Toddlers’ endless questions, followed by even more questions after every answer, equip them with an understanding of the world around them.
We can say the same for psychoeducation.
Psychoeducation was originally an approach to educate users of all types of mental health services and their family members about their condition, the problems it may cause, and various treatment options (Walsh, 2010).
This educational process is intended to promote a client’s insight and understanding following a mental health diagnosis and help the loved ones of the newly diagnosed provide them with support.
By answering their “whys,” psychoeducation empowers mental health service users to actively participate in the decisions made about their care and aims to improve treatment compliance. Today, psychoeducation has also become an important component of counseling and psychotherapy, and we will discuss why in this article.
Before you continue, we thought you might like to download our three Positive CBT Exercises for free. These science-based exercises will provide you with detailed insight into positive Cognitive-Behavioral Therapy (CBT) and give you the tools to apply it in your therapy or coaching.
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What Are Psychoeducation Therapy Interventions?
Psychoeducation interventions in therapy involve providing clients with information about psychological concepts, their specific problems, and the relationships between thinking, emotion, and behavior.
They are also an important component of obtaining informed consent to treatment by offering the client an opportunity to ask questions about the outcomes of various treatment options, including the side effects of medications.
They are a primary component of Cognitive-Behavioral Therapy (CBT; Morrow, 2018) and many third-wave therapies that combine elements of CBT with mindfulness skills, such as
- Acceptance and Commitment Therapy
- Mindfulness-Based Cognitive Therapy
- Mindfulness-Based Stress Reduction
Educating a client about psychological concepts is crucial when a client has a poor understanding of how their thoughts are linked to emotion and behavior. Hornby (1990) explained how psychoeducation can be applied during person-centered counseling by reframing a client’s problems as skill deficits rather than symptoms.
Counselors can then intervene by teaching and modeling life skills, including goal and value clarification, interpersonal communication, boundary setting, decision-making, conflict resolution, and emotional awareness (Hornby, 1990).
Psychoeducation can have a remedial function in therapy by addressing relationship skill deficits and a preventive function by supporting the client’s acquisition of the skills required to live a meaningful life.
10 Examples of Topics to Address
Psychoeducation usually begins early in the therapeutic process and involves explaining the model or intervention to the client.
It may be geared toward working with a particular diagnosis or involve explaining the therapeutic approach to solving the client’s problems in general.
Often, psychoeducation will involve providing information about a specific mental health problem when conducting therapy with a newly diagnosed user of mental health services, as well as explaining the theory and objectives of the therapeutic model.
Topics can include the following:
- Information about a specific diagnosis or problem. See the handouts section below for further resources.
- Explaining and reviewing treatment options and combinations of treatments such as medication and CBT. Mind has published this free guide for practitioners to use.
- Explaining psychological concepts and the interventions that will be used in your specific approach to counseling or psychotherapy.
- Assessing a client’s psychoeducational needs to identify gaps in the client’s life skills.
- Value clarification to ensure your client understands what gives their life meaning.
- Emotional literacy training.
- Boundary clarification and boundary setting to develop and maintain healthy relationships while moving on from unhealthy situations.
- Conflict resolution skills to help maintain relationships.
- Coping with grief following relationship breakdown, divorce, bereavement, or job loss.
- Developing parenting skills.
CBT depression psychoeducation
The first few sessions of CBT typically involve educating the client about the relationships between thoughts, emotions, and behavior to explain the benefits of the approach for mental health.
When educating a client with depression, core beliefs are examined that contribute to faulty thinking or cognitive distortions that lead to a depressed mood.
Look at our 25 CBT Techniques and Worksheets for tools to manage the following:
- The maximization and minimization of events, such as catastrophizing, exaggerating mistakes, or underestimating the importance of achievements.
- Jumping to conclusions by interpreting events with little available evidence. For example, ‘I shouldn’t bother applying for a promotion at work because my boss probably thinks I’m stupid.’
- All-or-nothing thinking. These thoughts typically revolve around words like ‘never’ or ‘always,’ such as, ‘I never feel happy because I am always sad.’
- Overgeneralization, such as experiencing anxiety or lack of confidence before an exam and thinking, ‘I am an anxious, unconfident person.’
