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A psychoeducational group is a group therapy group conducted by a mental health professional that educates clients about their disorders and ways of coping. Psychoeducational groups utilize the group therapy process, where clients share their concerns and struggle with recovery with the group and facilitator comparable to other substance abuse groups. However, a key difference between psychoeducational groups compared to substance abuse therapy groups is the injection of materials to help convey significant information to the clients.
The introduction of materials into the psychoeducational group helps to make the group not only a safe place for clients to process their feelings and struggles, but it adds a strong educational component. Some of the material used in a psychoeducational group include sheets with statistical information, videos, handouts, books, curriculum, and even guest speakers. These materials enable the client to see statistics, see written examples, read about others’ recovery details, have materials to study, and see other people sharing their stories including their ups, downs, consequences, and triumphs of recovery. These materials help to increase a participant’s self-awareness of their choices.
Psychoeducational groups help the counselor have a topic with an agenda including activities. These groups are particularly valuable because they can provide resources that may aid in recovery, knowledge related to their affliction, and information to become more self-aware of the consequences of their condition.
The History of Psychoeducational Groups
According to Wikipedia, “The concept of psychoeducation was first noted in the medical literature, in an article by John E. Donley “Psychotherapy and re-education” in The Journal of Abnormal Psychology, published in 1911. It wasn’t until 30 years later that the first use of the word psychoeducation appeared in the medical literature in the title of the book, The psychoeducational clinic by Brian E. Tomlinson. (New York, NY, US: MacMillan Co.) published in 1941. In French, the first instance of the term psychoéducation is in the thesis “La stabilité du comportement” published in 1962.
The popularization and development of the term psychoeducation into its current form is widely attributed to the American researcher C.M. Anderson in 1980 for the treatment of schizophrenia. Her research concentrated on educating relatives about the symptoms and the process of schizophrenia. Also, her research focused on the stabilization of social authority and improving the handling of family members among themselves.
Finally, Anderson’s research included more effective stress management techniques. Psychoeducation in behavior therapy has its origin in the patient’s relearning of emotional and social skills. In the last few years, increasingly systematic group programs have been developed, to make the knowledge more understandable to patients and their families.
The premise of Psychoeducational Groups
According to the research conducted by E.P. Lukens in 2004, “Psychoeducation has the potential to extend the impact of care provision well beyond the immediate situation by activating and reinforcing both formal and informal support systems (Caplan & Caplan, 2000; Lundwall, 1996; Pescosolido, Wright, & Sullivan, 1995) and teaching individuals and communities how to anticipate and manage periods of transition and crisis. If developed and implemented carefully, following specified guidelines for delivering and documenting evidence-based practices (Task Force on Promotion and Dissemination of Psychological Procedures, 1995).
“… Psychoeducational interventions have far-reaching application for acute and chronic illness and other life challenges across levels of the public health, social and civic services, and/or educational systems.” – E.P. Luken
Who Can Benefit From Psychoeducational Groups
Clients from diverse ethnic, racial, cultural, social-economic, educational, gender, age, religious, and sexual orientations can all be helped with psychoeducational groups. Psychoeducational groups embrace the diversity of their clients while focusing on the specific issue or mental health concern for a particular psychoeducational group. Psychoeducational groups make the topic the identified common equivalent. This helps to put everyone on the same playing field in regards to the participants being able to trust that everyone in the group has a basic understanding and knowledge base for what the other members are experiencing. Psychoeducational groups can be utilized to help clients in multiple areas of mental health.
Psychoeducational groups include helping individuals with:
- Phobias
- Mental Illness
- Substance Abuse
- Domestic Violence
- Trauma Survivors
- Weight Loss
- Chronic Physical Disease
- Anger Management
- Grief
- Criminal Behavior
Psychoeducational Groups Topics
Psychoeducational groups focus on sharing information on a particular topic and/or teaching skills to the clients in the group. The members of the group are all working and/or healing from the same concern. They are struggling with equivalent issues. This commonality helps the group members to connect and relate better to each participant in the group. In psychoeducational groups, the counselor has the role of an instructor and not just the therapist. The therapist has a more active role in the therapeutic process which includes not only providing a topic for each group but having supplementary materials to educate, show examples and engage the clients in a supportive, therapeutic and educational manner. Topics covered in psychoeducational groups can vary depending on the group type.
