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Created by Ella Middlemiss
over 7 years ago
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Question | Answer |
Psycho-education (background) | Psycho-education = educating individuals & their families about their mental health disorder - empowers them & also offers coping strategies. +Been shown to improve compliance with treatments as well as reducing relapse. -However, could lead to lower self-esteem & bring feelings of hopelessness. |
Previous research on psycho-education | Mostly focused on low-security or community settings so lack generalisability to patients in high-security settings. High security settings = often patients have more severe symptoms, higher levels of control, loss of freedom, 24 hour care (constantly watched). |
Aim | to study the usefulness of psycho-education within group work for offender patients in a high security forensic hospital setting |
Ppts | 42 male patients detained in Broadmoor high security hospital, most had received a diagnosis of S/Z or a similar disorder. Assessed as being likely to be helped by knowing more about their illness. Referred to as the psycho-education group. |
Problems compared to studies in low-security/ community settings | many patients stayed up to 8 years and readmission was not a measurable outcome |
Outcome measures - quantitative | Relapse measured by medication change. Level of care (high or low dependency ward). Engagement in therapy. Number of violent incidents. |
Outcome measures - qualitative | Semi-structured interviews after the psycho-education sessions - get patients' view of the group work. Questions included asking about the patients' experience of relating to & with group facilitators. |
P.E. sessions themselves | Groups ran for 20 sessions & over a 3-year period 4 different groups were run. Each session was an intervention using psycho-education to focus on S/Z, depression & anxiety. The emphasis was on preventing relapse. |
Content analysis | 4 key themes from interviews identified: What ppts valued & why. What was helpful about the group. Clinical implications. What was difficult/ unhelpful. |
Findings - quantitative | Medication changed little. No SD in number of violent incidents pre and post sessions. Those who completed the group (31 ppts) did engage more with in-ward treatments compared with non-completers. |
Findings - qualitative | (of the completers, 21 were interviewed) Patients valued knowing & understanding their illness & the group sessions allowed them to understand their own symptoms & how other people's experiences were similar. Many reported increased confidence in dealing with their illness, which made them more positive about the future. |
Conclusions | P.E. had a positive impact for the majority of patients. Limited positive change on qualitative measures and problems with retention of the information was highlighted by patients in interviews - suggests a need for booster sessions or further therapy work e.g. CBT. Feedback from patients emphasised the positive impact on their sense of empowerment. Future research should focus on identifying the most effective way of targeting those patients who will benefit positively from this group. |
Strengths | Interviews useful for the sensitive nature of mental health problems & actually helped ppts. Ethical. Semi-structured = more ideographic, in depth & detailed(people more likely to talk than write). Triangulation. Good ecological validity & mundane realism. Longitudinal - can pick up details & changes over time. Good application - shows usefulness of group therapy. |
Weaknesses | Gender bias, small sample - low pop val. Low replicability - semi-structured. Subjective interpretations of qualitative data. High-security patients more likely to lie/ be manipulative to move to lower-security - social desirability. Targets those who are likely to be helped by P.E. - biased & ignores individual differences. Quantitative & qualitative data don't support each other. |
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