Table 4.
The final thematic structure of the education program
| The PEPP sessions | Structure | Main focus | |
|---|---|---|---|
| 1 | Information | Introduction | The acquaintance and an overview of the program |
| Active information | The importance of taking an active and central role in the health care system | ||
| Exercise | How to ask questions to health care professionals | ||
| Homework | To draft questions for a visit to professionals | ||
| Appetizer | Past experiences with keeping a diary/journal | ||
| 2 | Self-monitoring | Homework discussion | Homework discussion of session 1 |
| Active information | To learn about self-monitoring techniques, like a diary. | ||
| Exercise | An exercise ‘body awareness’ focused on breathing and muscular tensions | ||
| Homework | Option 1: Use a diary to record (i.e. fluctuations in mood or PD symptoms) | ||
| Option 2: Perform the exercise ‘body awareness’ | |||
| Appetizer | Bring something pleasant to the next session (i.e. an object or experience) | ||
| 3 | Health promotion | Homework discussion | Homework discussion of session 2 |
| Active information | To improve well being through pleasant activities | ||
| Exercise | To explore pleasant activities | ||
| Homework | Perform a pleasant activity every day | ||
| Appetizer | Observe your own behavior in a stressful situation | ||
| 4 | Stress management | Homework discussion | Homework discussion of session 3 |
| Active information | The role of unrealistic and unhelpful thoughts in stressful situations (ABC scheme) | ||
| Exercise | Option 1: Learn to replace unrealistic and unhelpful thoughts through realistic helpful thoughts | ||
| Option 2: Perform relaxation exercises to deal with stress | |||
| Homework | Option 1: Try alternative ways of thinking | ||
| Option 2: Relaxation training | |||
| Appetizer | Observe changes of mood and causes of worry | ||
| 5 | Management of anxiety and depression (patients)/caregiver’s challenge | Homework discussion | Homework discussion of session 4 |
| Active information | To teach about the difference between normal feelings of anxiety and sadness and when they turn into anxiety disorders or depression/caregiver overload. Second, learning about the role of unrealistic, unhelpful thoughts (ABC scheme) | ||
| Exercise | Option 1: Usage of positive thoughts (illustrative video clip) | ||
| Option 2: Maintaining healthy activities | |||
| Homework | Option 1: Think of a positive event | ||
| Option 2: Maintain healthy activities | |||
| Appetizer | Notice situations in which you want to express your thoughts and feelings but not having the confidence to do so | ||
| 6 | Social competence | Homework discussion | Homework discussion of session 5 |
| Active information |
Social skills like communication are discussed. Option 1: Unhelpful and helpful thoughts in communication |
||
| Option 2: Ways of communication | |||
| Exercise | Discussion of a video clip addressing communication problems | ||
| Homework | Option 1: Note situations in which unhelpful thoughts contributed to a lack of socially competent behavior | ||
| Option 2: Tell someone that you have PD | |||
| Appetizer | To focus on the informal or formal support, you would like to receive | ||
| 7 | Social support | Homework discussion | Homework discussion of session 6 |
| Active information | To discuss the importance of and how to obtain social support | ||
| Exercise | Role play/discussion | ||
| Homework | Finding sources of support and asking for support | ||
| Appetizer | Reflecting about the entire program | ||
| 8 | Evaluation | Homework discussion | Homework discussion of session 7 |
| Active information | The group goes through the previous sessions and the program is evaluated. Expectations and achievements are compared | ||
| Exercise | Writing a postcard for each other and filling in an evaluation questionnaire |
The topics are the same for patients and caregivers, who participate in separate but parallel groups. Only session five has a different topic for patients (Management of anxiety and depression) and caregivers (Caregivers’ challenge). Sessions have a standardized sequence: skills learned in previous sessions return in and are necessary for next sessions. The detailed description of the intervention has been written down in a manual, which is available in several languages in bookshops. Future studies are, therefore, able to replicate this intervention in several countries