Key words
Psychoeducation; Website; Constructionism; Connectivism
Introduction
This project is an authentic learning activity with naturalistic feedback, online community learning feedback and scafolding and facilitator response. Patient, peers and community feedback also informed the connectivist model of learning. The fnal outcome of a Web-site for the purposes of Psychoeducation is a dynamic project that will grow within a model of life-long and life-wide learning.
Discussion
Aims and Projected outcomes
Psycho-education has been found to be an important adjunct to good wholistic treatment of mental illness.( Shimazu et al (2005); Sorensen, Done & Rhodes 2006; Pekkala & Merinder, 2002; United States Department of health and human services; Queensland Health; Psycho-Educational Counselling Services, Inc. 2003) I have been using ‘talk and chalk’ methods for many years as a clinical psychiatrist in private practice. I felt quite advanced when I moved to the technology of a white board. Many patients are technologically savvy and it is easier to refer them to the Internet (HON Surveys 2001; Leu et al 2004). In fact many patients have already researched their illness and treatments before they come and see me. Psychiatrists today have learnt that they can’t know everything that has been stated about psychiatry on the Internt or in the popular press and that our role has offten become that of facilitator in the learning process. We help people make meaning of all the things they have heard, give a professional perspective and direct them to other sources for a balanced view. It was important however to ensure that psychoeducation was not learned only in an online format as the therapeutic relationship and medical treatment were the most important treatment parameters.
Rationale
For many years I have realised that a website that collated this information, from my perspective was neccesary. Offering links to information and resources to patients and their families was also a frequently requested item.Referring people to the website for ememergency procedures, contacts and advise could help cover the resource issues in this rural region especially in ‘after-hours’ timeframe (RANZCP 2007 ).
This project seemed like the ideal time to put the process into action and gave me a structure to use.There was a timeframe set by the university calendar and the resources, support, ideas, supervision available from facilitator and online study community. I already had in mind the general outline, structure and design of the website based on projected need, visiting other websites and my own creativity. The added content from this course to think about was multimodal and online learning pedagogies.
Evaluation
Researching what is already there was a good place to start. There were no other colleaugues who had established a website for reference, that I know. The Royal Australian and New Zealand has a very useful website (The Royal Australian and New Zealand College of Psychiatrists).The American and British colleges and the American Academy of Child and Adolescent Psychiatry all had reams of information and proffesionally designed website(Royal College of Psychiatrists ; The American Academy of Child and Adolescent Psychiatry; The American College of Pscyhiatrists) . Googlesearchs of the main diagnoses and treatments revealed huge numbers of resources. The problem was too much information.
Researching patient’s needs became the next most important step. I designed a quick questionairre to assess the perceived needs.(Appendix 2). I checked with my lecturer about the ethics of that research. By keeping the responses anonymous and asking my receptionist to ask people to fill in the questionairre, I was appying no pressure to the patients and they would know that their treatment or the therapeutic relationship was not harmed by this process. It was interesting to see that everyone was keen to fill out the form. Even some carers, colleaugues and occasional visitors showed a keen interest in the project, projected benefits from it and volunteered to fill in the form.By keeping it simple and small it was not an onerous task. By keeping the questions yes or no, it was easy to score. The final question was a projective question that was seeking areas of need and interest and was the most useful.
It was interesting to note that almost all my patients had a computer and Internet facilities.This may reflect the bias of this sample as they are all private patients who may have more disposable income that the general population. They were mostly keen to see a website devoted to their needs and this was reflected in their choices for content. Most patients asked about the project and the website and discussed this as part of their consultation, giving me extra feedback.They were keen to see the website when completed and give feedback online.
I had aimed to put the information together in a weekend and have the site ready within a week. I found that it was much more work than that.Each topic needed to be concise but give structure to the reader. Some of my patients need basic information and others need academic, scientific levels of information. I did not want to write a text book but took the idea that the World Wide Web is really a network and to make it productive, networking and links to other information was its very essence (Lee ). I spend more time researching the various websites for inclusion and excluding those that were unsuitable. I realised that this website I am constructing will always remain a work in progress.Once the basic structure is in place, I can keep adding to it and altering information as it is needed. In this way the website can remain a dynamic document but will always require a few hours of work a week to maintain.
The webmaster was my son who studies Bachelor of Information Technology and is a computer technician. I began to understand that the communication required to direct him towards the creation of the website was a whole new field of learning for me. I was frustrrated that I could not navigate html myself so it is next on the list of things to learn. It took a lot of work and time to construct the website, more than I thought it would. The nice things about websites is that they are interesting and not like a book, so the creative component of the website, colour, layout, design, fonts were all important aspects of communication to the webmaster. The webmaster used his e-mail for feedback. He soon realised that the e-mail name ‘addlebrains’ was potentially disrespectful and so had to change this to his workplace account.
