Depression Clinical Trial
Official title:
Group Intervention for Improving Stigma Coping and Empowerment of People With Mental Illness (STEM)
This multi-center, 2-arm interventional study within different mental health care settings (psychiatry: in-patient, day-unit and out-patient, as well as psychiatric rehabilitation) evaluates a psychotherapeutic group intervention to improve stigma coping and empowerment using a psychotherapeutic module embedded in a psychoeducational group therapy.
People with mental illness suffer both from the burden of disease itself and from the social
stigma related to mental illness, hence impeding their treatment (Sartorius et al. 2005,
Link et al. 1999). Negative attitudes towards and discriminating behavior against people
with mental illness negatively affect health care utilization, the course of disease,
compliance, self-esteem, and social functioning (Sirey et al. 2001, Link et al. 2001,
Perlick et al. 2001). Internalizing negative social stereotypes (self-stigmatization;
Ritsher et al. 2003, Watson et al. 2007) impairs the quality of life and leads to social
withdrawal (Rüesch 2005). Furthermore, self stigma is associated with lower empowerment
(Ritsher et al. 2004), a poorer social network (Lysaker et al. 2007), lower compliance (Fung
et al. 2008) and a higher extent of symptoms (Corrigan et al. 2006). The stigma of mental
illness leads to an impaired pursuance of individual life goals, as job-related ambitions or
living in a relationship (Rüesch 2005).
Current approaches targeting the stigma of mental illness primarily focus on education about
mental illness in different target groups (e.g. Gaebel et al. 2003, 2004) and can be
successful, if appropriately implemented (Gaebel et al. 2008). Yet there is a lack of
RCT-tested psychotherapeutic approaches which directly address patients with mental illness
improving their skills of coping with stigma and discrimination. Therefore it is intended to
develop, manualise, and to evaluate such a psychotherapeutic group intervention within a
randomized clinical control group design.
In this context, group-based cognitive-behavioral psychotherapy has been proved as efficient
therapeutic approach for patients with depression (cf. McDermut et al. 2006) and with
schizophrenia (cf. Lawrence et al. 2006, Barrowclough et al. 2006) in different settings.
Patients can serve each other as role models and will modify negative self-related
cognitions, thus developing new cognitions supporting self-esteem (Corrigan et al. 2001).
The following interventional effects should improve the patients' quality of life and also
result in a reduction of frequency and length of inpatient stays and sickness-related
absenteeism:
- improved skills to cope with negative stigmatizing experiences,
- a reduced burden through of self-stigmatizing cognitions,
- a better utilization of resources for disease managing in coherence with reduced
self-stigmatization, and
- an improved coping with stigma-related conflicts at work.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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