Year: 2011
Type: dissertation
Abstract: The main objectives of the present study were to investigate the feasibility, effects, and patient experiences of group psychoeducation for forensic long-term patients with schizophrenia in a high-security forensic context.The starting point of the research was to develop and modify a suitable psychoeducational program for these often severely ill patients and study its effects both by experimental research design and from the patient's perspective.By focusing on patient perspective and patient feedback it was hoped to get more in-depth information to better understand the process and factors contributing to the outcomes of psychoeducation among these patients.Finally, based on the obtained empirical as well as earlier findings on patient psychoeducation for schizophrenia, a tentative model of the effective factors is presented, defined as information, sharing and support, and participation.The importance of trust and hope in the process of psychoeducation, especially when offered to forensic patients, is highlighted.The data were collected in three phases during the period 2001-2006 at Niuvanniemi Hospital, Finland.First, a small-scale pilot study was conducted.Treatment outcomes were compared between the intervention group (n=7) and a matched treatment as usual control group (n=8).Four years later the experiences of the participants of the pilot group were collected through interviews ( n=6).An exploratory RCT design was then conducted to investigate the efficacy of this group psychoeducation program among forensic patients with schizophrenia (n=39), and at the same time their motives, initial expectations and satisfaction with the intervention were examined.The results suggested that even severely ill patients were able to improve their knowledge of their illness, their self-esteem increased, and psychoeducation also had a positive impact on their awareness of the illness.The results are considered promising, as the patients referred to research had characteristics that ordinarily might have excluded them both from participating in psychosocial group interventions and clinical research.Their opinions of the intervention were for the most part rather positive, which is encouraging because patients had been committed to hospital care against their own will, and consequently their motivation to undergo treatment was often lower than usual.The present set of studies provides information about the feasibility and effects of a group psychoeducation program as a basic component of the comprehensive treatment of challenging forensic patients with schizophrenia.Group psychoeducation could be seen as a low threshold psychosocial intervention, since even severely ill and symptomatic patients were able to join the group.Even when a patient's psychiatric condition does not allow them to participate in more intensive psychosocial rehabilitation efforts or interventions at some point in time, joining group psychoeducation may still be possible, and provide a base for further rehabilitation and recovery.Despite the multiple psychiatric problems among the sample, the psychoeducation group was also found to be feasible among patients with cognitive deficits, and they were able to derive benefits from the group.Future research should focus on the long-term effects of the intervention, and research and development into psychoeducational interventions for these patients should in particular aim at fostering hope, normalizing mental illness, and correcting stigmatizing misconceptions.
Author: Kati Aho‐Mustonen
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3095143218