Peer-to-peer psychoeducation in schizophrenia: a new approach.
OBJECTIVE
To evaluate the feasibility of the first peer-to-peer psychoeducation program in schizophrenia.


METHODS
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.


CONCLUSIONS
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.
Rummel
Christine B
CB
Department of Psychiatry and Psychotherapy, Center for Disease Management, Technical University Munich, Möhlstrasse 26, 81675 Munich, Germany. christine.rummel@lrz.tum.de
Hansen
Wulf-Peter
WP
Helbig
Alexandra
A
Pitschel-Walz
Gabriele
G
Kissling
Werner
W
D000223:Adaptation, Psychological; D000328:Adult; D003479:Curriculum; D004493:Education; D005240:Feasibility Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D010379:Peer Group; D010865:Pilot Projects; D011615:Psychotherapy, Group / Q000379:methods*; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D012657:Self-Help Groups / Q000458:organization & administration*; D016896:Treatment Outcome