Managing group process in nonprocess groups: Working with the theme-centered psychoeducational group

While there has been a recent proliferation of groups for consultative and psychoeducational purposes, little has been written about using the group process in these nonprocess groups. This paper investigates the management of various group processes in a group whose contracted focus is teaching stress management skills. Distinctions are made between psychotherapeutic and theme-centered psychoeducational process management. Many group processes can be predicted given the group's normal developmental stages, while other ongoing group processes arise spontaneously. A working dialogue between the presented content and the emerging process is necessary in order for psychoeducation to be personalized and most fully assimilated. A clinical vignette follows the evolution of a stress management group conducted for high-level executives who have been identified as manifesting Type-A behaviors. For each session, the format and material content are briefly outlined, the emerging group process is described, and the clinical interventions involved in the process management are discussed.     

Group therapy for eating disorders: A step-wise approach

Group therapy is emerging as a favored treatment for eating disorders. Open-ended psychodynamic group therapy is an effective treatment for the underlying conflicts in eating-disordered patients, yet these groups are difficult to form. The authors suggest a specific sequence using time-limited psychoeducational groups initially for symptom control, then offering an open-ended group for patients who are ready to address deeper issues in a group therapy setting.     

A brief cognitive behavioural therapy psychoeducational group for Chinese people with chronic illnesses: an evaluation study

This pilot study attempted to examine the effectiveness of a brief cognitive behavioural therapy (CBT) psychoeducational group for Chinese people with chronic illness in Hong Kong. It adopted a single group design, and 52 participants joined the group. A questionnaire with three outcome measures, measuring general mental health, quality of life and dysfunctional attitudes and beliefs, was administered to participants at pre-test, post-test and six month follow-up. Repeated measures ANOVAs were employed and revealed positive changes in most of the outcome measures across the three time points. Cohen’s d showed a moderate to large effect size for most outcome measures. From a step care perspective, a culturally attuned brief CBT psychoeducational group may serve as an early intervention and a triage to attract suitable people with chronic illness to engage in the treatment process.     

Steigerung des ?empowerment“ bei Angeh?rigen von schizophren Erkrankten

Objective

Enhancing empowerment is one of the aims of psychoeducational family interventions but it has never been examined in psychoeducational groups for relatives led by professionals. This study investigated the knowledge gain and the increase of empowerment of psychoeducational group programs for relatives in a naturalistic setting.

Methods

A total of 54 relatives of persons with schizophrenia or schizoaffective disorders took part in a psychoeducational group program of 8 sessions. A short questionnaire was used to assess the empowerment before and after the group programs. Knowledge gain was measured with the knowledge of illness about schizophrenia questionnaire (WFB).

Results

Among the participants of the psychoeducational groups the level of empowerment was significantly enhanced and the knowledge was significantly increased (p?<?0.01). The improvement of empowerment was independent of the knowledge gain and did not correlate with gender, age, education or group attendance.

Conclusions

Psychoeducational groups for family members not only reduce the rehospitalization rates of the ill relatives but also have additional positive effects on the family members themselves: better knowledge of the illness and enhanced empowerment. The findings emphasize the importance of psychoeducational groups for the relatives of persons with schizophrenia.     

Introducing the living with illness group: A specialized treatment for patients with chronic schizophrenic conditions

This paper introduces a specialized psychotherapy/psychoeducational group treatment for patients with chronic psychotic symptoms who receive only partial benefit from psychotropic medications, psychotherapy, and milieu/activities therapy. The goal of the group is to assist patients to accurately identify the feelings, thoughts, and behaviors that are dysfunctional symptoms of their disability and then use the functional aspects of their brain as well as learned coping strategies to compensate for their disability. The group format, philosophy, procedures, and typical topics of discussion are detailed.The authors would like to thank Bruce Levine, Ph.D., and Terry Fujeoko, Ph.D., for their assistance with the initial formation of the group. Mr. Howe and Dr. Fujeoko originated the Living with Illness group and began the first group in 1985 at Waterbury Hospital Health Center, Waterbury, CT.     

Impact of Psychoeducational Interventions on Distressed Family Caregivers

This study compared the effectiveness of two active interventions to a waiting-list control condition to reduce depression and burden and increase use of adaptive coping strategies in family caregivers (N = 161) of physically and/or cognitively impaired older adults. Chi-square analysis of change in depression status from pre- to postintervention showed a higher percentage of improvement among participants in the increasing life satisfaction psychoeducational condition compared to the improvement rate in either the problem-solving psychoeducational class or the wait-list condition. Change in coping strategies and subjective level of burden also differed by group, with participants in the class conditions reporting more frequent use of cognitive or behavioral coping strategies, and less subjective burden, from pre- to postintervention. There was no change in either avoidant coping or perceived stress over time. Results show that intervention programs targeted to improve specific coping skills and psychological symptoms can have a significant impact on caregivers' distress.     

