Psychoeducational Groups

Abstract

Clients attending psychoeducational groups report that in addition to skills learned and social benefits, the activities reinforce content, assist in establishing healthy milieus, encourage involvement in the group, and assist with the recollection of the topic discussed (Cowls and Hale, Can J Occup Ther 72(3):176–182, 2005).

I valued a lot of the exercises. They were all good introductions to the topic and they also got you involved.

Participant

Appendices

The Case Study of Natalie: Returning to Work Following a Mental Health Disability Leave

Keywords

Anxiety, depression, isolation, return to work

Introduction

The theme of this case study concerns preparing a client for a return to work through developing coping strategies and increasing confidence.

The students’ tasks include:

• 1. Learn about the history of psychoeducational groups

• 2. Learn the concept of group facilitation for psychoeducational groups

• 3. Identify the benefits of using psychoeducational groups versus individual treatment

• 4. Identify how to assess a client’s readiness to participate in a psychoeducational group

Important references are:

Brown N (2011) Psycho-educational groups: process and practice, 3rd edn. Routledge, New York

Champe J, Rubel D (2012) Application of focal conflict theory to psycho-educational groups: implications for process, content and leadership. J Spec Group Work 37:71–90

Cowls J, Galloway E (2009) Traumatic re-enactment in the workplace: assisting clients with depression, anxiety and PTSD return to work successfully. Work 33:401–411

Cowls J, Hale S (2005) It’s the activity that counts: what clients value in psycho educational groups. Can J Occup Ther 72(3):176–182

Furr S (2000) Structuring the group experience: a format for designing psycho-educational groups. J Spec Group Work 25:29–49

Overview of the content:

Major goals of the actual intervention are (a) complete an assessment of Natalie’s occupational performance issues including barriers and component issues, (b) outline appropriate psychoeducational groups for Natalie to attend that will address her current needs, (c) facilitate a variety of psychoeducational groups that will increase self-esteem and develop coping strategies, such as assertiveness, anxiety management, sleep hygiene, work–life balance, and stress management.

Learning Objectives

By the end of studying this chapter, the student will:

• Be able to utilize information from the literature review to apply to the case study

• Be able to use information gained through the case study method to guide clinical reasoning in future clinical situations

• Understand the skills required to effectively create and facilitate psychoeducational groups for clients with mental health concerns

• Create a six-session psychoeducational group on a specific topic, e.g., self-esteem

The Background History of the Clinical Case Study

Personal data:

Natalie is a 49-year-old married woman living in an urban setting. She is currently in her second marriage and has three grown children, all of whom have left the family home. Natalie is employed as a Registered Nurse; however, she has not worked for the past 18 months. Long-term disability is her current income replacement.

Medical diagnoses:

Natalie has been diagnosed with posttraumatic stress disorder, major depressive disorder, and alcohol dependence (in remission). Natalie has been attending 12-step programs and has remained sober for the past 10 months.

Current circumstances:

Natalie has been working as a nurse for the past 12 years with the elderly in a continuing care environment. Following a significant workplace injury, Natalie had to take a leave from work to heal physically. When attempting to return to work gradually , she experienced considerable anxiety dealing with her supervisor and peers. Natalie felt judged and intimidated during her return-to-work process and was unable to stand up for herself. Due to anxiety and persistent physical pain, Natalie had a failed return to work and left for a second time on a sick leave . Following this sick leave , Natalie began to drink wine to numb her difficult feelings and physical pain.

While off on disability, Natalie’s anxiety increased; she did not leave her home during the day, she slept excessively, and isolated herself from friends and family. Memories of earlier abuse have resurfaced through nightmares and flashbacks. Despite having past abusive relationships, Natalie currently lives with her husband who is healthy and supportive.

Natalie was admitted to an inpatient addiction program for 8 weeks where she was diagnosed with major depressive disorder and posttraumatic stress disorder. With 10 months of sobriety behind her, Natalie was referred to an inpatient program for clients with anxiety disorders.

Reason for seeking occupational therapy:

Natalie was referred to an occupational therapist (OT) on the treatment team as she was worried about her ability to return to work. Natalie loves her job and feels that her work contributes to her sense of meaning. She lacks self-esteem and doubts her ability to cope with conflict and her illness symptoms. Natalie worries about experiencing another failed return to work.

Occupational performance issues:

As a caregiver, Natalie focuses constantly on the needs of others before herself. She does not take time for basic self-care, such as healthy sleep or eating three meals a day. Although Natalie used to dance and spend time with her friends, she has spent most of the past 18 months in isolation at home with her husband. Natalie loves her work; however, she is anxious about her ability to perform her duties competently. Barriers for Natalie include poor self-esteem and anxiety. When faced with conflict, Natalie tends to become passive and struggles to find a voice for herself; therefore, she is also worried about her ability to manage the aggressive behavior of her colleagues.

The Student’s Report

The following guided questions have been identified in developing solutions for Natalie. These questions are generated from the available literature references and our clinical experiences:

• 1. What are the major occupational performance issues in this case?

• 2. Is it appropriate to be addressing return-to-work concerns during an inpatient stay?

• 3. What types of psychoeducational groups may be appropriate for Natalie?

• 4. What may be the benefits for Natalie attending group therapy over individual therapy?

• 5. How may the use of activity in the psychoeducational groups be designed to address Natalie’s specific goal of returning to work?