There is substantial evidence that internalized stigma and related processes have profound negative effects upon both the objective (e.g., social functioning) and subjective (e.g., self-esteem and well-being) components of recovery for persons with severe mental illness (SMI) that persist independent of the severity of symptoms;however, few efforts have been made to develop treatment to address this issue. There is nevertheless support that both cognitive-behavioral therapy and narrative psychotherapy are promising approaches for addressing self-conceptualizations among people with SMI. The purpose of the present Exploratory Intervention Development study is to develop and study a structured, group-based Narrative Enhancement/Cognitive Therapy (NECT) intervention geared toward reducing internalized stigma and improving related outcomes among people with SMI. This intervention developed will focus on identifying and challenging internalized stigma beliefs, and will be facilitated by principles of an integrative recovery-oriented narrative psychotherapy for people with SMI. After developing and pilot testing the intervention with a group of 10 persons, we will screen 150 persons with SMI at two sites (New York and Indiana) for evidence of high internalized stigma. We will then conduct an initial randomized study of NECT vs. treatment as usual in a sample of 50 individuals with SMI meeting criteria for high internalized stigma.
The specific aims of the project are to: 1) Develop a manualized group-based NECT treatment for persons with SMI who have high internalized stigma that can be implemented in routine settings;2) conduct an initial randomized study of the effectiveness of the group-based treatment, comparing outcomes for persons randomly assigned to the NECT treatment with outcomes for persons remaining in treatment as usual;and 3) examine the mediating impact of changes in use of problem-centered coping strategies on outcomes for persons assigned to the NECT treatment. The proposed research responds to PAR-06-248 """"""""From Intervention Development to Services: Exploratory Research Grants (R34)."""""""" The intervention, if found to be effective, can have important implications for enhancing usual care services to facilitate recovery and reduce disability for people with SMI, and therefore has potentially important implications for improving the public health.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Planning Grant (R34)
Project #
5R34MH082161-03
Application #
7748974
Study Section
Mental Health Services in MH Specialty Settings (SRSP)
Program Officer
Goldstein, Amy B
Project Start
2008-03-01
Project End
2011-05-30
Budget Start
2009-12-01
Budget End
2011-05-30
Support Year
3
Fiscal Year
2010
Total Cost
$196,922
Indirect Cost
Name
John Jay College of Criminal Justice
Department
Psychology
Type
Other Domestic Higher Education
DUNS #
620128863
City
New York
State
NY
Country
United States
Zip Code
10019
Roe, David; Hasson-Ohayon, Ilanit; Mashiach-Eizenberg, Michal et al. (2014) Narrative enhancement and cognitive therapy (NECT) effectiveness: a quasi-experimental study. J Clin Psychol 70:303-12
Mashiach-Eizenberg, Michal; Hasson-Ohayon, Ilanit; Yanos, Philip T et al. (2013) Internalized stigma and quality of life among persons with severe mental illness: the mediating roles of self-esteem and hope. Psychiatry Res 208:15-20
Yanos, Philip Theodore; West, Michelle Leigh; Gonzales, Lauren et al. (2012) Change in internalized stigma and social functioning among persons diagnosed with severe mental illness. Psychiatry Res 200:1032-4
Yanos, Philip T; Roe, David; West, Michelle L et al. (2012) Group-based treatment for internalized stigma among persons with severe mental illness: findings from a randomized controlled trial. Psychol Serv 9:248-58
Lysaker, Paul H; Tunze, Chloe; Yanos, Philip T et al. (2012) Relationships between stereotyped beliefs about mental illness, discrimination experiences, and distressed mood over 1 year among persons with schizophrenia enrolled in rehabilitation. Soc Psychiatry Psychiatr Epidemiol 47:849-55
Yanos, Philip T; Roe, David; Lysaker, Paul H (2011) Narrative enhancement and cognitive therapy: a new group-based treatment for internalized stigma among persons with severe mental illness. Int J Group Psychother 61:577-95
West, Michelle L; Yanos, Philip T; Smith, Stephen M et al. (2011) Prevalence of Internalized Stigma among Persons with Severe Mental Illness. Stigma Res Action 1:3-10
Yanos, Philip T; Roe, David; Lysaker, Paul H (2010) The Impact of Illness Identity on Recovery from Severe Mental Illness. Am J Psychiatr Rehabil 13:73-93
Roe, David; Hasson-Ohayon, Ilanit; Derhi, Oren et al. (2010) Talking about life and finding solutions to different hardships: a qualitative study on the impact of narrative enhancement and cognitive therapy on persons with serious mental illness. J Nerv Ment Dis 198:807-12
Lysaker, Paul H; Glynn, Shirley M; Wilkniss, Sandra M et al. (2010) Psychotherapy and recovery from schizophrenia: A review of potential applications and need for future study. Psychol Serv 7:75-91

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