Groups Psychoeducation Therapy

Psychoeducational groups are a form of group therapy that is less focused on developing relationships between clients, and instead, focused on providing education through information-sharing and the development of healthy coping mechanisms.

Psychoeducational groups provide opportunities for their members to learn about a range of psychological phenomena.

Psychoeducation is a type of group therapy for those seeking help for mental health disorders or addiction. Psychoeducation isn’t always well understood by the public or by those who seek out psychoeducational group therapy. Yet, its premise is very simple and very valuable.

Psychoeducational groups work to educate those who are seeking mental illness or addiction treatment on how to live with these conditions. It’s not a new concept, having been in use for over 100 years, but it hasn’t always been accepted as a viable option. It’s also changed significantly over the years. During the mid-1980s, it was designed to bring families together in a type of intervention-style meeting.

For instance, they can facilitate greater self-insight and interpersonal functioning. They might also help their members gain skills to understand and solve problems that affect their functioning in daily life (Brown, 2018b).

Importantly, group psychoeducation can be applied in the context of many conditions and disorders, including phobias, mood disorders, and substance abuse.

In this article, we’ll walk you through some best-practice tips for providing psychoeducation in groups. We’ll also provide you with 10 useful templates and ideas to help you design sessions that use modern digital psychotherapy tools.

How to Provide Psychoeducation in Group Therapy

If you’re considering offering group psychoeducation, there are several important decisions to make and initial steps to take before diving into your first session.

In general, these initial steps occur in three phases (Brown, 2018b):

1. Planning
   Information gathering surrounding the target audience of the group and their needs, presenting challenges, and demographics.
2. Structural decisions
   Selection of members, whether the group will be open or closed, environmental factors, and a framework for the sessions.
3. The specifics
   Deciding on the group’s purpose, rules, informed consent policies, social media policies, session plans, and evaluation plans.

This article will focus predominantly on the specifics, focusing on intake forms, policy documents, and ideas for particular group activities that meet a range of different psychoeducational goals.

For a comprehensive guide to designing a psychoeducational group from the ground up, be sure to check out professor Nina Brown’s (2018a) book, Conducting Effective and Productive Psychoeducational and Therapy Groups.

Determining a Group’s Purpose, Goals, and Objectives

The purpose of a therapy group typically centers on one of three aims: education, training, or support (Brown, 2018b).

The nature of a group’s sessions will differ depending on this chosen aim.

For instance, imagine a group of 10 young adults who struggle to form relationships because of social anxiety and weak interpersonal skills. An educational group might work to teach these young adults about different theories of relationships and frameworks surrounding effective communication.

In contrast, a training group might involve role-play and hands-on practice in communication, while a support group might provide opportunities for participants to empathize with one another and receive encouragement.

There can often be overlap between a group’s purposes, but facilitators must be clear about a group’s primary purpose from the outset to minimize tangents and the risk of losing focus.

Flowing from this exploration of a group’s purpose should be a consideration of its goals. For instance, a group that aims to provide social skills training might work toward the goal of increasing participants’ self-reported confidence in social situations (Brown, 2018b).

Likewise, a group should have clear behavioral objectives. The therapist must ask themselves what their participants should be able to do (or do differently) following group sessions. An example might be that upon the conclusion of a particular group session, participants become able to confidently introduce themselves and their occupation to someone they have just met.

Psychoeducation in Groups: 3 Examples

Now that we’ve considered the steps involved in determining your group’s purpose, let’s look at three examples of how to design group sessions that meet these aims.

In several of the examples that follow, we’ll draw on a range of pre-made tools and psychoeducational activities from the comprehensive psychotherapy platform Quenya.

Quenya is an easy-to-use online tool designed to connect therapists with science-backed psychoeducational content in a range of audio and visual formats.

The platform also enables clients to engage with psychoeducational content from the comfort of their smartphone, tablet, or computer.

If any of the examples pique your interest, you can access and experiment with them for yourself by taking advantage of Quenza’s 30-day trial for just one dollar.

1. Intake forms

Brown (2018b) notes the importance of setting clear expectations for group participants using carefully constructed intake materials.

These materials should include several important features:

• Group rules

Therapists should prepare a list of group rules in advance to ensure member safety and orderly conduct. These should include expectations for attendance, behavior, and confidentiality. Further, therapists should review these in person with group members during their screening, orientation, or first session.

• Informed consent

An informed consent document enables the therapist to educate potential participants about the risks, benefits, and alternatives of the group therapy intervention (Shah, Thornton, Turrin, & Hipskind, 2020). This document should elaborate on the group rules and include a space for the client to sign to indicate their agreement.

• Social media policy

The American Counseling Association’s (2014) code of ethics recommends that therapists establish clear guidelines for the use of social media as it relates to the professional counseling relationship and between group members. For instance, the therapist might include a statement in this policy asking that participants not engage with other group members via social media without explicit consent from that person.

