O.V. Rychkova, O.D. Pugovkina, M.A. Moskacheva. M. : Neolit, 2016. 96 p.
  12. Shlafer A.M. Metod komplaens-terapii v sisteme lecheniya bol'nyh shizofreniej: diss. ... kand.med.n. Moskva, 2012. 26 p.
  13. Anderson C.M., Hogarty G.E., Reiss D.J. Family treatment of adult schizophrenic patients: a psycho-educational approach. Schizophr Bull, 1980, № 6(3), pp. 500-505. DOI: 10.1093/schbul/6.3.490
  14. Avasthi A., Sahoo S., Grover S. Clinical Practice Guidelines for Cognitive Behavioral Therapy for Psychotic Disorders. Indian Journal of Psychiatry, 2020, № 62 (2), pp. 251-262. DOI: 10.4103
  15. Bäuml J., Froböse T., Kraemer S., Rentrop M., Pitschel-Walz G. Psychoeducation: a basic psychotherapeutic intervention for patients with schizophrenia and their families. Schizophr Bull, 2006, № 32 (1), pp. 1-9. DOI: 10.1093/schbul/sbl017
  16. Bellack A.S., Mueser K.T. Psychosocial Treatment for Schizophrenia. Schizophr Bull,1993, № 19 (2), pp. 317-336. DOI: 10.1093/schbul/19.2.317
  17. Bighelli I., Pitschel-Walz G., Schneider-Thoma J. et al., Psychosocial and psychological interventions for relapse prevention in schizophrenia: a systematic review and network meta-analysis. Lancet Psychiatry, 2021, vol. 8, № 11, pp. 969-980. DOI: 10.1016/S2215-0366(21)00243-1
  18. Bröms G., Cahling L., Berntsson A., Öhrmalm L. Psychoeducation and motivational interviewing to reduce relapses and increase patients' involvement in antipsychotic treatment: interventional study. BJPsych Bull, 2020, № 44(6), pp. 265-268. DOI: 10.1192/bjb.2020.28
  19. Chien W., Cheung E., Mui J., Gray R., Ip G. Adherence therapy for schizophrenia: a randomised controlled trial. Hong Kong Med J, 2019, № 2(1), pp. 4-9.
  20. Chien W., Clifton A., Zhao S., Peer S.L. Peer support for people with schizophrenia or other serious mental illness. Cochrane Database Syst Rev, 2019, № 4. DOI: 10.1002/14651858.CD010880.pub2
  21. Farooq S., Naeem F., Singh S.P. Telling the patients about diagnosis and outcome of schizophrenia: what, when and how? Early Interv Psychiatry, 2016, № 10 (2), 101-112. DOI: 10.1111/eip.12310
  22. Gigantesco A, Pontarelli C, Veltro F; CBGI Italian Study Group. Psycho-educational group therapy in acute psychiatric units: creating a psychosocial culture. An update of spread and effectiveness of a psychosocial intervention in Italian psychiatric wards. Ann Ist Super Sanita, 2018, № 54 (4), pp. 272-283. DOI: 10.4415/ANN_18_04_03.
  23. Greenfeld D., Strauss J.S., Bowers M.B., Mandelkern M. Insight and interpretation of illness in recovery from psychosis. Schizophr Bull, 1989, № 15(2), pp. 245-252. DOI: 10.1093/schbul/15.2.245
  24. Jackson H., McGorry P., Edwards J., et al. Cognitively-oriented psychotherapy for early psychosis (COPE). Preliminary results. Br. J. Psychiatry, 1998, vol. 172, № 33, pp. 93-100.
  25. Keepers G.A., Fochtmann L.J., Anzia J.M., et al. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia. Focus (Am Psychiatr Publ), 2020, № 18(4), pp. 493-497. DOI: 10.1176/appi.focus.18402
  26. Kemp R., Hayward P., Applewaite G., Everitt B., David A., Compliance therapy in psychotic patients: randomised controlled trial. BMJ, 1996, № 312, pp. 345-349.
  27. Loughland C., Cheng K., Harris G., et al. Communication of a schizophrenia diagnosis: A qualitative study of patients' perspectives // Int J Soc Psychiatry, 2015, № 61(8), pp. 729-734. DOI: 10.1177/0020764015576814