- Disqualifying the positive, which involves focusing on the negative to the exclusion of the positive. For example, a client may have several healthy friendships but one difficult friendship and yet only dwells upon their difficult friendship.
- Should and ought statements. ‘I shouldn’t feel angry.’ ‘I ought to do what my partner wants; then he will be nice to me.’
- Personalization, which involves taking responsibility for events outside your control. This might lead to thoughts like, ‘My partner drinks too much, perhaps because I can’t help her.’
- Emotional reasoning, which involves identifying with feelings. For example, ‘I feel sad because I am a sad person.’
- Magical thinking, such as believing that because you are a kind person, bad things shouldn’t happen to you.
CBT practitioners educate their client about how cognitive distortions can lead to negative emotions and actions that reinforce a depressed mood, such as social withdrawal and avoidance of the risk entailed in making changes or trying anything new.
CBT practitioners challenge these faulty ways of thinking during treatment by helping their client reframe their thoughts so they become more realistic.
4 Topics for your group therapy sessions
Psychoeducational groups are led by a therapist who takes on the role of a teacher and trainer (Brown, 2018).
This contrasts with process-oriented groups, where the therapist takes a background role as a facilitator of the group experience. Psychoeducational groups often combine information with life skills training focused on a specific mental health diagnosis or problem. Group therapists may offer training in a broad range of skills that can help alleviate the stress caused by living with mental health problems or recent life changes.
The following four worksheets each offer methods for managing different aspects of the stress response, including identifying sources of stress, speaking up, negative thinking, and reactive emotions.
1. Sources of stress
This free Coping With Stress worksheet will probably be useful for all group members, whether they are learning to live with a new mental health diagnosis or tackling any type of life problem.
The sheet helps individuals identify sources of stress in their lives and develop new and healthier ways of coping with it.
2. Speaking up
This free Assertiveness Formula worksheet is a useful tool to help group members learn how to speak up assertively when difficult situations arise in life. Assertiveness skills are key to managing the stress caused by discrimination and bullying.
Clients with a mental health diagnosis may encounter social stigma and discrimination in many life situations, making assertiveness skills essential.
3. Negative thinking
Another cause and consequence of stress are automatic negative thoughts (ANTS). Everyone falls prey to negative thoughts in difficult situations, which can direct behavior in ways we wouldn’t choose if we were more aware of them.
This free Identifying ANTS: Challenging Different Types of Automatic Thoughts worksheet will help group members recognize and overcome ANTS, then replace them with more adaptive thoughts.
4. Reactive emotions
When we are stressed, we often react emotionally to the negative aspects of situations rather than responding to the available facts. This free Skills for Regulating Emotions worksheet offers several methods for regulating intense emotions and reducing stress.
Psychoeducation on schizophrenia
Psychoeducation for those newly diagnosed with schizophrenia is intended to empower patients and their families by providing them with up-to-date information about the illness, treatment options, and how to monitor symptoms and prevent relapse (Xia et al., 2011).
Psychoeducation programs about living with schizophrenia enhance patients’ insight into the condition, improve treatment compliance, and result in a higher quality of life for patients and their families (Xia et al., 2011; Dixon, Adams, & Hucksted, 2000; Loots et al., 2021).
The overall benefit of psychoeducation is a reduced rate of relapse and hospitalization, and a reduced risk of suicide. This is according to a recent systematic review published in The Lancet (Bighelli et al., 2021), which assessed the results of 85 research studies and concluded that psychoeducation should be an early intervention in those newly diagnosed with schizophrenia because of its evidence-based benefits.
Another pilot study (Lam, Leung, Lin, & Chien, 2020) investigated the effects of a mindfulness-based psychoeducation program (MBPP) on emotional regulation in those newly diagnosed with schizophrenia in Hong Kong.
In the study, 46 patients diagnosed with schizophrenia were randomly assigned either to the eight-week MBPP group or the ‘treat as usual’ group. Results were followed up after three months. The MBPP appeared to improve emotional regulation, especially in reducing rumination and enhancing cognitive reappraisal.
A large-scale randomized control trial is being planned by Lam et al. (2020) to assess the effectiveness of the MBPP with a wider range of patients with schizophrenia. This pilot study has supplied new scientific evidence that is advancing the application of positive psychology to the treatment of psychosis.
