Psychoeducation: concepts, applications, and outcomes

¶ … Session Christ-Centered Psycho-Educational Process Group Program for Adolescents and Young Adults

The purpose of this initiative is to develop a six-session Christ-centered psycho-educational process group program for the population of interest described further below. This intervention is designed for six weeks duration.

The population of interest for the initiative outlined herein is male adolescents aged 13 to 17 years and young adults aged 18 to 25 years who have experienced a significant personal loss or transgression by another individual in the past that requires forgiveness.

Male adolescents and young adults experience higher levels of involvement with the criminal justice system by virtue of family-related problems and emotional turmoil compared to their female counterparts, indicating a lack of self-control and impulsivity (Hartwig & Myers, 2009). For instance, according to Hartwig and Myers, "These additional problems include family and relationship dysfunction, higher incidences of violence, drug use, deficiencies in mental health, sexual promiscuity and victimization, teen pregnancy, and dropping out of school" (2009, p. 57). A group counseling format has been shown to be effective with male adolescents and young adults (Lambie, 2004). In addition, according to White (2000), "Psycho-educational approaches are designed to achieve the best compromise between clinical effectiveness for each individual and clinical efficiency -- allowing greater numbers of people to receive appropriate treatment" (p. xiii).

This point is also made by Zaretsky and Rizvi (2007) who report, "Psychoeducation may be given individually and often includes family members in a limited way, but group interventions constitute most of the interventions" (p. 15). Moreover, the psycho-educational format is deemed well suited for these applications because the process does not require individuals to discuss personal information which may be intimidating for some young people in group settings (White, 2000).

d.

Theoretical Approach. The theoretical approach of the psychoeducational intervention envisioned herein is based on the self-regulation model in learning propounded by Pintrich, Smith, Garcia, and McKeachie (1993). The main reason for choosing this model is that the efficiency of this model in acquisition of self-regulation skills in studies conducted with primary and high school students from different countries has been emphasized in the relevant literature (Goldstein & Miklowitz, 2009).

Beginning in the 1970s, family intervention programs were developed to address problems between dysfunctional family members in a process that has come to be called psychoeducational (Goldstein & Miklowitz, 2009). The psychoeducational theoretical approach, though, was not based on any specific theory of family dynamics or traditional family therapy techniques (Goldstein & Miklowitz, 2009). Instead, psychoeducational interventions were forged based on empirical observations and clinical experience (Goldstein & Miklowitz, 2009). To date, the majority of the research on psychoeducational group interventions has involved college-aged students, but there has been some exploration of the modality's application with other populations (Worthington, Hunter & Sharp, 2010).

Mental health counselors can use psychoeducational groups as supplemental approaches to therapeutic interventions in order to facilitate forgiveness by individual who may have experienced difficulties with interpersonal relationships, who have experienced interpersonal traumas, or who problems that include forgiving past transgressions (Worthington et al., 2010). In addition, psychoeducational interventions can use group sessions for community members who are not in therapy but who are looking for a healthier way to deal with issues surrounding transgressions (Worthington et al., 2010).

e.

Integration. Christian themes will be introduced into each group session meeting following the guidance provided by Greenfield (2009) that the facilitator should read a passage from the Bible or pose a discussion question for the meeting. However, participants of any religious faith will be welcome in the group sessions, but everyone will be advised that the focus of the meetings will be Christ-centered. This approach is congruent with the guidance provided by Worthington and his associates that, "A Christian-tailored group is superior to a secular group for Christian participants" (2010, p. 76). Likewise, membership in other Christian groups is not restricted to Christians only. For instance, Greenfield points out that in Young Life meeting, "members talk about Bible passages and Christian themes [but]Young Life is open to any interested students" (2009, p. 1).

f.

Recruitment. Advertisements concerning the availability of the group sessions will be placed in local church newsletters, news releases will be sent to the media and local schools, and notices will be placed in online forums dedicated to helping young people cope with the stressors of life in the 21st century. These advertisements and notices will be posted 2 months in advance of the pre-group meeting (discussed further below) and allowed to continue until 20 group members have been recruited or the end of the 2 months has elapsed, whichever comes first.

g.

Screening. According to Onemli and Yondem (2012), an intake form that can be used for screening group members can be prepared by the researcher and should include demographic metrics such as age and educational level/status; since all of the recruited candidates for the intervention will be male, gender will not be collected on the intake form. A proforma copy of a sample intake form that will be used for screening candidates for the psychoeducational sessions is provided at Appendix A.

h.

Structure. The psychoeducational intervention envisioned herein will consist of six 2-hour group meetings with one 15-minute break that will take place from noon to 2:00 P.M. On consecutive Saturdays to facilitate attendance by group members employed or attending school. The sessions will be closed to unscreened candidates, but new candidates can apply and be accepted at any point during the duration of the interventions once they have been screened using the form shown at Appendix A; however, in any event, group sessions will be limited to 20 participants. It is recommended that the group sessions be held in a mutually conveniently located facility such as a church's or school's conference room. Donations will not be accepted but refreshment (soft drinks, doughnuts, pizza) will be served at each meeting.

