Peer-to-Peer Psychoeducation in Schizophrenia: A New Approach
J Clin Psychiatry 2005;66(12):1580-1585
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Objective: To evaluate the feasibility of
the first peer-to-peer psychoeducation program in schizophrenia.
Method: We developed a 5-step
curriculum for structured training of peer moderators. In
step 1, peer moderators participate in regular
psychoeducation, and in step 2, they participate in
workshops on knowledge about schizophrenia and moderation techniques. In step 3, peer
moderators conduct peer-to-peer groups in the presence of
a mental health professional, and in step 4, they conduct the groups independently with
regular supervision. Further peer moderators are
recruited in step 5. Psychoeducation by trained peer
moderators comprises 8 60-minute group sessions (warm-up, symptoms, diagnosis, causes,
medication, psychosocial therapy, warning signs,
coping with schizophrenia) with 6 to 10 patients
per group. The feasibility of the 5-step
curriculum was evaluated by conducting a pilot study of
7 peer groups with 2 peer moderators. Evaluation
of peer-moderated groups was done from January 2003 to July 2004 using inpatients of a
university hospital who had schizophrenia or
schizoaffective disorder according to ICD-10. The primary
outcomes of interest were change in knowledge and concept of illness from baseline to endpoint.
Results: Two peer moderators
conducted psychoeducational groups with a total of 49
patients in the presence of a physician (step 3).
On the whole, conduction of peer-moderated groups worked well. Knowledge of illness increased
significantly (N = 44, p < .001), and concept of
illness changed significantly in 3 subscales: trust in
physician (N = 40, p = .002) and trust in medication (N = 40, p = .001) increased, and negative
treatment expectations decreased (N = 40, p = .001).
Subjective assessments of peer moderators by
participating patients were positive.
Conclusion: First results suggest that
peer-to-peer psychoeducation in schizophrenia
according to the 5-step curriculum is feasible and may
be comparable to professional psychoeducation in regard to short-term outcomes.