Reinforcing Recovery and Relapse Prevention: Creation of a Junior Doctor Led Psychoeducation Course for Adolescent Inpatients With Psychosis

Abstract

AimsThe aim was to provide psychoeducation sessions to inpatients at a London adolescent mental health unit, admitted with first episode psychosis, at the recovery stage of admission. The COVID-19 pandemic-associated rise in admissions and clinical demand meant psychologists within the unit struggled to provide psychoeducation sessions; a deficit in care was identified and junior doctors established a psychoeducation group to meet this clinical need.MethodsCourse participants were three adolescent inpatients from black and ethnic minority backgrounds who were informal/voluntary patients approaching discharge. This ensured adequate insight into their mental health disorder and its impact on functioning, to effectively benefit from psychoeducation, and capacity to consent to this pilot programme.Doctors liaised with psychologists, occupational therapists and nursing colleagues to create this holistic, patient-centred course, suited to patients’ current psychosocial abilities with appropriate accommodations for age, developmental level and stage in recovery.The team provided effectual, engaging content to deliver key messages while ensuring sessions were enjoyable for teenagers. Use of repetition accounted for residual effects of psychosis such as impaired concentration and memory. Patients actively participated with use of colourful visual aids, created interactively to consolidate learning. Peer discussion and personal reflection was supported, balanced with the need for patient confidentiality.ResultsThrough post-course feedback, patients agreed sessions provided better understanding of their diagnosis and difficulties, and felt more empowered in managing their recovery. They reported highly enjoying the group and actively looking forward to sessions. Patients were able to recall key points and take home messages several weeks after content delivery, suggesting effective learning had taken place.Doctors involved in creation and delivery of the course experienced greater rapport and empathy with patients, greater understanding of psychosis as a condition and its wider impact on the individual and their family. Deeper understanding of relapse prevention interventions allowed juniors doctors to take a more active role in discharge planning, with greater appreciation for patients’ biopsychosocial needs.ConclusionPsychoeducation sessions were highly impactful for patients and doctors involved, and are anticipated to have a positive effect on prognosis, likely reduced relapse rate and increased engagement with community care. The earlier deficit in care was successfully filled through this doctor-led psychoeducation course.Next steps involve standardising content and training colleagues to deliver a more extensive course to larger numbers of inpatients. The project has been heavily patient-centred with involvement of young people throughout, and aims to consult more closely with patients during further development.