New intervention to reduce self-stigma

A

Apotheosis

Guest
#1
New intervention to reduce self-stigma among persons with serious mental illness

A new intervention, the result of a collaboration between researchers from the University of Haifa, City University of New York and Indiana University, was found to reduce the self-stigma and improve the quality of life and self-esteem among persons with serious mental illness.

"Just like wheelchairs and Braille have increased social integration for people with physical handicaps, there is also a need to identify and remove the barriers to community inclusion for people with serious mental illness," says Prof. Roe, Chair of the Department of Community Mental Health, Faculty of Social Welfare and Health Sciences at the University of Haifa who led the study together with his colleagues from the US - Professors Paul H. Lysaker from Indiana University School of Medicine, Dept of Psychiatry and Philip T. Yanos of the Department of Psychology, John Jay College of Criminal Justice, City University of New York, and from Israel – Dr. Ilanit Hasson-Ohayon, Yaara Zisman-Ilani and Oren Deri.

Much attention has been given to providing accessibility to all facilities intended for the public, in striving to gain equality for people with physical disabilities. But while the obstacles facing the physically challenged can be relatively easily identified, pinpointing the obstacles that persons with a mental illness must overcome is much harder.

According to Prof. Roe, earlier studies have shown that one of the central obstacles is the negative stigma attached to mental illness by society at large, which is much more powerful than the labels attached to people with other disabilities. This stigma may lead to social exclusion. Another obstacle that may result from stigma is "self-stigma", whereby people with a mental illness adopt and internalize the social stigma and experience loss of self-esteem and self efficacy. "People with a mental illness with elevated self-stigma report low self-esteem and low self-image, and as a result they refrain from taking an active role in various areas of life, such as employment, housing and social life," Prof. Roe explains.

In an attempt to address this problem, Prof. Philip Yanos of City University of New York Prof. David Roe and Prof. Paul Lysaker of Indiana University School of Medicine, with the help of a research grant from the National Institute of Mental Health, developed what they term "Narrative Enhancement Cognitive Behavioral Therapy (NECT)", which is aimed at giving people with a mental illness the necessary tools to cope with the "invisible " barrier to social inclusion - self-stigma.

The research team ran a twenty-meeting pilot course of the new intervention at three separate locations: New York, Indiana and Israel. Following the pilot run, Prof. Roe headed a study in Israel, in which 21 people with a mental illness (with at least 40% mental handicap) completed the intervention. This study examined the effects of the intervention compared to a control group of 22 mentally ill people of similar disabilities who did not participate in the intervention. It showed that those who participated in the intervention exhibited a reduced self-stigma and, in parallel, an increase in quality of life and self-esteem.

"The intervention method that we developed helps persons with mental illness cope with one of the central obstacles that they face – self-stigma. We hope to be able to train more professionals in this intervention and root the method in rehabilitation centers and community health centers, so as to assist in recuperation processes and in community inclusion over a larger and more significant population of people with a mental illness," Prof. Roe concludes.
 
R

rasselas

Guest
#2
...

Interesting, though it's a shame they don't go into specifics of what the therapy entails. I've tried looking for their paper, but can't pin it down. If anyone can find it please post a link - it's always worth biting into the primary source.

I would expect this is some kind of 'thought police' action to get people to embrace their diagnosis and overcome doubt, rejection or the feeling of being dehumanised by the psychiatric label.

During the decade of being diagnosed schizophrenic I had a terrible time of accepting it; I could accept that I often had very difficult experiences and mood shifts, and an ongoing problem adjusting to 'normal' life; but I could never accept that word as anything other than an insult.

So - on top of the schizophrenia label I got another one: persistent non-complier. That ensured a frosty reception from many professionals; to them it means, trouble-maker.

Eventually I acquiesced, and started saying, "I have schizophrenia" and when I was required to I'd write it down and confirm it with my signature. This pleased them. Aha, they'd say, you now have insight into your condition. Now then, perhaps you will re-consider the anti-psychotics?

Naturally, I'd tell them to eff off. And I'm so glad I did.

They cured me a year ago. It was incredible. It only took them 10 minutes. Ten years of struggling to find a way to get over the label and silly me didn't realise I just had to sit in a room with a new psychiatrist and be charming and humorous and talk about the last ten years of mayhem unbitterly.

They had the last laugh though. They didn't let me leave the room unblemished. The cure was a re-diagnosis. Now they say I'm bipolar. It's gone from bad to ridiculous. Of all the silly words they could think of... and they came up with that one.

Of course, I reject it. I accept I have ongoing problems but I reject the label. They've offered more drugs and I've tried them and they are just as bad. Although now I'm at least non-threatening, and they don't say I'm a non-complier they say I'm insightful and deploy coping mechanisms.

In reality, I'm treading water.