Pre/Post Group Meetings. One pre-group meeting will be conducted 2 weeks prior to the first scheduled session at the same time and place with all interested pre-screened participants approved for participation in the formal group sessions. During the pre-group meeting, the topics that will be discussed during group sessions will be described and feedback solicited concerning alternatives and additional topics of interest to the participants. In addition, one post-group meeting will be conducted one week following the final group session at the same time and place to discuss the effectiveness of the group sessions, complete the evaluation forms (see proforma copy at Appendix B and discussion further below) and to identify opportunities for improving the content and structure for future sessions.

j.

Goals. The overarching goal of the psychoeducational process group program is to provide young males with the coping tools and techniques they need to overcome personal transgressions in ways that can help them repeat the process when confronted with transgressions in the future. This goal is congruent with the guidance provided by Worthington and his associates who note, "Although most psychoeducational interventions focus on forgiveness of a specific transgression, the hope is that forgiveness interventions may help people to become more forgiving in general -- that is, that the skills used to forgive a specific transgression will be transferred to past and future transgressions" (2010, p. 76).

k.

Ground Rules. The group sessions will have several ground rules established by the facilitator for conduct and participation. First and foremost, the anonymity of all participants will be protected. Group session participants will be known be their first names only and their first names and last initials only will be recorded on the intake screening form shown at Appendix A. The second group rule will be that there will be no interruption of speakers during group sessions, and that all participants' views are valid and authentic irrespective of whether other group members agree with them or not. A final ground rule is that what is discussed in group, stays in the group. Group members will not have a voice in these basic ground rules, but may suggest additional rules as the sessions progress which will be voted upon by all participants and a simple majority will be all that is required for their implementation.

l.

Ethical Issues. Young people in general represent a highly vulnerable population that must be provided with sufficient information concerning the nature of the psychoeducational sessions to make an informed choice concerning whether they wish to participate or not (Pearrow, 2011). All participants will have these issues explained to them thoroughly during the pre-group session meeting held preparatory to the formal six session format. Participants' continuing enrollment in the formal sessions will be considered informed consent for this purpose.

m.

Multicultural Issues. In an increasingly multicultural society, there will inevitably be some multicultural issues that emerge in group sessions that are open to all males. As Vespia and Fitzpatrick point out, "Multicultural competencies are essential to effective practice in counseling" (2010, p.54). Because group membership will vary from session to session, it is vitally important that the session content be culturally appropriate for the participants in attendance. For instance, according to Worthington et al. (2010), "Mental health counselors must tailor [psychoeducational] interventions to different populations" (p. 76). The primary multicultural issues that are expected in the psychoeducational intervention envisioned herein include cultural constraints to discussing personal issues that adversely affect the sense of machismo among Latin Americans and significant reluctance on the part of some Asian young males to reveal personal details concerning their lives in front of others for fear of losing face (Vespia & Fitzpatrick, 2010). These constraints to productivity in the group sessions will be handled directly by emphasizing the non-threatening nature of the group sessions and the opportunity they represent for all participants to receive peer support and confirmation of their feelings (Vespia & Fitzpatrick, 2010).

n.

Group Leader. The facilitator will serve as the initial group leader during the pre-group session at which time a group leader will be selected from the pool of enrolled participants who are in attendance. The qualifications that are necessary for the group leadership position will include a willingness to serve, the ability to remain calm and neutral during heated discussions and a capacity for understanding and posing of open-ended questions that will allow the conduct of group sessions in an orderly but spirited fashion (Brown, 1999).

A non-directive leadership style will be bested suited to achieving the goals of the group sessions since this approach provides all group members with an equal opportunity to have their views heard in a non-threatening environment. For example, Brown (1999) reports that nondirective group leaders "do not decide what is important for members to focus on and insist that they explore it" (p. 50). Moreover, a nondirective group leader helps group members "feel safe, accepted, valued, and thereby, lowering of defenses is more likely, thus allowing relevant material to emerge in a form that can be accepted and used by them" (Brown, 1999, p. 50).

An important point made by Brown, though, is that nondirective leaders are not necessarily silent during group sessions, and they take active steps to help participants reflect on the session's content. In this regard, Brown advises that, "The [nondirective] leader can pose open-ended questions and statements that help the others reflect on the experience and make statements that highlight the process" (1999, p. 50). In fact, it is important for nondirective leaders to perform these promptings in order to keep the group on track and moving in the right direction. As Brown cautions, "It must be emphasized that being nondirective does not mean doing or saying nothing. The group leader who does or says little or nothing can provoke great anxiety which does not promote feelings of safety and trust" (1999, p. 50).