  28. Miller W.R., Rollnick S. Motivational interviewing: Preparing people to change addictive behavior. N.Y.: The Guilford Press, 1991. 384 p.
  29. Moritz S., Menon M., Balzan R., Woodward T.S. Metacognitive training for psychosis (MCT): past, present, and future. European Archives of Psychiatry and Clinical Neuroscience, 2023, № 273,  pp. 811-817. DOI: https://doi.org/10.1007/s00406-022-01394-9
  30. Moritz S., Woodward T.S., Burlon M. Metacognitive skill training for patients with schizophrenia (MCT): manual. Hamburg: VanHam Campus Verlag, 2005.
  31. Psychosis and Schizophrenia in Adults: Treatment and Management: Updated Edition, 2014 [Elektroniy resurs]. URL: http://www.ncbi.nlm.nih.gov/books/NBK248060/(accessed 01.08.2014)
  32. Rehabilitation in health systems: guide for action [Elektroniy resurs]. Geneva: WHO, 2019. URL: https://www.who.int/publications/i/item/9789241515986 (accessed 01.08.2014)
  33. Rummel-Kluge C., Kissling W. Psychoeducation for patients with schizophrenia and their families. Expert Rev Neurother, 2008. № 8(7), pp. 1067-1077. DOI: 10.1586/14737175.8.7.1067
  34. Sarkhel S., Singh O.P., Arora M. Clinical Practice Guidelines for Psychoeducation in Psychiatric Disorders General Principles of Psychoeducation. Indian J Psychiatry, 2020, № 62(2), pp. 319-323. DOI: 10.4103/psychiatry.IndianJPsychiatry_780_19
  35. Tandon R., Nasrallah H., Akbarian S., Carpenter W.T. et al. The schizophrenia syndrome, circa 2024: What we know and how that informs its nature. Schizophr Res, 2024, № 264, pp. 1-28. DOI: 10.1016/j.schres.2023.11.015
  36. The WHO special initiative for mental health (‎2019-2023)‎: universal health coverage for mental health [Elektroniy resurs]. Geneva: WHO, 2019. URL: https://apps.who.int/iris/handle/10665/310981 (accessed 01.08.2024)
  37. Veltro F., Falloon I., Vendittelli N., et al. Effectiveness of cognitive-behavioural group therapy for inpatients. Clin Pract Epidemiol Ment Health, 2006, № 21, pp. 2-16. DOI: 10.1186/1745-0179-2-16.
  38. Vigod S.N., Kurdyak P.A., Dennis C.L., et al. Transitional interventions to reduce early psychiatric readmissions in adults: systematic review. British Journal of Psychiatry, 2013, № 202 (3), pp. 187-194. DOI: 10.1192/bjp.bp.112.115030. PMID: 23457182
  39. Wölwer W, Baumann A, Bechdolf A, et al. The German Research Network on Schizophrenia--impact on the management of schizophrenia. Dialogues Clin Neurosci, 2006, № 8(1), pp. 115-121. DOI: 10.31887/DCNS.2006.8.1/wwoelwer
  40. Wood L., Alsawy S. Patient experiences of psychiatric inpatient care: A systematic review of qualitative evidence. Journal of Psychiatric Intensive Care, 2016, № 12(1), pp. 35-43. DOI:10.20299/jpi.2016.001
  41. Xia J., Merinder L.B., Belgamwar M.R. Psychoeducation for schizophrenia. Cochrane Database Syst Rev, 2011, № 6: CD002831. DOI: 10.1002/14651858.CD002831
  42. Zhao S., Sampson S., Xia J., Jayaram M.B. Psychoeducation (brief) for people with serious mental illness. Cochrane Database Syst Rev, 2015, № 9: CD010823. DOI: 10.1002/14651858.CD010823.pub2

Information About the Authors

Alexandr V. Palin, Head of the Department of Medical and Psychological Care, Mental-health Clinic No. 4 named after P.B. Gannushkin, аssistant of the Department of Psychiatry, Moscow, Russia, ORCID: https://orcid.org/0000-0002-9480-731X, e-mail: pavelpalin@yandex.ru

Metrics

Views

Total: 116
Previous month: 46
Current month: 70

Downloads

Total: 34
Previous month: 16
Current month: 18