Rehabilitating civilian victims of war through psychosocial intervention in Sierra Leone

This research assessed an intervention (involving drug therapy and psychoeducational counseling) for war trauma in Sierra Leone. We examine the impact of the intervention on symptoms of post‐traumatic stress disorder (PTSD) and indicators of intergroup emotions and attitudes. Civilian war victims were drawn from a rehabilitation program (Intervention, N=50) or a waiting list Control group (N=50). The rehabilitation program combined general psychiatric treatment with additional life skills support. Those in the Intervention group had significantly lower PTSD symptoms and also scored lower on Intergroup Anxiety and Outgroup Blame, than those in Control. The intervention had an indirect effect on PTSD symptoms through Intergroup Anxiety. The reduction in PTSD in the intervention was greater for participants with a stronger identification with Sierra Leone.     

A controlled evaluation of group cognitive therapy in the treatment of irritable bowel syndrome

We randomized, at two sites, 210 patients with Rome II diagnosed irritable bowel syndrome (IBS), of at least moderate severity, to one of three conditions: group-based cognitive therapy (CT; n=120), psychoeducational support groups (n=46) as an active control, or intensive symptom and daily stress monitoring (n=44). One hundred eighty-eight participants completed the initial treatment. Those in symptom monitoring were then crossed over to CT. For an intent to treat analysis on a composite GI symptom measure derived from daily symptom diaries, both CT and the psychoeducational support groups were significantly more improved than those in the intensive symptom monitoring condition, but the CT and psychoeducational support group did not differ. Among treatment completers on the same composite measure of GI symptoms, again, both CT and psychoeducational support groups were statistically superior to symptom monitoring but did not differ on the symptom composite, or on any other measure. On individual IBS symptoms, both CT and psychoeducational support were statistically superior to symptom monitoring on reductions in abdominal pain and tenderness and for flatulence. Patient global ratings at the end of treatment showed the two active conditions statistically superior to symptom monitoring on change in Bowel Regularity, with CT superior to symptom monitoring on reduction in overall pain and in improvement in sense of well-being. Three-month follow-up data on 175 patients revealed maintenance of significant improvement or continued significant improvement on all IBS symptoms, including the McGill Pain Questionnaire. Group CT and psychoeducational support groups continued not to differ on any measure. We thus conclude that group CT is not superior to an attention placebo control condition.     

Worried About us: Evaluating an Intervention for Relationship‐Based Anxiety

Although romantic relationships are commonly a source of pleasure and comfort, for some individuals they can be a source of persistent anxiety. The aim of the current investigation was to explore the construct of relationship‐based anxiety and to evaluate the effectiveness of a brief couple‐based psychoeducational session for this issue. Common behavioral patterns and cognitive tendencies seen among individuals with relationship‐based anxiety were examined, including excessive reassurance‐seeking, self‐silencing, and partner accommodation. In the current investigation, a single psychoeducational session was developed to address these maladaptive interactive patterns of behavior specifically. The session was administered to a sample of 21 couples and was found to decrease levels of reassurance‐seeking and self‐silencing significantly among individuals with relationship anxiety, and to decrease levels of maladaptive accommodation behaviors significantly in their partners.     

Treatment Efficacy of Multiple Family Therapy for Chinese Families of Children with Attention Deficit Hyperactivity Disorder

The treatment efficacy of multiple family therapy (MFT) for Chinese families of children with attention deficit hyperactivity disorder (ADHD) has not been studied in the past. In this paper, the effect of MFT on different aspects of the lives of the parents in the experimental group (n = 61) was compared with the effect of only the psychoeducational talks on parents in the control group (n = 53). The results of a MANOVA have shown that by the time they reached the posttreatment phase, the parents who had completed the full 42 hours of the MFT program perceived their children's ADHD symptoms as being less serious and less pathological than they had originally thought compared to the parents in the control group. The effect of MFT on parent–child relationships, parenting stress, parental efficacy, hope, and perceived social support was statistically insignificant. Contributions and limitations of our study are discussed.     

The Prophylactic Mastectomy Dilemma: A Support Group for Women at High Genetic Risk for Breast Cancer

The goal of this pilot study was to test the usefulness of a six session psychoeducational support group for women at high genetic risk for breast cancer who were considering prophylactic mastectomy. The themes of the group sessions included overestimation of and anxiety about risk; desire for hard data; the emotional impact of watching a mother die of breast cancer; concerns about spouse reactions; self- and body image; the decision-making process; and confusion over whom to trust in decision making. Both the participants and the multidisciplinary leaders concluded that as a supplement to individual counseling, a support group is a beneficial and cost-effective treatment modality. Recommendations for the optimal format for such a group are described.     

