12.2. Group psychoeducation for forensic long-term patients with schizophrenia

 

Public examination of a doctoral dissertation in the field of psychology
Doctoral candidate: Kati Aho-Mustonen, MA (Psychology)
Time and venue 12.2.2011 at 12 noon, room M100, Metria building, Joensuu Campus

 

Group psychoeducation for forensic long-term patients with schizophrenia

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 we 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/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 with 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, was we also found the psychoeducation group 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.

 

The doctoral dissertation of MA (Psychology) Kati Aho-Mustonen, entitled Group psychoeducation for forensic long-term patients with schizophrenia, will be examined at the Philosophical Faculty. The opponent in the public examination will be Professor Raimo Lappalainen of the University of Jyväskylä, and the custos will be Professor Hannu Räty of the University of Eastern Finland.

For further information, please contact Kati Aho-Mustonen

kati.aho-mustonen (at) uef.fi, +358 13 2515304

Photo available for download at http://www.uef.fi/vaitoskuvat

 

 

Publishing year: 2011

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