Group-based treatment for internalized stigma among persons with severe mental illness: Findings from a randomized controlled trial.

Abstract

Elevated internalized stigma is common and is linked to subjective and objective outcomes for severe mental illness. The authors developed a manualized group-based intervention (Narrative Enhancement/Cognitive Therapy; NECT) to address internalized stigma in severe mental illness. The purpose of the present study was to evaluate the feasibility and effectiveness of NECT. 144 individuals were screened at two sites to evaluate if they met criteria for “elevated” internalized stigma; 39 and were eligible were randomized to NECT or to treatment as usual (TAU) and were assessed at baseline, post-treatment, and 3-month follow-up. Fifteen of the 21 individuals assigned to NECT were classified as “exposed” to treatment. Intent-to-treat analyses found no significant difference between the NECT and TAU groups. A comparison of exposed vs. unexposed participants noted trends for exposed participants to have improved more in two aspects of self-stigma as well as insight. We conclude that NECT is feasible and tolerable, but findings did not support the hypothesis that NECT was more effective than TAU, although small sample size and significant dropout may have restricted the ability to detect an effect.

The Mediation Role of Self-Esteem for Self-Stigma on Quality of Life for People With Schizophrenia: A Retrospectively Longitudinal Study

“…First, self-stigma reduction programs, such as Narrative Enhancement and Cognitive Therapy (Yanos, Roe, & Lysaker, 2011;Yanos et al, 2012), could be beneficial for people with schizophrenia. A self-stigma reduction program may prevent them from the worst health outcomes.…”

Insight in psychosis: An independent predictor of outcome or an explanatory model of illness?

“…REFLEX -a brief psychosocial intervention to improve insight in schizophrenia (Pijnenborg et al, 2011), NECT -Narrative Enhancement/Cognitive Therapy (Yanos et al, 2012) and MERIT -Metacognitive Reflection and Insight Therapy, ].…”

Development and Effects of a Cognitive-behavioral Therapy Based Program in Reducing Internalized Stigma in Patients with Schizophrenia

“…는 인지치료에 근거한 중재 프로그램이 시도되었다 [5][6][7]. 이러한 인 지 프로그램으로 정신과적 증상 관리에 정신교육 방법을 혼합한 교 육 프로그램 [5,6], 내러티브와 인지치료를 혼합한 중재 프로그램 [7], 증상 중재와 문제해결을 혼합한 교육 프로그램 [8] 등이 시도되 었다.…”

“…이러한 인 지 프로그램으로 정신과적 증상 관리에 정신교육 방법을 혼합한 교 육 프로그램 [5,6], 내러티브와 인지치료를 혼합한 중재 프로그램 [7], 증상 중재와 문제해결을 혼합한 교육 프로그램 [8] 등이 시도되 었다. 이들 프로그램은 자존감증진에는 대부분 효과가 있었으나 [5,6] 내재화된 낙인에는 한 편에서만 효과가 있었다 [7].…”

“…이러한 인 지 프로그램으로 정신과적 증상 관리에 정신교육 방법을 혼합한 교 육 프로그램 [5,6], 내러티브와 인지치료를 혼합한 중재 프로그램 [7], 증상 중재와 문제해결을 혼합한 교육 프로그램 [8] 등이 시도되 었다. 이들 프로그램은 자존감증진에는 대부분 효과가 있었으나 [5,6] 내재화된 낙인에는 한 편에서만 효과가 있었다 [7]. 또한 자존 감에 영향을 주는 주요요소인 역량을 증진시키는 자존감 증진 프로 그램 [9], 역량강화 교육 프로그램 [8,10] ·Helping participants to identify their positive or negative self-concept ·Educating participants on the relationship between positive or negative self-concept and recovery ·Educating participants on their choice of internalized stigma and behaviors by utilizing internalized stigma and behavior checklist ·Explaining how to rate participants' choice of internalized stigma and behaviors ·Facilitating problem-solving focused discussion about participants' choice of internalized stigma and behaviors ·Educating participants on the relationship between treatment compliance and internalized stigma ·Explaining worksheet assignment for treatment compliance…”