I wanted pictures and photographs for a multimodal effeect as I could see that text was not very enticing (Semali & Fueyo, 2001). Another son gave me the link to deviant art which was a wonderful place to lose more time in a pleasant way (Deviantart). I have always used art to convey meaning in lectures and found it useful. I added photographs and art work so that the website started to look really lovely. Then I realised that I had a copyright problem.I had already needed to limit some of the work on my website as the text would have breached copyright, although no knowledge is plaigarism free. So I had to remove all the pictures and start again. I found some clipart that sufficed and was free to use. My next part of this project is to photograph my own artwork and use those pieces and take my own photographs to illustrate the website. Gradually you can see that although I have learnt a lot of useful information along the way, the process was becoming more complex over time. The timeframe for launching the website and obtaining feedback from colleaugues and patients, and the general public was escaping.
I was able to launch the first draft website and got some interesting feedback from two of my peers in my online learning community. I have yet to add a wiki as a simple and easy to administer feedback system. We changed the headings and highlights for links in keeping with other feedback. I was interested to note that my peers were also keen to see the site and give me their thoughts and useful links. This was a pleasant pat of the learning experience.
The pedagogies in use in the website involve a constructivist approach. By providing links to information and a baseline framework of how to look at the various illnesses and contact with other sufferers in the global community, there is validation for each person as well as their capacity to seek and understand information to their own needs and levels of understanding. The connection to various websites and pieces of information allows a connectivist approach (Kinzer, 2003).
This reflects Vygotsky’s approach of a zone of proximal development and scafolding towards learning (Blunden, 2001). There is a sense of the socio-historico-cultural learning process in such a website. One can also see that there is the potential for discourse for learning as well. My pedagogy for learning was a project based, authentic, problem-based approach (Finkle & Torp, 2005; Holland, 2005; Jarvin, 2006).
Linguistic design was an important component to me (Cope & Kalantzis, 2000). The words used need to be explained and simple without infantalising. This was complex given the differrent levels of education my patients have. I think that people prefer simple language and not to feel overwhelmed by techincal or academic language.This is difficult for me as my mind is well versed and trained to think academically and I love a rich vocabulary. There is no feedback from patients as when they are in my rooms so I had to be careful of using simple language but not to insult anyone’s intelligence (Cope & Kalantzis 2000 (2). I found that a website about metal illness to be very depressing, serious and dour which reflects the problems of mental illness. I wanted the information to be positive, without denying or failing to validate the suffering and to be lighthearted without being irreverant.
I chose light blue/gray as a background and the front page with limited colur and information to present a professional image and not to clutter the non-verbal presentation (Callow 2003). I chose to not include audio input at this point in time because it was too complex and would delay the launch of the website. The project for the future is to record, using authentic presentation, an intoduction, providing audio input for the visually impaired and expanding the sensory learning. The pages lead towards the centre and contain concise information so as not to overwhelm the reader. I also wanted plenty of space and not clutter the pages as some patients are already thought disordered and would find it too confusing. I think that the basic information needed to be linear and the links for divergent thinking were scafolded on top of this.This is reflected in the architecture of the pages. I originally used a stream of consciousness to write the pages but found that it was too easy for others to get lost in the flow. I then introduced headings and spaces to allow a framework to develop and room to think between topics. I think tha the page ‘anger management’ reflects this style well especially given that people with anger management problems often get frustrated, have language and communication problems and poor concentration (Apendix 4)
The website can be found at http://drjoycearnold.freehostia.com/psych.html. There is still more information that the webmaster needs to load which is available on my blog (http://joycearnoldsspace.blogspot.com/). As discussed above, this is an evolving process, a work-in-progress and will have continual updating. Some of the updating will be in repsonse to the wiki included and feedback from site visitors. I intend to give all my patients this address on my business card so that they can visit and comment online or when they see me. I intend to advertise this link to general practitioners so they can access it and the links and they can provide feedback. I will give this link to my colleuagues at our Maintenence of professional standards (MOPS ) meetings and obtain feedback from them. They are already aware of this project and agree that it is useful and innovative.It reflects the future of learning in the digital age (North Central Regional Educational Laboratory 2005).They were happy to allow me to set it up and give feedback before they would do this project themsleves. Thay are more likely to refer their patients to my website than set up their own as time is precious and are psychiatrists are busy people.
