EAI's mission is to support people with emotional difficulties in their efforts to live a more manageable life. The EA program aims to improve the quality of life for individuals and families affected by mental health issues. Psychoeducational groups are designed to educate clients about substance abuse and related behaviors and consequences. This type of group presents structured, group-specific content, which is often taught using videotapes, audio cassettes, or conferences. Often, an experienced group leader will facilitate discussions about the material (Galanter et al., 2000).
Psychoeducational groups provide information designed to have direct application in the lives of clients to instill self-awareness, suggest options for growth and change, identify community resources that can help clients in recovery, develop an understanding of the recovery process, and incite people who use substances to take action on their behalf, such as entering a treatment program. While psychoeducational groups can inform clients about psychological problems, they do not aim at intrapsychic change, although these individual changes in thinking and feeling often occur. The primary goal of psychoeducational groups is to expand awareness of the behavioral, medical, and psychological consequences of substance abuse. Another main objective is to motivate the client to enter the stage of preparation for recovery (Martin et al., 2002). Psychoeducational groups are provided to help clients incorporate information that helps them establish and maintain abstinence and guide them to more productive options in their lives.
Main CharacteristicsPsychoeducational groups generally teach clients that they need to learn to identify, avoid, and eventually master specific internal states and external circumstances associated with substance abuse.
Coping skills (such as managing anger or using first-person phrases) that are normally taught in a skill-building group often accompany this learning. Psychoeducational groups are considered a useful and necessary, but not sufficient, component of most treatment programs. For example, psychoeducation can take clients to a precontemplative or perhaps contemplative stage to commit to treatment, including other forms of group therapy. For patients who enter treatment through a psychoeducational group, programs must have clear guidelines about when group members are prepared for other types of group treatment. Often, a psychoeducational group integrates skill development into its program. As part of a larger program, psychoeducational groups have been used to help clients reflect on their own behavior, learn new ways to deal with problems, and increase their self-esteem (La Salvia 1991).
Psychoeducational groups are highly structured and often follow a pre-planned manual or curriculum. Psychoeducational groups must actively work to engage participants in group discussion and encourage them to relate what they are learning to their own substance abuse. Ignoring the problems of the group process will reduce the effectiveness of the psychoeducational component. Group sessions are generally limited to set times, but need not be strictly limited. The instructor often plays a very active role in leading the debate.
While psychoeducational groups have a different format than many other types of groups, they must meet in a quiet, private place and take into account the same structural issues (for example, seating arrangements) that matter in other groups. As with any type of group, adaptations may need to be made for certain populations. Clients with cognitive disabilities, for example, may need special considerations. Psychoeducational groups have also been shown to be effective with clients with co-occurring mental disorders, including clients with schizophrenia (Addington and el-Guebaly 1998; Levy 1997; Pollack and Stuebben 1999). For more information on how to make accommodations for clients with disabilities, see TIP 29, Substance Use Disorder Treatment for People with Physical and Cognitive Disabilities) (CSAT 1998b).
Techniques for Conducting Psychoeducational GroupsTechniques for conducting psychoeducational groups refer to how information is presented and how helping clients incorporate learning so that it leads to productive behavior, a better way of thinking, and emotional change.
Adults who are in the midst of crises in their lives are much more likely to learn through active interaction and exploration than through passive listening. As a result, it is the responsibility of the group leader to design learning experiences that actively engage participants in the learning process. Four elements of active learning can help. Most skill development groups operate from a cognitive-behavioral orientation, although counselors and therapists of various orientations apply skill development techniques in their practice. Many skill development groups incorporate psychoeducational elements into the group process, although skill development may remain the group's primary objective. Skill development groups generally stem from a cognitive behavioral theoretical approach that assumes that people with substance use disorders lack the skills necessary for life.
Clients who rely on substances of abuse as a method of coping with the world may never have learned important skills that others have, or they may have lost these skills as a result of substance abuse. Therefore, the ability to develop new skills or to relearn old ones is essential for recovery. Skill development groups usually have a limited number of sessions. Group size should be limited, with an ideal range of 8 to 10 participants (perhaps more if a co-facilitator is present). The group must be small enough for members to practice the skills being taught.
While skill development groups usually incorporate elements of psychoeducation and support, the main objective is to develop or strengthen behavioral or cognitive resources to better cope with the environment. Psychoeducational groups tend to focus on developing an information base upon which decisions can be made and action taken. Support groups which will be discussed later in this chapter focus on providing the internal and environmental supports to sustain change. Everyone is appropriate in substance abuse treatment. While a specific group may incorporate elements from two or more of these models it is important to keep the focus on the overall objective of the group and link the methodology to that goal. In skill-building groups as in psychoeducation leaders need basic group therapy knowledge and skills such as understanding the ways in which groups grow and evolve knowing the patterns that show how people relate to each other in the group skills to foster interaction etc.