Phase Appropriate Copy

Psychoeducation should begin as early as possible and be adapted so that it is appropriate to the phase of recovery.

In the early stages, information should be as practical and concrete as possible. Psychotic symptoms for the client and shock for the family will limit the amount of information they are able to process. More formal education should be withheld until the recovery stage.

As the psychosis responds to treatment, clients appear to use one of two main recovery styles:

  • Integration – incorporating the experience of psychosis into one’s life
  • Sealing-over – isolating the experience of psychosis from the rest of one’s life

In early psychosis clients, an integrative recovery style appears to be associated with better outcome while sealing over is associated with low service engagement. Recovery style is dynamic and changes over time. There is a tendency to go from an early integrative style to a sealing over style within the first three months. Psychoeducation very early in the course of the disorder may ensure that an individual maintains an integrative style. At this stage, information should be concrete, paced and delivered in small chunks. Allow time for the client to process information that you are providing and to ask questions.

When psychosis develops in a close relative, the family may experience reactions ranging from fear to denial. Frequently, the family will attribute the psychotic behaviour to substance abuse, adolescence, family conflicts, or other explanations. These reactions suggest that the family should actively be sought out and engaged as early as possible. Most families with a relative experiencing early psychosis will feel high levels of distress and difficulties – regardless whether their relative lives with them or not. Psychoeducation can provide family members with the knowledge and skills necessary to help them understand and care for their relative and increase their ability to cope.

Clients and families should be provided an explanation of their rights and confidentiality and the treatments being provided. Both verbal and written information should be provided where possible. Recognize that literacy levels and English as a second language should not prevent the provision of information. Materials in other languages may be available however not all languages have terms which equate with terms such as psychosis. Contacting local multi-cultural service agencies or translation services may be necessary.

Some educational materials in other languages are available at

  • BC’s Provincial Early Psychosis website has all the care pathway handouts translated into Punjabi, Chinese and Hindi www.earlypsychosis.ca
  • Early psychosis information in Punjabi and Chinese
    Download the document here as well as athttp://www.healthservices.gov.bc.ca/mhd/bpelementsbc.html
  • Schizophrenia information in Bengali, Hindi, Punjabi, Spanish and Urdu (Chinese and Tagalog translations coming soon)
    Download the documents here.
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