Learn and ACT: Changing prejudice towards people with mental illness using stigma reduction interventions

Psychological inflexibility and stigma: A meta-analytic review

“…For example, Hayes, Bissett, et al (2004) found that their ACT condition had significantly less burnout at follow-up when compared to multicultural training and an educational control. Other studies found that ACT decreased overall prejudice more than an educational control (Kenny & Bizumic, 2016b) and that ACT led to higher positive behavioral intentions than an educational control . Of eight studies that compared ACT to active controls, two reported completely equivalent outcomes for ACT and the control condition (Clarke, Taylor, Bolderston, et al, 2015;, another two found advantages for ACT on some outcomes or for some subgroups (Hayes, Bissett, et al, 2004;Masuda et al, 2007), and four reported that ACT was significantly superior on primary outcomes (Kenny & Bizumic, 2006b;Luoma et al, 2012;Minkesh & Masroor, 2014).…”

“…Basic characteristics of these studies are presented in Table 2. All studies were conducted in the United States with the exception of two studies conducted in the United Kingdom (Clarke, Taylor, Bolderston, et al, 2015;, one conducted in Australia (Kenny & Bizumic, 2016b), and one conducted in India (Minkesh & Masroor, 2014). The studies vary notably in terms of methodological approach and rigor, including 1 multiple-baseline study, 6 randomized trials with active controls, 1 randomized waitlist-controlled trial, 1 nonrandomized comparison trial, 5 uncontrolled pilot trials, and 1 counterbalanced time-series group study.…”

“…The specific areas of stigma targeted by the studies include stigma towards individuals with mental illnesses in general (Kenny & Bizumic, 2016b;Masuda et al, 2007;, stigma by treatment providers towards individuals with personality disorders (Clarke, Taylor, Bolderston, et al, 2015;, stigma by substance use counselors toward their clients (Hayes, Bissett, et al, 2004), self-stigma among substance users (Luoma et al, 2008;Luoma et al, 2012), self-stigma in individuals with schizophrenia (Minkesh & Masroor, 2014), self-stigma in obese individuals (Berman et al, 2016;, prejudice toward racial and ethnic minorities , HIV stigma (Moitra et al, 2015;Skinta et al, 2015), and self-stigma related to sexual orientation (Yadavaia & Hayes, 2012). Several studies targeted a general population such as undergraduate students (e.g.…”

“…This theory suggests that neither selfstigma nor public stigma is inherently linked to poorer psychological health or behavioral intentions towards others, respectively, but their effects are mediated by the relationship with or the function of stigmatizing thoughts or attitudes. It may also be possible that having a flexible relationship with private events related to stigma could affect the impact of educational interventions (Kenny & Bizumic, 2016b). Given that individuals do not unlearn cultural stereotypes once they are learned (Devine, 1989) it may make more sense to target and modify relationships to internal experiences, such as stigmatizing thoughts, than to change the content or frequency of the internal experiences.…”

“…Although ACT does not necessarily seek to reduce stigmatizing thoughts or attitudes, studies have shown that ACT may reduce selfstigma among those with HIV (Moitra, Chan, & Stein, 2015;Skinta, Lezama, Wells, & Dilley, 2015) and schizophrenia (Minkesh & Masroor, 2014) as well as individuals who abuse substances (Luoma et al, 2008;Luoma, Kohlenberg, Hayes, & Fletcher, 2012), are overweight or obese (Berman, Morton, & Hegel, 2016;, or identify as LGBT (Yadavaia & Hayes, 2012). ACT has also been shown to reduce stigma towards racial minorities , towards people with psychological disorders (Clarke, Taylor, Bolderston Lancaster, & Remington, 2015;Kenny & Bizumic, 2016b;Masuda et al, 2007, and in substance abuse counselors towards their clients (Hayes, Bissett, et al, 2004). Process of change analyses suggest that these effects on stigma are due to changes in the believability of stigmatizing thoughts (Hayes, Bissett et al, 2004), acceptance and flexibility , and psychological flexibility .…”