Group Treatment of Perceived Stigma and Self-Esteem in Schizophrenia: A Waiting List Trial of Efficacy

Abstract

The experience of stigma by individuals with schizophrenia can impact on self-esteem and potential for recovery. Previous attempts to reduce stigma within society have reported variable success. The present study aimed to formulate and evaluate a therapeutic intervention for those who perceive themselves as stigmatized by their mental illness and who suffer low self-esteem. A waiting-list control design with repeated measures within participants was used. Treatment efficacy was evaluated by a principal outcome measure of self-esteem. Ancillary outcome measures included a measure of perceived stigmatization, and two symptom measures. Assessments were completed on four occasions, which covered a waiting list period, a treatment period and a follow-up. All participants (N = 21) received group Cognitive Behavioural Therapy (CBT) focused on stigma and self-esteem. Self-esteem improved significantly following treatment. Levels of depression, positive and negative symptoms of schizophrenia and general levels of psychopathology decreased significantly. A longer-term effect was found for positive and negative symptoms of schizophrenia, and general levels of psychopathology. Participant feedback was predominantly positive. In addition to societal interventions, the potential for limiting the effects of stigma within a therapeutic context should be investigated.