1. PSYCHOEDUCATION: APPLICATIONS FOR CROSS- SYSTEMS PRACTICE IN INTERNATIONAL CONTEXT Mainstreaming Mental Health in Public Health Paradigms: Global Advances and Challenges Global Foundation for Democracy and Development /Fundación Global Democracia y Desarrollo UN Headquarters, New York Ellen Lukens, PhD, LCSW Columbia University School of Social Work April 11, 2011 1

2. Psychoeducation 2  Model that provides collaborative opportunity for participants & facilitators to exchange knowledge & learn together about an area of concern  Evidence-based/evidence-informed  Principle-based/curriculum-driven  Flexible model  Clinical & group practice  Community practice & advocacy  Training

3. PSYCHOEDUCATION 3  educational & therapeutic interventions work together  therapeutic use of education  knowledge as power  education  psychiatry  Illness & wellness  other life challenges  practical strategies for coping in the face of stress, trauma, & other challenges  community education & collaboration  potential for building community awareness & advocacy skills regarding health & mental health literacy  builds on resilience as well as challenge

4. Why Psychoeducation?  Stress & Trauma Interfere with Processing & Using Information & Knowledge  Can occur at individual, family, community, national level  Understood in different ways depending on culture, history & resources Haiti Japan Kazakhstan United States 4

5. Why Psychoeducation-continued?  Stress & Trauma Interfere with Processing & Using Information & Knowledge  Daily life is disrupted & no longer predictable  Can occur at individual, family, community, national level  Can be acute or cumulative or both 5

6. Intervention or Training Goals 6  enhance communication  create a common language  foster knowledge exchange  allow participants to bear witness  build self-awareness/pattern recognition  build community & supports  models value of structure, sense of “normalcy”, return to the ordinary

7. Knowledge is power…  and information alone is not enough without…  Insight  Interpretation  Understanding  Context

8. Stages of Healing through Psychoeducation  Safety  Bearing witness  Managing feelings/self-care  Grief & loss  Personal power/self-efficacy  Meaning making  Transformative learning through knowledge exchange  Building community awareness

9. Knowledge as Capital 9  Integrate information with experience  Knowledge supports safety  Safety supports knowledge  Knowledge leads to self awareness  Self awareness creates opportunity for healing  Knowledge contributes to community advocacy & healing

10. Collaborative Community of Care 10  Share experience  Learning together  the learning community  the learning collaborative  the learning exchange  Facilitators & members collaborate  Embrace multiple perspectives  Share responsibility & accountability

11. PSYCHOEDUCATION AS COLLABORATIVE MODEL: shifting a paradigm 11  Participants & facilitators ALL serve as:  educators  students  translators  consultants  facilitators  advocates  monitors

12. Planning a psychoeducational intervention  Assets & needs assessment  Draw on professional & local knowledge to leverage assets & plan intervention  Policy makers  Organizational members & leaders  Community members & leaders  Spiritual leaders  Youth  Curriculum development 12

13. Sources of Knowledge for Integrated & Cross- Systems Practice in Health & Mental Health 13  Policy & politics  Organizational knowledge  Research  Practitioner knowledge  User knowledge  Cultural context

14. Assets & Needs Assessment  Professional knowledge (of the expert)  the “experience far”  Local knowledge (of the crowd)  the “experience near”, the lived experience  recognizing shared history, perspective, world view  Validating both  Privileging neither

15. Challenges to implementation..  Need for commitment within & across systems  among organizational, community, spiritual, political leaders (i.e. buy-in from top-down & bottom-up)  Investment in health & mental health literacy among general public  Sensitivity to linguistic & cultural interpretation of stress, trauma, life challenge  Dissemination  Sustainability 15

16. Potential  Ripple effects of accurate information & knowledge  Bridges formal (provider) & informal (community/family/peer) supports  Reduces power disparities  Can be used as group, community, organizational and/or training model  Can lead to collective & community response & action moving forward  Builds interdependent & mutual support  Builds social capital, agency & community leadership 16

17. IN SUM... 17  partnership among professionals & participants  shifting paradigm from challenges to strengths  present focused  focus on critical time periods  attention to timing  active use of group structure  emphasis on education & insight  community building/education  creates a learning collaborative or exchange  parallels principles of community based participatory research