Psychoéducation : définition, historique, intérêt et limites

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Psychoeducation can be defined as a systematic didactic and psychotherapeutic intervention which aims to inform patients and relatives on a psychiatric disorder and to enable their ability to cope with the illness. This is not only a transmission of information, but also a teaching method adjusted to the disorder with the objectives to clarify identity, to promote empowerment and to change attitudes and behavior. The introduction of the education in the treatment of mental disorders is at the origin of the “moral treatment”. The term of psychoeducation was born originally in the scientific literature to overcome problems in formal learning among children with mental health problems. This origin is common with the term of therapeutic education, which has been then applied mainly to somatic health problems. The term psychoeducation was then used from 1980s to describe the transmission of knowledge on psychiatric disorders for therapeutic purposes, first to relatives, then to people suffering from schizophrenia. Since the end of the 1990s, the use of psychoeducation was then extended to other psychological disorders such as eating disorders, bipolar disorder, panic attacks and agoraphobia or posttraumatic stress disorders. Therapeutic efficacy of family psychoeducation to reduce the risk of relapse and readmission in schizophrenia was a revolution in family therapy during the 1980s. In a polemical way, psychoeducation was criticized as a way to impose a conception of mental illness by medical doctors and pharmaceutical industry. However, by the end of the 1990s, psychoeducation became clearly a source of power, knowledge and social connections for patients and relatives. In conclusion, psychoeducation has an evidence-based efficacy to prevent relapse and hospitalisation when associated with other treatments, including medication or psychosocial rehabilitation. In a modern medical perspective, it precedes and supplements in psychiatry the notions of “informed consent”, “shared decision-making” or “mental health literacy”. In the limitations, psychoeducation remains not enough systemically used, some programs are not recovery compatible. Moreover, specific programs independent from diagnosis for the early phases of psychiatric disorders should be developed.