Group building: Developing protocols for psychoeducational groups

Short-term, focused and targeted groups have become a staple in the mental health field and in the general cultural intervention milieu. This paper presents a model for group building aimed at guiding the group leader in constructing, organizing and ordering such psychoeducational groups. This model is applicable to a range of themecentered groups, addressing a variety of specific symptoms, habits, developmental milestones, organizational problems, or normative life crises. First, the defining characteristics of psychoeducational groups will be discussed. Subsequently, the steps in building group protocols will be outlined, including the use of phase-specific group dynamics and curative variables. To demonstrate the utility and generalizability of the model, two populations with extremely diverse thematic foci, a latency incest and a smoking cessation group, will be used to illustrate the ordering of the group protocol and the building of appropriate didactic structures. This paper is intended as a companion to an earlier one in this journal (Ettin et al., 1987), which considered the management of group process in just these types of nonprocess groups.     

A Pilot Study Assessing the Effectiveness of Equine-Assisted Learning with Adolescents

This study contains an observation of six female participants (N = 6) who completed 8 weeks of a psychoeducational life skills program. The program included psychoeducational sessions that covered life skills related to partnership, respect, boundaries, communication, emotional regulation, problem-solving, and teamwork followed by an Equine-Assisted Learning (EAL) session. A paired sample t-test was conducted to measure the effectiveness of the equine therapy program with the psychoeducation lesson. A mental health professional, equine specialist, and a ranch worker observed and scored participants’ behaviors after each session. A paired-samples t-test was conducted after week 4 and week 7; the results indicated that participants showed improvement in communication, confidence, and respect scores. The participants demonstrated improvements with emotional regulation t(11) = 2.862, p = .015.     

Post-traumatic stress disorder in families

When one or more members of a family are traumatized, the entire family can suffer from post-traumatic symptoms. Unfortunately, this may go unrecognized by the family, friends, and professionals. A cycle of post-traumatic victimization and fragmentation of family integrity can lead to disastrous consequences. The post-traumatic phases leading to such a destructive outcome are discussed in detail. Treatment of the traumatized family should include psychoeducational, psychodynamic, systemic, behavioral and spiritual interventions.     

Ethnic Identity Development and Urban Haitian Adolescents

This experimental study describes the effect of a preventive, psychoeducational, counselor intervention on the ethnic identity development of urban Haitian adolescents. Significant differences were found for gender but not between the control and experimental groups. Boys scored significantly lower (p < .05) than girls on the Multigroup Ethnic Identity Measure. Recommendations are made regarding school as a frontier for the enhancement of healthy minority adolescent development.     

Issues in group work with older lesbians

This article outlines considerations in group interventions with older lesbians. It is intended for mental health professionals who work—as leaders, supervisors, and consultants—with various kinds of groups in their professional practice, including therapy, psychoeducational, support, growth, recreational, and self-help groups. First, unique issues in the life circumstances of older lesbians are addressed. Next, five case examples are presented that illustrate the usefulness of group interventions with this population. The article concludes with recommendations for effective practice.     

A Psychoeducational Group for Adult Children of Alcoholics

The authors describe a campus-based psychoeducational support group for adult children of alcoholics. Group goals are outlined, recruitment procedures identified, and sessions described and evaluated. This successful group format could easily be adapted to other settings and age groups (e.g., high schools, community mental health centers).     

Evaluating a brief prevention program for improving marital conflict in community families.

Marital conflict is related to well-being in children and adults (E. M. Cummings & P. T. Davies, 2002). Marital conflict is likely most effectively ameliorated before it becomes clinically significant. However, families without significant problems may be unwilling to participate in couples therapies or other lengthy or intensive interventions. Responding to this gap, the authors developed a 4-session psychoeducational program about marital conflict for community families. Couples with children 4-8 years of age were randomly blocked into 1 of 3 groups: (1) a parent-only group (n = 24), (2) a parent-child group (n = 33), or (3) a self-study group (n = 33). Pre- and posttest and 6-month and 1-year assessments were conducted. This report evaluates (a) whether participation in a psychoeducational program for parents improved marital conflict, especially concerning ways of expressing disagreements, and (b) whether changes in marital conflict subsequently improved marital satisfaction, parenting, and child adjustment. Greater constructive and less destructive marital conflict was observed at all assessments for treatment groups, and these changes were linked with improvements in other family processes. The findings support the promise of brief, psychoeducational programs for improving marital conflict for community samples.     

A Year's Experiences with a Postpartum Depression Group

The author defines postpartum mood and adjustment disorders, risk factors, symptoms, treatment, and resources. The purpose, goals, themes, and co-leadership issues of a postpartum depression psychoeducational group, offered year-round in an urban community center, are discussed. A vignette from the group is presented to sample its process and content.