PSYCHOEDUCATION: APPLICATIONS FOR CROSS-SYSTEMS PRACTICE IN INTERNATIONAL CONTEXT

Mainstreaming Mental Health in Public Health Paradigms: Global Advances and Challenges

Global Foundation for Democracy and Development /Fundación Global Democracia y Desarrollo

UN Headquarters, New York

Ellen Lukens, PhD, LCSW

Columbia University School of Social Work

April 11, 2011

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Psychoeducation2

Model that provides collaborative opportunity for participants & facilitators to exchange knowledge & learn together about an area of concern

Evidence-based/evidence-informed Principle-based/curriculum-driven Flexible model

Clinical & group practice Community practice & advocacy Training

PSYCHOEDUCATION3

educational & therapeutic interventions work together

therapeutic use of education knowledge as power

education psychiatry Illness & wellness other life challenges

practical strategies for coping in the face of stress, trauma, & other challenges

community education & collaboration potential for building community awareness &

advocacy skills regarding health & mental health literacy

builds on resilience as well as challenge

Why Psychoeducation?

Stress & Trauma Interfere with Processing & Using Information & Knowledge Can occur at individual, family, community,

national level Understood in different ways depending on

culture, history & resources Haiti Japan Kazakhstan United States

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Why Psychoeducation-continued? Stress & Trauma Interfere with

Processing & Using Information & Knowledge Daily life is disrupted & no longer

predictable Can occur at individual, family, community,

national level Can be acute or cumulative or both

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Intervention or Training Goals6

enhance communication create a common language

foster knowledge exchange allow participants to bear witness build self-awareness/pattern recognition build community & supports models value of structure, sense of

“normalcy”, return to the ordinary

Knowledge is power…

and information alone is not enough without… Insight Interpretation Understanding Context

Stages of Healing through Psychoeducation

Safety Bearing witness Managing feelings/self-care Grief & loss Personal power/self-efficacy Meaning making Transformative learning through

knowledge exchange Building community awareness

Knowledge as Capital9

Integrate information with experience Knowledge supports safety Safety supports knowledge Knowledge leads to self awareness Self awareness creates opportunity for

healing Knowledge contributes to community

advocacy & healing

Collaborative Community of Care

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Share experience Learning together

the learning community the learning collaborative the learning exchange

Facilitators & members collaborate Embrace multiple perspectives Share responsibility & accountability

PSYCHOEDUCATION AS COLLABORATIVE MODEL:shifting a paradigm

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Participants & facilitators ALL serve as: educators students translators consultants facilitators advocates monitors

Planning a psychoeducational intervention Assets & needs assessment Draw on professional & local knowledge

to leverage assets & plan intervention Policy makers Organizational members & leaders Community members & leaders Spiritual leaders Youth

Curriculum development

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Sources of Knowledge for Integrated & Cross-Systems Practice in Health & Mental Health13

Policy & politics Organizational knowledge Research Practitioner knowledge User knowledge Cultural context

Assets & Needs Assessment

Professional knowledge (of the expert) the “experience far”

Local knowledge (of the crowd) the “experience near”, the lived experience recognizing

shared history, perspective, world view

Validating both Privileging neither

Challenges to implementation.. Need for commitment within & across systems

among organizational, community, spiritual, political leaders (i.e. buy-in from top-down & bottom-up)

Investment in health & mental health literacy among general public

Sensitivity to linguistic & cultural interpretation of stress, trauma, life challenge

Dissemination Sustainability

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Potential

Ripple effects of accurate information & knowledge

Bridges formal (provider) & informal (community/family/peer) supports Reduces power disparities

Can be used as group, community, organizational and/or training model

Can lead to collective & community response & action moving forward Builds interdependent & mutual support Builds social capital, agency & community leadership

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IN SUM...17

partnership among professionals & participants shifting paradigm from challenges to strengths present focused

focus on critical time periods attention to timing

active use of group structure emphasis on education & insight community building/education creates a learning collaborative or exchange

parallels principles of community based participatory research