I also kept a reflective journal about the process so I did not lose any ideas I had, could revisit the issues and build on them, using a constructivist appoach, Some of these ideas are on my blog and others in a private journal. http://joycearnoldsspace.blogspot.com/
I think that the process of setting up a website was a huge learning curve and an authentic learning project for me.As part of life- long and life -wide learning, this is the first step ( Education Queensland nd) There is more to do and learn and this project wil lalso help people with mental illnes and their carers obtain information, find resources and steer away from negative or wrong information. I have experienced an authentic learning project and have realised its potential to teach. At this point in time I do not see this as useful for the website design but it may be possible, particulalrly in the kidszone part where projects will be posted (O’Brien, 2001). I already use this technique for treating specific phobias and there is no reason it could not be incorporated into the design of the website.
Conclusion
A personalised Website for my patients allows access to information, using connectivism and constructionist learning . The value of such psychoeducation has been well established. Using digital technology as the medium for learning provides new opportiuities for learning and access. This project also established the value of a website for psychoeducation for my patients.
I learned using a project based, authentic process of learning. I will also learn from feedback from peers, facilitator and recipients. Within a sociocultural learning environemnt, I also was given scafolding to learn from this project. The outcome is a a living educational resource that will change over time, new information and new technologies. It will also change as I learn new aspects of digital literacies.
List of references
American Academy of Child and Adolescent Psychiatry retrieved 6/5/2007
http://www.aacap.org/
Arnold, J (2007) blog
http://joycearnoldsspace.blogspot.com/
website
http://drjoycearnold.freehostia.com/psych.html
Blunden, A (2001). The Vygotsky school Spirit, Money and ModernitySeminar retrieved 6/5/2007
http://home.mira.net/~andy/seminars/chat.htm
Callow, J (2003), Talking about visual texts with students, Reading online, vol. 6 (8) retrieved 6/5/2007,
Cope, B & Kalantzis,M, (2000) (2) Investigating Identity and Power relationships
Retrieved Googlesearch 6/4/2007
http://www.thenetwork.sa.edu.au/identity_web/multiliteracies.html.
Deviantart, retrieved 6/5/2007 http://browse.deviantart.com/
Education Queensland (nd): New times, new literacies, Literate futures, pps. 1–12, retrieved 6/5/2007
Finkle & Torp (2005) Problem based learning Retrieved Googlesearch 6/4/2007
http://www.cotf.edu/ete/teacher/teacherout.html
Holland,S.,(2005) Problem based learning. Department of Education and Children’s Services Government of South Australia Retrieved Googlesearch 6/4/2007
http://www.tsof.edu.au/resources/pbl/
HONSurveys (2001) Evolution of Internet use for Health Purposes retrieved 6/5/2007
http://www.hon.ch/Survey/FebMar2001/survey.html
Jarvin.L.,(2006). What is the Big 6? TM V Retrieved Googlesearch 6/4/2007
http://big6.com/showarticle.php?id=415
Kinzer, C.K, (2003), The importance of recognizing the expanding boundaries of literacy, Reading online, vol. 6(10), retrieved 6/5/2007,
Lee, S (nd) The World Wide Web: Its uses as a teaching tool Online Teaching Tools and Projects retrieved 6/5/2007
http://www.oucs.ox.ac.uk/ltg/projects/jtap/reports/teaching/chapter4.html
Leu, D, Kinzer, C K, Coiro J.L & Cammack, D.W (2004), ‘Toward a theory of new literacies emerging from the internet and other information and communication technologies’, Reading online, retrieved 6/5/2007
North Central Regional Educational Laboratory (2005), 21st century skills, retrieved 6/5/2007
O’Brien,D (2001) At-risk Adolescents: re-definig competence through the multiliteracies of intermediality, visual arts and representation, retrieved 6/5/2007
Papert , S & Harel, I (1999) Situated Constructionism retrieved 6/5/2007 http://www.papert.org/articles/SituatingConstructionism.html\
Pekkala E, & Merinder L. (2002) Psychoeducation for schizophrenia. in The Cochrane Database of Systematic Reviews 2007 Issue 2,The Cochrane Collaboration. John Wiley and Sons, Ltd. Art No.: CD002831. DOI: 10.1002/14651858.CD002831.retrieved 22/4/2007 Googlesearch
http://www.cochrane.org/reviews/en/ab002831.html
Psycho-Educational Counselling Services, Inc. (2003) Psychoeducation retrieved 21/4/2007 Googlesearch
http://www.psychoeducation.com/psychoeducation.htm
