Ending Self Stigma for PTSD
Condition: Post Traumatic Stress Disorder
MeSH terms: Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic
Study type: Interventional

Summary: 
      Veterans with PTSD report that stigma and fear of stigma have a chilling effect on their
      participation in mental health treatment. Despite the widely-documented effects of stigma on
      the recovery of individuals with mental illnesses and research demonstrating harmful
      consequences of internalized stigma, including decreased hope, self-esteem, personal
      motivation, and persistence regarding illness management, no interventions are currently
      available to assist Veterans with PTSD in combating the impact of internalized stigma. The
      goal of this research is to develop and pilot-test an intervention to provide Veterans with
      PTSD the skills to cope effectively with stigma and to mitigate the internalization of
      stigmatizing beliefs and stereotypes. To accomplish this purpose, Ending Self Stigma (ESS),
      an intervention composed of evidence-based methods for combating internalized stigma for
      serious mental illness, will be modified and tested to address issues particular to PTSD.
    

Detailed description: 
      Stigma and fear of stigma are widespread among Veterans with PTSD and both have pernicious
      effects on Veterans' well-being and participation in mental health treatment. Internalized
      stigma is a harmful consequence of societal stigma, and has been associated with decreased
      hope, self-esteem, personal motivation, morale, self-regard, and persistence regarding
      illness management among individuals with a range of mental illnesses. Internalized stigma
      also has negative impacts on the recovery and well-being of Veterans with PTSD specifically,
      but no evidence-based interventions are currently available to assist Veterans with PTSD in
      combatting the impact of internalized stigma. Therefore, the purpose of this proposal is to
      develop and pilot-test an intervention to provide Veterans with PTSD the skills to cope
      effectively with stigma and to mitigate the internalization of stigmatizing beliefs and
      stereotypes. To that end, the investigators will modify Ending Self Stigma (ESS), an
      intervention composed of evidence-based strategies for combating internalized stigma for
      mental illness developed by the investigators' team, to specifically serve the needs of
      Veterans with PTSD.

      This proposed project is composed of two phases. In Phase I, the investigators will produce
      an intervention and accompanying manual for the PTSD version of ESS (ESS-P), based upon the
      strategies and structure of the existing ESS intervention. To this end, the investigators
      will interview Veterans with a PTSD diagnosis to learn more about their experience with
      societal and internalized stigma associated with PTSD, plus other considerations and issues
      in addressing internalized stigma with such Veterans. Information gleaned in these
      qualitative interviews will form the basis of the investigators' adaption of the ESS
      intervention to specifically address the needs of Veterans with PTSD. In Phase II, the
      investigators will pilot-test ESS-P with Veterans who have PTSD, to evaluate the feasibility
      and acceptability of the intervention. In addition, the investigators will preliminarily
      estimate the effects of ESS-P through comparison to a control group receiving only an
      informational brochure on internalized stigma associated with PTSD. These feasibility,
      implementation and pilot outcome data will be used to further refine the intervention,
      towards the goal of conducting a future larger scale study of ESS-P within the VA system.
    

Intervention name(s): Ending Self Stigma for PTSD; Enhanced Treatment as Usual
Intervention type(s): Behavioral; Other
Intervention description(s): Ending Self Stigma for PTSD (ESS-P) is a 9-session small-group (6-8 persons) course designed to help individuals with PTSD develop skills to effectively cope with stigma and minimize the internalization of stigmatizing beliefs and stereotypes. Sessions combine in-class lecture, discussion of relevance to group members' personal experiences, review and practice of strategies and skills, and group sharing, support, and problem-solving. Each session is designed to focus on a specific strategy for addressing self-stigma.; The comparison condition will consist of providing a pamphlet that discusses societal stigma and internalized stigma, and provides resources to help combat the effects of both. Participants will be given the informational pamphlet and study staff will discuss its content with the participant.
Other intervention name(s): ESS-P; ETAU
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Stigmatization