Group Intervention for Improving Stigma Coping and Empowerment of People With Mental Illness (STEM)
Condition: Schizophrenia; Depression
MeSH terms: Schizophrenia; Mental Disorders
Study type: Interventional

Summary: 
      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.
    

Detailed description: 
      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.
    

Intervention name(s): psychotherapeutic STEM modules; Interventional control of normal psychoeducational treatment
Intervention type(s): Behavioral; Behavioral
Intervention description(s): psychoeducational and psychotherapeutical group intervention. 8 sessions of psychoeducation + 3 sessions + 1 booster session of STEM module for schizophrenia or depression); 11 sessions + 1 booster session of psychoeducation (for schizophrenia or depression)
Intervention MeSH terms: Psychotropic Drugs
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment