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4. PSYCHO EDUCATIONAL GROUPS
Recovery Warriors Psycho-Education Group:
Recovery Warriors is a monthly group that includes activities and strategies for coping and staying connected. This group is facilitated by two practitioners and run online and in person. Careful consideration is made in facilitating this group as it can often be the first time a client engages with EDQ services and gets insight into the counselling interventions used and the community that exists at EDQ.
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The group aims to support clients until they can move into more intensive therapy and support services. Participants are introduced to various therapeutic and support interventions as well as providing ongoing recovery skills and reminders to help their recovery pathway. This group is run in conjunction with the Recovery + Discovery Centre Mental Health Hub.
Trauma Informed Yoga Group:
Recovery from an eating disorder often involves a process of reconnection to the body. A yoga practice can be a way for people to make peace with the body, reclaim the body, and learn that the body can be reliable and safe again. Each group is run in person and six sessions are provided to participants. The sessions encourage connection with the body through practices of movement, breathing, meditation and relaxation.
Compassion and kindness for self are underlying principles for the practice and choice is provided for people to go at their own pace and comfort level. The yoga classes are taught from a trauma informed and mental health perspective and involve safety planning, which includes medical clearance by their treatment medical practitioner.
Wise Choices:
Wise Choices is an Acceptance and Commitment Therapy based group program that runs for 11 weeks. It is facilitated by two practitioners and runs either online or in person. The group supports people who experience eating disorders or body image concerns to learn strategies to flexibly manage difficult thoughts and feelings. Within a group setting, the program aims to support participants to develop skills to lead a life of healthy and meaningful relationships with self and others.
Events:
Events are hosted at various times throughout the year, and they typically involve informal activities that aim to connect the community, reduce isolation and increase awareness of eating disorders. These events are open to all people in the community, not just clients who received EDQ services.
36. Safety is always ensured.
Psycho-educational groups are an important way of ensuring the clients receive information about eating disorders and the various pathways to recovery. Research suggests that psycho-educational groups may increase the likelihood of people seeking support for their eating disorder as well as facilitating a reduction in symptoms 69 .
Each psycho-educational group is designed to create a safe, intentional environment. Risk assessments must be carried out at the point of intake where all group participants are assessed for group readiness. This is a more complex issue for open rather than closed groups and facilitators may have to rely on their facilitation skills to deal with any unexpected issues and ensure the safety of the group. Similarly, confidentiality is an important aspect of ensuring safety in the group.
Each group should have clear group agreements about confidentially and for open groups, these agreements must be reinforced at the beginning of each session.
The worker needs to be clear about the purpose and expectations of the group to ensure that all participants are aware that these are psycho-educational and not therapeutic groups. Group participants should be encouraged to reach out for support when required.
37. Each group is designed to build skills and capacity.
Psycho-educational groups should focus on supportive skill development rather than therapeutic work. This can be a difficult balance to achieve for the facilitators and highlights the importance of clearly stating the purpose of each group so that story telling is limited. These groups are generally more structured and intentional and frequently use existing evidence-based group programs.
There are a range of high-quality psycho-educational programs related to eating disorders that can assist workers in developing these group programs. For example:
• Wise Choices is a group work program based on Acceptance and Commitment Therapy. The Wise Choices group treatment program focuses on a series of psycho-educational sessions around mindfulness and acceptance, avoidance and struggle, values and choices.
• 8 Keys to Recovery from an Eating Disorder Workbook is a companion book to the main text and includes a range of worksheets and exercises.
• RAVES is a framework that supports the development of positive food relationships and the progression toward intuitive eating practices. RAVES stands for Regularity Adequacy Variety Eating socially and Spontaneity.
• Centre for Clinical Interventions is a clinical psychology service in Western Australia. They provide a range of free psycho-educational resources including worksheets and information packages.
Group content should include the following topics:
• Values • Awareness of Thoughts • Awareness of Emotions • Mindfulness • Acting on Values • Avoidance, Obstacles and Choice • Healthy Relationships • Dominant Social Views of Weight and Body Images • Managing Stress
38. Empowerment, choice and participation are important in all groups.
Attention should be paid to the power imbalances inherent in group work and the ways workers can reduce these by participating in activities and ensuring the material is presented in an open way. Participants should be encouraged to always choose their level of engagement.
Connection through participating is a key purpose of these groups. This is more difficult to facilitate in an open group where rapport building can take more time if participation in the group is not consistent.
39. Groups are facilitated by experienced practitioners.
Each psycho-educational group must be co-facilitated. This ensures the safety of each member of the group and helps to ensure the group remains focused on its purpose. The facilitators must model the practical skills that are the focus of each group to ensure consistency between the content and the process of each group.
Groups should have a flexible format to ensure equitable access to those who are unable to attend in person. Groups can be run in person or online depending on interest and regional focus.