Queensland Health (nd) Psychoeducation retrieved 21/4/2007 Googlesearch
http://www.health.qld.gov.au/rbwh/inbmhs/factsheets/psychoeducation.pdf
RANZCP (2007) RANZCP Trainee survey: Perspectives on rural pscyhatry and rural experience, RASTS Project retrieved 6/5/2007
http://ranzcp.org/pdffiles/policy/RANZCP%20trainee%20survey%20-%20Perspectives%20on%20rural%20psychiatry%20and%20rural%20experience.pdf
Semali, M & Fueyo, J (2001) Transmediation as a metaphor for new literacies in multimedia classrooms retrieved 6/5/2007
Shimazu, A, Kawakami, N, Irimajiri, H, Sakamoto, M & Amano, S (2005) The effects of web-based psychoeducation on self-efficacy, problem solving behaviour, stress responses and job satisfaction among workers: a controlled trial, Journal of Occupational Health 47 (5) pps 405-413, retrieved 21/4/2007 Googlesearch
http://www.jstage.jst.go.jp/article/joh/47/5/47_405/_article
Siemens, G (2004) Connectivism a theory for the digital age elearnspace retrieved 5/6/2007
http://www.elearnspace.org/Articles/connectivism.htm
Sorensen, J, Done, D.J & Rhodes, J (2006) A case series evaluation of a brief, psycho-education approach intended for the prevention of relapse in Bipolar Disorder Behaviour and Cognitive Psychotherapy, Cambridge University Press retrieved 21/4/2007 Googlesearch
http://journals.cambridge.org/action/displayAbstract;jsessionid=D39006D069A0540BCA952650ABF94CCD.tomcat1?fromPage=online&aid=461240
The American College of Psychiatrists retrieved 6/5/2007
http://www.acpsych.org/
The Royal Australian and New Zealand College of Psychiatrists retrieved 6/5/2007
http://www.ranzcp.org/
The Royal College of Psychiatry retrieved 6/5/2007
http://www.rcpsych.ac.uk/default.aspx?page=0
United States Department of health and human services (nd) Evidence –Based Practices: Shaping Mental Health Services Toward Recovery, Family Psychoeducation, Retrieved 21/4/2007 Goooglesearch
http://mentalhealth.samhsa.gov/cmhs/communitysupport/toolkits/family/
Appendix 1
Definitions
Psycho-education Psycho-education is teaching and learning about psychiatric illness and mental health and psychological treatment.
Website. On the World WideWeb and Internet resources a virtual space is created that looks like a page on which text, graphics, audio, video can be found. The Webpage is then part of a website which is a collection of webpages linked to one another.
Constructionism. The pedagogy of constructionism was introduced by Vygotsky and Papert. They constrasted constructionism with instructionism. By allowing induvuduals to learn and construct their own meaning in the process, the teacher does not instruct but facilitates from the side , the student to learn by construction. Social and distributed construction are used to describe the network connectivity in constructionsism (Papert &Harel 1999)
Connectivism Chaos theory describes the complexity of knowldedge especially since the technology revoultion and information/knowledge explosion. Overriding older pedagogies, connectivism describes the mulitple networkeed pathways that learning can take (Siemens 2004).
Appendix 2
Research Questionairre
1. Do you own a computer in your home?
Circle yes or no
2. Do you use a computer outside your home?
Circle yes or no
3. Do you research on the Internet?
Circle yes or no
4. Would you visit a webs-page designed for education concerning psychiatric illness?
Circle yes or no. If no thank you for your help.
5. Would you like links to information from this web-page.
Circle yes or no
6. What information would you like on such a webbpage?
Appendix 3
Research results ( taken from proposed webpage and will soon be available at http://drjoycearnold.freehostia.com/psych.html)
Thank you for all your help getting some background information to help me put this site together. Here are the results.
Do you own a computer in your home yes 50 no 3
Do you use a computer outside your home yes 20 no 32
Do you research on the Internet? yes 44 no 9
Would you visit a Web page designed for education concerning psychiatric illness?
yes 45 no 7
Would you like links to information from this web page?
yes 43 no 3
What information would you like on such a web page?
The responses can be summarised as – signs and symptoms for Depression, Schizophrenia, Asperger’s syndrome, adolescent social problems, Children’s behaviour problems, Bipolar disorder
Treatments- medications and their side effects
Group therapy, hospitals and clinics available
Self help groups and chat rooms
Help for carers and parents
How to handle difficult behaviour
Where to find help.
Support for staff
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