In the pictured example, the therapist used Quenza to develop these agreement documents digitally. The therapist distributed the documents to the Quenza accounts of prospective group participants via a single ‘activity’ so that clients can read and digitally sign them.

Carrying out these steps using Quenza has the added advantage of enabling the therapist to track which agreements are still outstanding using the platform’s dashboard. Using the tool, therapists also have the option to send push notification reminders to complete these materials.

For a useful template on which to base your intake forms, check out the Coaching Client Agreement activity, available through Quenza’s Expansion Library.

2. Example session

There are many ways you can structure your group psychoeducation sessions to facilitate learning and reflection.

Here is an example of a session you might run with adults undergoing Cognitive-Behavioral Therapy (CBT) on the theme of goal setting. We will also look at two more examples and ideas for session plans in the sections that follow.

• Session objective
  To educate group members about different types of goals and their utility.
• Materials
  The Reframing Avoidance Goals to Approach Goals activity on the client’s Quenza account.
• Verbal introduction
  Introduce the session by telling participants the following: “Goals help you think about your ideal future and motivate you to change your behavior to reach this future more easily. Setting goals is the first step in turning your hopes and ambitions into real possibilities. Today, we’ll look at two different strategies you can use to set goals and consider how you might frame goals more positively to help keep you motivated to achieve them.”
• Mini-lecture
  Introduce the hedonic principle that people approach pleasure and avoid pain (Higgins, 1998). Highlight that people may exhibit a stable tendency to set goals with a focus on either seeking pleasure (approach goals) or avoiding pain (avoidance goals). However, it has been shown that there are greater benefits associated with setting approach goals (Hirst, Yeo, Celestine, Lin, & Richardson, 2020).
• Activity
  Allow participants 10 minutes to complete the Reframing Avoidance Goals to Approach Goals activity on their smartphone. Invite them to share their reflections about the exercise with the group.

3. Evaluation forms

It is important to conduct formative evaluations of the effectiveness of psychoeducational groups. That way, the data from these evaluations can be used to improve the group and its outcomes.

Most groups use what are known as summative evaluations, where data is gathered following the conclusion of a series of sessions and then analyzed (Corey, Corey, Dwivedi, MacGowan, & Mymin, n.d.). This data can point to gains experienced by participants in the areas of learning, behavior change, and attitudes.

For a useful template, you can adapt for this purpose, look at Quenza’s End of Therapy Evaluation activity, available through the platform’s Expansion Library.

2 Ideas for Your Group Sessions

So far, we’ve looked at some ideas for planning your group psychoeducational sessions, as well as some templates you can use in the early, middle, and concluding stages of a group.

Let’s now look at two more examples of plans you could use for your group sessions, all of which draw on ready-to-use templates available through Quenya.

1. Developing self-appreciation

Psychoeducation groups can be an effective environment in which to explore themes around self-appreciation and gratitude.

Participants may recognize positive aspects of themselves in another person, and sometimes it is easier to show appreciation toward proxies for the self before extending that appreciation to ourselves.

• Session objective
  To help group members develop a sense of self-appreciation.
• Materials
  The Developing Self-Appreciation activity on the client’s Quenza account. (See image)
• Verbal introduction
  Introduce the session by telling participants the following: “Self-appreciation is saying thank you to ourselves for all the things that we usually compliment others about. For some of us, even thinking about our positive traits makes us uncomfortable. However, appreciating ourselves is important. Today, we’ll practice getting more comfortable demonstrating self-appreciation by expressing gratitude for those who helped us develop our best qualities.”
• Mini-lecture
  Define self-appreciation as the act of “[enjoying] what’s good about ourselves” (Neff, n.d.). Highlight that we cannot claim personal responsibility for our good qualities, gifts, and talents. This is because they stem from our genes, the love and nurturing we’ve received, culture, collective wisdom, and our environment. Therefore, by practicing self-appreciation, we’re honoring the forces that have shaped us into who we are today.
• Activity
  Allow participants 10 minutes to complete the Developing Self-Appreciation activity on their smartphone. Invite them to share their reflections about the exercise with the group.

2. Metaphor of the two arrows

Experiencing pain in life is inevitable. However, at the core of most CBT and mindfulness-based interventions is the knowledge that we can unnecessarily exacerbate our suffering by becoming over-identified with unhelpful thoughts.

The following group lesson idea explores these themes using the metaphor of the two arrows.

