Group psychoeducation for forensic and dangerous non-forensic long-term patients with schizophrenia: A pilot study

Abstract

-Background and Objectives:The effectiveness of patient psychoeducation has only rarely been studied among forensic populations. This paper examines the outcomes of an eight-time psychoeducational group comprised of schizophrenic patients in a forensic hospital setting in Finland.Methods: The intervention group contained forensic or dangerous non-forensic longterm patients with schizophrenia. Treatment outcomes were compared between the intervention group (n = 7) and a matched treatment-as-usual control group (n = 8). The group provided information about schizophrenia and its treatment and cognitive-behavioural elements were used to enhance patients' learning and coping. The results were obtained from a knowledge of schizophrenia, awareness of mental disorder, attitudes toward psychiatric treatment and medication, and depression.Results: The results of this pilot study suggest that even severely ill patients were able to gain improved knowledge about their illness, and psychoeducation also had positive impact on their awareness of the illness. The results showed no significant changes in attitudes toward psychiatric treatment or medication, or depressive symptoms. No significant changes in any measures were found in the control group.Conclusions: Despite our positive results further research with larger samples is needed to discover the effectiveness of patient education as a component of the comprehensive treatment of forensic patients with schizophrenia.

A Critical Analysis of Clinical Evidence from High Secure Forensic Inpatient Services

“…Preliminary evidence for psychoeducation for those with mental illness (including schizophrenia) indicates improvements in insight and therapy engagement, emphasizing the interaction effects of interventions in the high secure setting (Aho-Mustonen et al, 2008). 'Third wave' cognitive-behavioural therapies offer promising evidence of risk reduction for detainees with a history of serious interpersonal violence (Evershed et al, 2003;Tarrier et al, 2010).…”

“…Evidence for the benefits from psycho-education with inpatients with a primary diagnosis of schizophrenia (n = 7) is provided from a single study including a Treatment-as-Usual control group (n = 8) (Aho-Mustonen, Miettinen, Koivisto, Timonen, & Räty, 2008). The most prominent intervention effects were reported for improvements in illness knowledge (SMD = 0.54), awareness of illness (SMD = 0.30) and attitudes towards treatment (SMD = 0.27).…”

“…Evidence that certain non-RCT design studies (Aho-Mustonen et al, 2008) were rated of higher quality compared to RCT designs also demonstrates the potential value in including alternative forms of evidence in informing clinical practice, including the follow up of forensic patients (Buchanan, 1998).…”

A randomised controlled trial to explore insight into psychosis; effects of a psycho-education programme on insight in a forensic population

“…This is of particular relevance to the forensic population, where there are many challenges in treating mentally ill offenders in secure settings (Aho-Mustonen, 2011). McCann (1999) describes people in forensic care as being a diverse group with a range of diagnoses, mental health problems and offences.…”

Kolme polkua huono-osaisuuteen – oikeuspsykiatristen potilaiden laitosurat, yhteiskunnallinen asema ja paranoidisuus

“…Oi keuspsykiatrista potilasryhmää koskeva tutkimustieto on kertynyt pääosin biolääketieteellisestä näkökulmasta, ja tieto yksilötasoisten tekijöiden ja hoitokeinojen merkityksestä heidän hyvinvointinsa kannalta on korostuneessa asemassa (esim. 4,5). Yhteiskuntatieteellisen näkökulman vähyys näyttäytyy elämänkulullisen, huono-osaisuuden kumuloitu-misen ja sosiaalisten olosuhteiden mahdollisten viivästyneiden vaikutusten ymmärryksen puutteena (ks.…”