L’éducation thérapeutique s’inscrit dans le parcours de soins du patient. Elle a pour objectif de rendre le patient plus autonome en facilitant son adhésion aux traitements prescrits et en améliorant sa qualité de vie. Il s’agit de créer un climat de collaboration entre le patient, l’équipe de soins et sa famille, afin qu’ils soient tous partenaires dans l’élaboration et la mise en œuvre d’une alliance thérapeutique. Ces thérapies s’accompagnent d’un changement de paradigme, en rendant le patient acteur de sa thérapie, dans un partenariat à la fois entre le patient et son médecin et entre le patient et l’ensemble des acteurs locaux du soin et des aidants. L’accent est alors mis sur l’importance des prises en charge inscrites dans la territorialité, en considérant la personne dans son milieu de vie, en phase avec son environnement quotidien et ses souhaits. Cependant, les particularités cognitives et émotionnelles de ces pathologies et la stigmatisation dont elles font l’objet sont des éléments à prendre en compte pour assurer l’acceptation et l’intégration des informations. Cette prise en compte est un préalable à la mise en œuvre de programmes d’éducation thérapeutique structurés. Il convient d’individualiser le programme d’éducation thérapeutique en fonction de l’état, des attentes et du niveau de conscience de chaque patient. Il s’agit donc de construire un programme individualisé intégratif, qui va accompagner le patient tout au long des étapes de son parcours de rétablissement. Nous allons illustrer cette démarche selon les principes du rétablissement en décrivant le programme « ETP schizophrénie », qui est un programme ciblant spécifiquement les déficits liés à la schizophrénie, destiné aux usagers et à leurs proches résidant dans l’Oise existant depuis 2011 sur le centre CRISALID (Centre interdépartemental de remédiation cognitive et de réhabilitation psychosociale) au Centre hospitalier interdépartemental de Clermont-de-l’Oise (région Hauts-de-France).

The objectives of this article are to describe first the main concepts of recovery in people suffering from mental illness, focusing on the concept of process of recovery; then to describe the definition of psychoeducation, from its beginning to the criteria established by the HAS (French Autority Health Department) and written in the Health French law HPST (2009). At the end, towards the description of recovery and educational therapeutic, this article highlights the similarities between recovery process and educational therapeutic programs. The concept of recovery can be approach around two definitions: the first one refers to a clinical and a functional remission according to Lieberman criteria: for two years, improvement of the clinical symptoms, part-full employment, autonomy and social interactions. The second one refers to a more subjective definition focusing on the process of recovery: it based on a longitudinal process, with the subjective transformation of the person living with a chronic mental disease, independently of the presence or not of the symptoms; it's a process not based on the disease but on the future of the person. It's a process based on hope and on the recovery of a personal efficiency feeling, restoring a place of citizen, with goals and desires. Subjective well being and quality of life become goals. Educational therapy is defined as a continued process, integrated care and patient centred. It includes sensitization, information, learning activities and psychosocial care regarding disease, medication, healthcare systems, behaviours around health and disease. It aims to help patients and relatives to understand disease and treatment, to cooperate with caregivers, to live the healthiest and to maintain or improve quality of life. Education should make the patient able to acquire and maintain resources to manage optimally his life with the disease. All the educational therapeutic program must meet HAS criteria, as described in the specification of the HAS and the Health Law, to be authorized. It is to create a collaborative climate between patient, relatives and caregivers, in order for them to be all partners in the development and implementation of a therapeutic alliance. These therapies involve a paradigm shift, making the patient actor of his therapy, in a partnership between the patient and his doctor, as well with all the local caregivers and relatives. That's why it is important to implement educational care in the local territory, helping patient in his living environment, respecting his own goals and desires. However, cognitive and emotional particularities of these mental diseases, and above their stigmatisation must be taken in the acceptation and learning processes. It is important to assess all the specific dimensions (objective and subjective) linked with mental illness, if we want to develop a personalized and integrative educational program respecting the process of recovery. A personalized program must be built from the own goals and desire of the patient, which becomes an actor of his care, of his own trajectory of recovery. We illustrate these integrative educational program with schizophrenia, describing an authorized program, called ETP Schizophrénie, proposed by Crisalid Center in the psychiatric hospital of Clermont-de-l’Oise (Hauts-de-France area). Preliminary observational results show improvements in clinical, neuropsychological and satisfaction assessments.