• Session objective
  To help group members understand how they can minimize unnecessary suffering in their life.
• Materials
  The Metaphor of the Two Arrows activity on the client’s Quenza account.
• Verbal introduction
  Introduce the session by telling participants the following: “This exercise introduces you to the two arrows metaphor, a well-known Buddhist story about managing pain and suffering in a skillful way. By the end of the exercise, you will have a good understanding of the metaphor and how you can use it in your life to prevent unnecessary suffering.”
• Mini-lecture
  Introduce the quote from Buddha: “If you get struck by an arrow, do you then shoot another arrow into yourself?” Highlight that we will all experience painful events that we cannot escape (a first arrow). Drawing on the frameworks relevant to your therapeutic approach (e.g., CBT, Rational Emotive Behavior Therapy), highlight some ways we may unnecessarily ‘shoot ourselves with a second arrow because of our cognitive or behavioral responses.
• Activity
  Allow participants 10 minutes to complete the Metaphor of the Two Arrows activity on their smartphone. After they have applied the metaphor to their own life in Step 2, invite them to share what they have written with the group if they are comfortable. Conclude by walking through Step 3, focusing on how to use the metaphor and techniques relevant to your therapeutic approach to prevent the firing of the second arrow.

Common Characteristics of Psychoeducational Group Therapy

Your psychoeducational group is likely to consist of members who all share the same diagnosis. In this case, education tends to focus on coping with that specific disorder

In other groups, members may have very different diagnoses, and the educational focus is on practical life skills such as managing stress or improving relationships.

The leader of the psychoeducational group you attend could be a mental health expert, a peer counselor who shares a similar diagnosis, or a member of the community. There are specific formats for certain types of psychoeducational groups, but some may be less structured than others.

Group Treatment for Adolescents with Social Anxiety Disorder

A psychoeducational group is the first part of a successful school-based treatment plan for adolescents with social anxiety disorder (formerly known as social phobia) called Skills for Social and Academic Success (SASS).2 The students gather in small groups for 12 weekly sessions of 40 minutes each. The group leaders guide each session and supportive peers without social anxiety disorder are in attendance, too.

During the first session, the group leaders use psychoeducation in a group setting to:

• Normalize the experience of anxiety
• Present the behavioral symptoms and let students share their own symptoms
• Give students space to discuss their negative thoughts and how avoidance affects their lives
• Identify students’ goals for the SASS program

The next four topics presented in the subsequent sessions of SASS are:

• Realistic thinking
• Social skills training
• Exposure
• Relapse prevention

Group Interventions for Specific Phobias

Psychoeducational group intervention is an effective approach for reducing the symptoms of social anxiety known as erythrophobia, a fear of blushing, and the specific phobia arachnophobia, a fear of spiders.

When it comes to a fear of blushing, a study published in the journal Clinical Psychology and Psychotherapy found that when 47 erythrophobia participants attended one weekly psychoeducational group session for six weeks, they showed significant improvement from baseline on a Blushing, Trembling, and Sweating Questionnaire.3

In regards to the specific phobia of spiders, a pilot study published in a German medical journal on child psychology evaluated 36 children between the ages of 8 and 10. Researchers wanted to try and reduce the likelihood of developing this common fear using a psychoeducative group program. After completing the program, both boys and girls showed a reduction in their fear.4

A Look at Substance Abuse Psychoeducation

Group therapy and addiction treatment are natural allies. Indeed, people who abuse substances have been shown to stay more committed to abstinence when taking part in group treatments, in part because of the support and affiliation of fellow group members (Leshner, 1997; Project MATCH Research Group, 1998).

There is a range of benefits of group therapy over other modes of treatment in the context of substance abuse (Flores & Georgi, 2005).

• Positive peer support
• Reduced sense of isolation
• Real-life examples of people in recovery
• Support for coping with substance abuse and other challenges
• Information and peer feedback
• A sense of family
• Social skills training and practice
• Peer confrontation
• The opportunity to help multiple clients at once
• Hope, support, and encouragement

Additionally, group psychoeducation sessions may provide other unintended benefits as well.

For instance, some clients may find the experience of structured time with a planned agenda to be a welcome respite from the disorganization that characterizes their life outside the group. Likewise, a group member’s peers may function as a kind of replacement family, healthier than their own family of origin (Flores & Georgi, 2005).

For useful resources on themes that tap into areas for education in the context of substance abuse, consider the following two activities on Quenza:

• Daily Exceptions Journal
  We often focus on the things that go wrong in life, but it can be powerful to look at things that go well, too. This is because reflecting on what goes well can point us toward our strengths and deepen our gratitude. To this end, the Daily Exceptions Journal will invite your clients to reflect on events that went well throughout their day.
• Self-Contract
  The Self-Contract Template is a powerful tool to help clients commit themselves to a new goal. The activity is a great opportunity to encourage clients to set goals beyond sobriety and consider how they might better themselves in one or more life domains.

A Take-Home Message

There are inherent benefits to spending time with others who can relate to our struggles and pursuits.

Skilled facilitators of therapy and psychoeducation groups recognize this fact and design their group sessions to maximize these benefits. Group psychoeducation sessions are ideal to help your clients achieve transformation by leveraging the support of their peers.