Psychoeducation – educating persons with mental illness and family members regarding mental illness – Prof. Suresh Bada Math
How to Give Psychoeducation to Clients
Offering psychoeducation to clients typically comprises four components:
- Giving a client information about their illness or problem
- Developing problem-solving skills
- Developing communication skills
- Assertiveness training
The therapist can provide psychoeducation verbally during therapy sessions in the form of leaflets, podcasts, videos, or as homework exercises that encourage a client to find out more for themselves.
A useful set of psychoeducation videos have been produced by the UK National Health Service Cheshire and Merseyside Rehabilitation Network and can be used to educate clients on issues of fatigue, memory, anxiety, and even the consequences of an injury.
Podcasts are always a great medium for psychoeducation, as the client can listen to them on their own time and share them with friends and family wanting to understand a new diagnosis and appropriate care.
Further links to online libraries of fact sheets, leaflets, and homework exercises are provided in the Tools, Worksheets, and Handouts section below.
4 Techniques to Use in Your Sessions
The following techniques can be used to guide the psychoeducational component of therapy and counseling.
1. Socratic questioning
The Socratic questioning technique can ascertain a client’s level of existing knowledge as well as their needs, values, and gaps in their understanding.
Socratic questioning is a method used in CBT to enhance insight; clarify existing thoughts, emotions, and behavioral patterns; and explore alternatives. Once a client has been assessed using this method, other techniques can be used to enhance existing knowledge and understanding.
2. Problem-solving skills
Once existing problems have been identified using Socratic questioning, you can introduce the client to problem-solving skills. Try Better Relationships’ guide to personal problem-solving or this Social Problem-Solving Model to steer the problem-solving process.
3. Improved communication
When questioning your client, you may have identified gaps in their communication skills. Perhaps they appeared withdrawn, suspicious, or were distracted and not really listening.
Good Therapy has a useful article that discusses client communication issues and how to explore them in therapy. You can also check out our How to Improve Communication Skills article to guide the process.
4. Assertiveness skills
Often, clients who present for therapy and counseling have experienced problems getting their needs met. Assertiveness skills are crucial for clear communication, which is necessary for a client to meet their needs, especially in challenging situations.
6 Tools, Worksheets, and Handouts
There is a lot of free information from mental health charities and institutes. The following three mental health information hubs offer a range of free handouts.
- The UK Mental Health Foundation has an extensive library of research-based information resources aimed at users of mental health services and helping professionals. They are free to view online.
In addition, they sell psychoeducation publications about how to look after your mental health and manage stress.
- The US National Institute for Mental Health also has several brochures and fact sheets in both English and Spanish that are free to order from inside the country or free to download in PDF or epub format.
- The UK mental health charity MIND hosts an online information resource called the A to Z of Mental Health aimed at users of mental health services. Each information sheet is downloadable for free in PDF format.
The following worksheets are useful psychoeducational tools for those working in a counseling or therapeutic capacity with clients with mental health problems.
- Core Beliefs worksheet 1 and Core Beliefs worksheet 2 can be used together to enhance a client’s self-awareness and self-acceptance. We all have core beliefs that shape the way we think, feel, and behave. Often, these beliefs are rooted in childhood experiences that govern us subconsciously. Becoming more aware of core beliefs is essential if we want to change the way we think, feel, and behave.
- The Preventing Mental Health Relapse worksheet can be used with the Core Beliefs worksheets above to identify the beliefs and thoughts that may trigger a relapse. The worksheet helps identify triggers and make a relapse prevention plan to manage poor habits, self-defeating actions, and other stressors.
- The Understanding Mental Health Stigma worksheet may be especially useful if your client has a new mental health diagnosis. Unfortunately, stigma toward those with mental health problems remains an issue in most societies and may discourage people from asking for support when they need it.
Combined with the worksheets above, the Understanding Mental Health Stigma worksheet can help a client identify the disrespect that feeds mental health stigma and learn how to cope with it. Clients may benefit from discussing the topic with close friends and family, too.
3 Helpful Books About Mental Health
There’s nothing like a good book to help one understand something better, and these books about mental health are no exception. Pick any one of these recommendations to improve your knowledge.
