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Abstract

Family discouragement, overinvolvement, or high levels of expression of critical emotions can contribute to relapse among persons with serious mental illness, but the opposite seems true as well. When families participate in psychoeducation alone or with other families, they learn skills to help the consumer cope with his or her situation and support the consumer’s recovery. In this systematic literature review of family and consumer psychoeducation, the authors conclude that both interventions empower families and individuals to participate more actively in treatment.

Abstract

Objective

Psychoeducation provides adult consumers who have serious mental illness or co-occurring substance use disorders with information to support recovery. Some models also provide this service to family members. This review examined the evidence base for psychoeducation models in group and individual formats.

Methods

Authors reviewed meta-analyses, research reviews, and individual studies from 1995 through 2012. Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, the Educational Resources Information Center, and the Cumulative Index to Nursing and Allied Health Literature. Authors chose from three levels of evidence (high, moderate, and low) on the basis of benchmarks for the number of studies and quality of their methodology. They also described service effectiveness.

Results

More than 30 randomized controlled trials (RCTs) of consumer psychoeducation and more than 100 RCTs of family psychoeducation provide a high level of evidence for the effectiveness of each model. Reviews of consumer psychoeducation found that experimental groups had reduced nonadherence (primarily with medication regimens), fewer relapses, and reduced hospitalization rates compared with control groups. Some studies found significant improvements in social and global functioning, consumer satisfaction, and quality of life. Multifamily psychoeducation groups (the focus of numerous studies) were associated with significantly improved problem-solving ability and a reduced burden on families, compared with control groups, among other strong outcome effects.

Conclusions

Psychoeducation should be included in covered services. Group and family interventions are especially powerful. Future research should assess psychoeducation models with children and adolescents and with individuals from various racial and ethnic backgrounds.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services

Cover: Marooned, by Howard Pyle, 1909. Oil on canvas. Delaware Art Museum, Museum Purchase, 1912.

Psychiatric Services
Pages: 416 - 428
PubMed: 24445678

History

Published in print: April 2014
Published online: 15 October 2014

Authors

Affiliations

D. Russell Lyman, Ph.D.
Dr. Lyman, Dr. Braude, and Dr. Dougherty are with DMA Health Strategies, Lexington, Massachusetts (e-mail: [email protected]). Dr. George, Dr. Daniels, and Dr. Ghose are with Westat, Rockville, Maryland. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, Maryland. This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
Lisa Braude, Ph.D.
Dr. Lyman, Dr. Braude, and Dr. Dougherty are with DMA Health Strategies, Lexington, Massachusetts (e-mail: [email protected]). Dr. George, Dr. Daniels, and Dr. Ghose are with Westat, Rockville, Maryland. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, Maryland. This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
Preethy George, Ph.D.
Dr. Lyman, Dr. Braude, and Dr. Dougherty are with DMA Health Strategies, Lexington, Massachusetts (e-mail: [email protected]). Dr. George, Dr. Daniels, and Dr. Ghose are with Westat, Rockville, Maryland. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, Maryland. This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
Richard H. Dougherty, Ph.D.
Dr. Lyman, Dr. Braude, and Dr. Dougherty are with DMA Health Strategies, Lexington, Massachusetts (e-mail: [email protected]). Dr. George, Dr. Daniels, and Dr. Ghose are with Westat, Rockville, Maryland. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, Maryland. This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
Allen S. Daniels, Ed.D.
Dr. Lyman, Dr. Braude, and Dr. Dougherty are with DMA Health Strategies, Lexington, Massachusetts (e-mail: [email protected]). Dr. George, Dr. Daniels, and Dr. Ghose are with Westat, Rockville, Maryland. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, Maryland. This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
Sushmita Shoma Ghose, Ph.D.
Dr. Lyman, Dr. Braude, and Dr. Dougherty are with DMA Health Strategies, Lexington, Massachusetts (e-mail: [email protected]). Dr. George, Dr. Daniels, and Dr. Ghose are with Westat, Rockville, Maryland. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, Maryland. This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.
Miriam E. Delphin-Rittmon, Ph.D.
Dr. Lyman, Dr. Braude, and Dr. Dougherty are with DMA Health Strategies, Lexington, Massachusetts (e-mail: [email protected]). Dr. George, Dr. Daniels, and Dr. Ghose are with Westat, Rockville, Maryland. Dr. Delphin-Rittmon is with the Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, Maryland. This article is part of a series of literature reviews that will be published in Psychiatric Services over the next several months. The reviews were commissioned by SAMHSA through a contract with Truven Health Analytics and were conducted by experts in each topic area, who wrote the reviews along with authors from Truven Health Analytics, Westat, DMA Health Strategies, and SAMHSA. Each article in the series was peer reviewed by a special panel of Psychiatric Services reviewers.

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