Psychoeducational Group Topics That Can be Included in Most Groups Include:
- Positive thinking skills
- Anger management
- People skills or soft skills
- Conflict management
- Visualization activities
- Choice points
- Communication
- Stress management
- Forgiveness
- Interpersonal communication
Psychoeducational Group Topics for Substance Abuse Clients can include:
- Triggers
- People, places, and things
- Idle time
- The 12 steps
- Self-care
- Support systems
- Short and long-term goals
Psychoeducational Group Topics for Grief Clients can include:
- The stages of grief
- Coping with loneliness
- Coping with loss
- Dealing with unmet expectations
- Planning a new future
- Saying goodbye to a loved one
- How to honor a loved one’s memory
Psychoeducational Group Topics For Social Phobia (Social Anxiety Disorder) Clients Can Include:
- Education on the particular phobia topic
- Decrease shame
- Anxiety
- Friendship formation and maintenance
- How to go from avoidance to approach
- Practice social skills
- Small talk role-plays
- Identify and pursue valued social goals
Psychoeducational Group Topics For Domestic Violence Clients Can Include:
- Understanding power and control
- Isolation
- Fear
- Financial freedom
- Parent relationships
- Trust
- Self-forgiveness
- Rebuilding social connections
- Freedom
- Safety planning
- Love does not hurt
- Seeking advocacy
Psychotherapy Notes
Most psychotherapists keep some sort of psychotherapy notes but many professionals do not know the definition, purpose, or legal protections behind what they are writing down. Here is everything you ever wanted to know about psychotherapy notes.
What is a Psychotherapy Note?
The definition of a psychotherapy note is largely legal. According to the Department of Health and Human Services, the definition of psychotherapy notes are as follows: “notes recorded (in any medium) by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual’s medical record. Psychotherapy notes excludes medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: Diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date” (USDHSS HIPAA Administrative Simplification, 2013)
Unofficially, psychotherapy notes are private notes kept by a therapist that is not meant for public consumption. Some people call them to process notes. They are a therapist’s unofficial thoughts, feelings, and hypotheses regarding a client. They do not include identifying information or formal diagnostic information. Most often, they would be taken during a session or right after a session so the therapist accurately remembers what they wanted to say while the session is fresh in his or her mind.
Psychotherapy Notes vs Progress Notes
A progress note is a note of public record. Although there is no absolute rule of what should be included in it, many people follow the Subjective, Objective, Assessment, and Plan (SOAP) note format (Lew & Ghassemzadeh, 2019). Generally, as a psychotherapist, you would want to include a diagnosis, symptoms, interventions, and a summary of the client’s progress.
Despite the difference between progress notes and psychotherapy notes, many therapists use them interchangeably. While hospitals and large agencies may have specific rules to follow regarding notes, therapists in smaller agencies and private practice are not subject to those rules. They may only ever create one set of notes and not distinguish between psychotherapy and progress notes. This is a personal therapist decision but privacy concerns need to be considered.
HIPAA and Psychotherapy Notes
The Health Insurance Portability and Accountability Act (HIPAA) offers large protections for psychotherapy notes compared to progress notes. Generally, psychotherapy notes cannot be shared with others if the therapist does not wish to share the information with them. The client (or the client’s parent if the client is a minor) is not even privy to what a therapist writes down in their psychotherapy notes. On the other hand, with a client’s permission, progress notes are allowed to be shared with others. In some states, client consent is not even necessary. For instance, office staff may be able to access the information in a progress note without client approval.
It is important to note that protections for psychotherapy notes include insurance companies. At times, insurance companies will want to audit your records to see if they want to pay for—or continue to cover—mental health services for particular clients. Under HIPAA, you may be required to give them your progress notes, but you are protected from having to share your psychotherapy notes.
Despite the protections afforded to psychotherapy notes, they can still be made public under certain situations. The court can order that the notes are necessary for a legal case or they can be divulged under the threat of public safety. Although it would take a more extreme case to have psychotherapy notes released against a therapist’s will, no psychotherapy note is truly private.
Important Consideration for Psychotherapy Notes
1) Even with psychotherapy notes, which have many HIPAA protections, you want to be careful with what you put into them. As mentioned above, no note is entirely confidential. You want to feel free to take down relevant notations but watch for incriminating information. A good rule is to never put down any information you would not want a judge or the police to be able to see.
2) Some therapists develop their shorthand for psychotherapy notes so they do not have to worry as much about someone else getting a hold of their contents.
3) Psychotherapy notes should be kept separate from progress notes. If psychotherapy notes are kept in the official record, it is not possible to keep them private; it can be argued that they are part of the official record and they will not be protected under the same laws as psychotherapy notes.
4) State laws and HIPAA statutes may differ when it comes to privacy (Zur, 2019). In those cases, whichever is more protective of client privacy should be followed. For example, if HIPAA says that you can disclose subpoenaed records without client permission and the state law says you need client authorization, then you follow the state law.
5) If your psychotherapy notes are subpoenaed that does not necessarily mean you have to hand them over (APA, 2016). You can take the following actions to attempt to keep them from becoming public.
- Negotiate with the person requesting your notes. This is likely a lawyer. No rule says you can’t contact the lawyer and negotiate with them. It may not always work but it is worth a try.
- File a motion to quash. This is a formal request you make to the court to prevent having to provide the requested information. You will state the reasons you feel the information should not be shared.
- File a protective order. This is somewhat of a compromise. You agree that you will provide the requested information but you want to define who is allowed access to it. It is an attempt to limit any negative consequences of having the information disclosed.
- Make sure the request for records weights the court behind it. In certain states, a lawyer can write a subpoena that might not hold up when challenged.