1. Be Calm: Proven Techniques to Stop Anxiety Now – Jill Weber
Be Calm by Jill Weber is a highly accessible book based on her extensive experience as a clinical psychologist working with clients with anxiety.
It comprises a collection of proven techniques for managing anxiety and removing obstacles to living a full and meaningful life.
Find the book on Amazon.
2. We’ve Been Too Patient: Voices From Radical Mental Health – L. D. Green and Kelechi Ubozoh
We’ve Been Too Patient comprises 25 mental health service users’ stories and the research they conducted to overcome the limitations of the biomedical model.
This is an empowering read for clients struggling with a major mental health problem that conventional treatments have not resolved.
Find the book on Amazon.
3. No Such Thing As Normal – Bryony Gordon
No Such Thing As Normal by Bryony Gordon, the founder of Mental Health Mates, explains what her mental illness taught her about mental wellness.
The book offers practical advice on common problems, including worry, medication, sleeping, addiction, and boundary setting.
Find the book on Amazon.
Resources From PositivePsychology.com
In addition to the resources above, our Positive Psychology Toolkit© contains over 400 psychoeducational tools created by academics based on the latest scientific research, and it’s updated monthly.
In addition, we have a few free psychoeducational worksheets you can use with clients to develop their understanding of the link between thoughts, feelings, and behavior.
Feel free to browse the wide range of psychoeducational resources we offer in our store.
If you’re looking for more science-based ways to help others through CBT, check out this collection of 17 validated positive CBT tools for practitioners. Use them to help others overcome unhelpful thoughts and feelings and develop more positive behaviors.
A Take-Home Message
While psychoeducation was originally used to inform newly diagnosed mental health service users about their condition, it is now recognized as an essential component of the therapeutic process.
The primary aim of psychoeducation in counseling and therapy is to develop a client’s understanding of the relationships between thoughts, feelings, and behavior. It answers their “whys,” and once these connections are understood, enhanced self-awareness can help motivate clients to develop the skills needed to live a more fulfilling life.
Directing clients to psychoeducational resources supports their personal development and empowers them to take an active role in the healing process.
We hope you enjoyed reading this article. For more information, don’t forget to download our three Positive CBT Exercises for free.
- Bighelli, I., Rodolico, A., García-Mieres, H., Pitschel-Walz, G., Hansen, W. P., Schneider-Thoma, J., … Leucht, S. (2021). Psychosocial and psychological interventions for relapse prevention in schizophrenia: A systematic review and network meta-analysis. The Lancet, 8(11), 969–980.
- Brown, N. W. (2018). Psychoeducational groups: Process and practice. Routledge.
- Dixon, L., Adams, C., & Hucksted, A. (2000). Update on family psychoeducation for schizophrenia. Schizophrenia Bulletin 26(1) 5–20.
- Gordon, B. (2021). No such thing as normal. Headline.
- Green, L. D., & Ubozoh, K. (2019). We’ve been too patient: Voices from radical mental health. North Atlantic Books.
- Hornby, G. (1990). A humanistic developmental model of counselling: A psycho-educational approach. Counselling Psychology Quarterly, 3(2), 191–203.
- Lam, A. H. Y., Leung, S. F., Lin, J. J., & Chien, W. T. (2020). The effectiveness of a mindfulness-based psychoeducation programme for emotional regulation in individuals with schizophrenia spectrum disorders: A pilot randomised controlled trial. Neuropsychiatric Disease and Treatment, 16, 729º747.
- Loots, E., Goossens, E. Vanwesemael, T., Morrens, M., Van Rompaey, B., & Dilles, T. (2021). Interventions to improve medication adherence in patients with schizophrenia or bipolar disorders: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 18(19).
- Morrow, K. (2018, January 12). The importance of psychoeducation in CBT. [Blog post]. Retrieved October 20, 2021 from https://anxietytraining.com/education/importance-psychoeducation-cbt/
- Walsh, J. (2010). Psychoeducation in mental health. Oxford University Press.
- Weber, J. (2019). Be calm: Proven techniques to stop anxiety now. Althea Press.
- Xia, J., Merinder, L. B., & Belgamwar, M. R. (2011). Psychoeducation for schizophrenia. The Cochrane database of systematic reviews, 2011(6),CD002831.