The Psychoeducational Approach to Complex Protocols in Neurorehabilitation

Abstract

Patients with multiple sclerosis (MS), a chronic and often disabling demyelinating dis ease of the central nervous system, are often confronted with repeated attacks over two to three decades, a wide variety of symptoms that affect a patient's functional sta tus, a variable and unpredictable disease course, and many socioeconomic problems. During the past decade, many technologic and pharmacologic advances have changed the treatment of MS from a “diagnose and adios” procedure to a complex process re quiring increasing patient and family action. Injectable disease-modifying agents, blad der management techniques, regimens to improve sexual functioning, and programs to reduce spasticity have made MS treatments more challenging, time-consuming, and demanding for patients. Health care providers are thus confronted by many tasks in patient and family education regarding proper implementation of the regimens as well as continuing patient compliance. At many MS centers, the psychoeducational ap proach is taken. This is a dynamic process based on a partnership between the pa tient and the health care team. It differs from traditional methods by teaching im portant skills in a psychotherapeutic rather than a didactic setting. A three-part psychoeducational teaching program developed at one center for patients receiving injectable medication has proved very effective in promoting adherence. It focuses on patient expectations and concerns and responds to both individual needs and per ceptions about the complex injection protocol. © 1997, SAGE Publications. All rights reserved.