If they tell me I need therapy to embrace my label I will again tell them to eff off. I think they sense this, so don't raise the matter. It's a kind of Mexican standoff; we get along this way, tensioning over each other's next move.
 
Last edited:
amathus

amathus

Well-known member
Joined
Apr 23, 2010
Messages
16,324
Location
goodness knows!
#3
Interesting, though it's a shame they don't go into specifics of what the therapy entails. I've tried looking for their paper, but can't pin it down. If anyone can find it please post a link - it's always worth biting into the primary source.

I would expect this is some kind of 'thought police' action to get people to embrace their diagnosis and overcome doubt, rejection or the feeling of being dehumanised by the psychiatric label.

During the decade of being diagnosed schizophrenic I had a terrible time of accepting it; I could accept that I often had very difficult experiences and mood shifts, and an ongoing problem adjusting to 'normal' life; but I could never accept that word as anything other than an insult.

So - on top of the schizophrenia label I got another one: persistent non-complier. That ensured a frosty reception from many professionals; to them it means, trouble-maker.

Eventually I acquiesced, and started saying, "I have schizophrenia" and when I was required to I'd write it down and confirm it with my signature. This pleased them. Aha, they'd say, you now have insight into your condition. Now then, perhaps you will re-consider the anti-psychotics?

Naturally, I'd tell them to eff off. And I'm so glad I did.

They cured me a year ago. It was incredible. It only took them 10 minutes. Ten years of struggling to find a way to get over the label and silly me didn't realise I just had to sit in a room with a new psychiatrist and be charming and humorous and talk about the last ten years of mayhem unbitterly.

They had the last laugh though. They didn't let me leave the room unblemished. The cure was a re-diagnosis. Now they say I'm bipolar. It's gone from bad to ridiculous. Of all the silly words they could think of... and they came up with that one.

Of course, I reject it. I accept I have ongoing problems but I reject the label. They've offered more drugs and I've tried them and they are just as bad. Although now I'm at least non-threatening, and they don't say I'm a non-complier they say I'm insightful and deploy coping mechanisms.

In reality, I'm treading water.

If they tell me I need therapy to embrace my label I will again tell them to eff off. I think they sense this, so don't raise the matter. It's a kind of Mexican standoff; we get along this way, tensioning over each other's next move.
An interesting article,I would have liked more information about the therapy too.

I too was completely de-moralised when, four years ago I was dx with Borderline Personality Disorder, I still find difficulty with it now.

I have found that apart from self-stigma, which is accurate for me, there is still an unacceptance within the general medical profession itself. I have been treated very shabbily by nurses and doctors, particularly in A&E, on 'admittance' of having that disorder.


meteos.
 
R

rabina

Guest
#4
When will everyone realize that the entire population is mentally ill...without exception....or this is one way to look at those who treat others badly...
They themselves are not right if they treat others badly in my opinion...one big vicious cycle of life...
Good for those though who seek to help others that are stigmatized and labeled with mental illness or anything for that matter....Labels, shables, don't be fooled, those very same people are ill themselves in one way or another..
The next time you look at your psychiatrist or therapist; keep this in mind and you'll see them in a whole new way...oh well...my 2 cents....
There are good people out there though who now realize what damage labeling and stigmatizing can do to a person...thank God...
 
R

rabina

Guest
#5
Simply Put...

Simply stated: the entire population are human beings and should be treated as human beings always and then there would not be any stigmas or labels to fend off from society.
I personally do not believe in mental illness for the most part.
We all have problems.
Let no one bring you down with words.
Stay well All....
 
S

suzieb8

New member
Joined
Jan 8, 2014
Messages
1
#6
Hi all,
The original paper was published in Narrative Enhancement and Cognitive Therapy: A New Group-Based Treatment for Internalized Stigma Among Persons with Severe Mental Illness. Yanos, Philip T.; Roe, David; Lysaker, Paul H.. International Journal of Group Psychotherapy61.4 (Oct 2011): 577-95.
Cheers
Suzie
 
McMurphy's Ghost

McMurphy's Ghost

Well-known member
Joined
Aug 9, 2010
Messages
1,800
#7
Hi all,
The original paper was published in Narrative Enhancement and Cognitive Therapy: A New Group-Based Treatment for Internalized Stigma Among Persons with Severe Mental Illness. Yanos, Philip T.; Roe, David; Lysaker, Paul H.. International Journal of Group Psychotherapy61.4 (Oct 2011): 577-95.
Cheers
Suzie


Thanks...Group-Based Treatment for Internalized Stigma among Persons with Severe Mental Illness: Findings from a Randomized Controlled Trial

I wonder if this could be more usefully employed in reverse....to change the negative attitudes and beliefs of MH staff....its a big ask.... a lot of them have been so brain washed they have something more akin to a neurological condition.....
 
calypso

calypso

Well-known member
Admin
Moderator
Joined
Jan 5, 2011
Messages
41,051
Location
Lancashire
#8
it would be fun to have a law that all patients have the right to see the different professionals' psychological profiles from tests, and then we can select the one we think if most "sane" or alternative or just fun.
 
J

john2054

Guest
#9
mod trust me boderline personality disorder is nothing in the world of mental illness!
 
calypso

calypso

Well-known member
Admin
Moderator
Joined
Jan 5, 2011
Messages
41,051
Location
Lancashire
#10
Hey John. As I answered elsewhere, I have Bipolar Disorder actually honey. I think it's a little derogatory to attack people with BPD though. Did you know that suicide amongst those people living with BPD is high? All MH problems can be as dangerous as each other honey. Depression can be the most lethal of all and yet is not given enough standing as a major mental illness IMO.

I don't see a hierarchy in MH problems, just degrees of distress suffered by people. I have known a man with OCD who suffered hugely on a daily basis. So much so his whole life was intolerable for him and he couldn't leave the house to do a degree like you are. Its all degrees of suffering honey.
 
Toasted Crumpet

Toasted Crumpet

ACCOUNT CLOSED
Joined
Feb 11, 2013
Messages
8,426
Location
under the Forum Troll bridge
#11
Maybe I am being dense, but in the it seems to me that first the professionals tell a person they have this illness and they are not like other people and will have to be on depots for the rest of their lives and be monitored by a psychiatric team and periodically hospitalised etc (I know it isn't always the approach used, but in general)...

....and then criticised for having internalised stigma

and yes i know they stigma does not come purely from the diagnosis and treatment but from wider societal messages etc

anyway maybe i am just being stupid, haven't read the entire study
 
N

Nicola398

Guest
#12
To be honest the attitudes of the professionals and the support workers go a long way to making the illness better or worse.People with BPD have a hard time of it and are labeled as 'untreatable' and 'difficult' and 'wasting resources' or 'seeking attention' or 'timewasters', this is really unacceptable and no wonder they are committing suicide. A helpful, supportive understanding attitude from those there to help minimizes the pain I go through from my illness, I am not diagnosed with BPD, I have experienced both good and bad care and I was even threatened with permanent section if I didn't stop getting involved with political issues.Lately have had problems with my care coordinator who is the same age as me and calls me 'sweetie' and 'honey ' which immediately makes me feel like a six year old infant who is incapable without her adult and superior input. I hate all this sexist labeling pretending to be a form or endearment, this so called care coordinator is stone deaf, she talks at me and never listens to a word I say, 'don't worry about it' and 'it doesn't matter' are her stock phrases and I have to endure her using me as a soundboard for her life and problems.She tries to act as if I am her friends but a friend to which she is superior to, she is ignorant and confident with it, I fear her visits and cannot help but lose self esteem because of her treatment of me, I get very depressed, almost ill again after seeing her.I have written a letter of complaint asking to be allocated someone else. I am hoping I will be taken seriously.It is all equally valid suffering I think not degrees of suffering,and 85% of it can be made worse or better
depending on the attitudes and approaches of the medical staff and support services. Calypso I notice you use the word honey to address people, I don't mean to be rude but are you aware how demeaning that is to someone to address them in that way?Sometimes when delivered in a sadistic tone of voice that word is an insulting, derogatory, threatening way to address someone as well as being as I said earlier infantalizing and patronizing.
 
Toasted Crumpet

Toasted Crumpet

ACCOUNT CLOSED
Joined
Feb 11, 2013
Messages
8,426
Location
under the Forum Troll bridge
#13
I was even threatened with permanent section if I didn't stop getting involved with political issues.
I don't think that can be legal, what are they saying, that it's part of your illness???
Lately have had problems with my care coordinator who is the same age as me and calls me 'sweetie' and 'honey ' which immediately makes me feel like a six year old infant who is incapable without her adult and superior input. I hate all this sexist labeling pretending to be a form or endearment, this so called care coordinator is stone deaf, she talks at me and never listens to a word I say, 'don't worry about it' and 'it doesn't matter' are her stock phrases and I have to endure her using me as a soundboard for her life and problems.She tries to act as if I am her friends but a friend to which she is superior to, she is ignorant and confident with it, I fear her visits and cannot help but lose self esteem because of her treatment of me, I get very depressed, almost ill again after seeing her.I have written a letter of complaint asking to be allocated someone else. I am hoping I will be taken seriously.
I hope you will be take seriously too, her behavour is unprofessional and dismissive in my view, and you're entitled to see someone who treats you with a bit more respect and certainly doesn't make you feel worse. She really shouldnt be unloading her personal problems onto you - she is meant to be there to support you! She has a supervisor if her personal stuff is affecting her work!