Cognitive therapy for internalised stigma in people experiencing psychosis: A pilot randomised controlled trial

Morrison, Anthony P.; Burke, Eilish; Murphy, Elizabeth; Pyle, Melissa; Bowe, Samantha; Varese, Filippo; Dunn, Graham; Chapman, Nicola; Hutton, Paul; Welford, Mary; Wood, Lisa J.

Abstract

We aimed to evaluate the feasibility of Cognitive Therapy (CT) as an intervention for internalised stigma in people with psychosis. We conducted a single-blind randomised controlled pilot trial comparing CT plus treatment as usual (TAU) with TAU only. Participants were assessed at end of treatment (4 months) and follow-up (7 months). Twenty-nine participants with schizophrenia spectrum disorders were randomised. CT incorporated up to 12 sessions over 4 months (mean sessions=9.3). Primary outcome was the Internalised Stigma of Mental Illness Scale – Revised (ISMI-R) total score, which provides a continuous measure of internalised stigma associated with mental health problems. Secondary outcomes included self-rated recovery, internalised shame, emotional problems, hopelessness and self-esteem. Recruitment rates and retention for this trial were good. Changes in outcomes were analysed following the intention-to-treat principle, using ANCOVAs adjusted for baseline symptoms. There was no effect on our primary outcome, with a sizable reduction observed in both groups, but several secondary outcomes were significantly improved in the group assigned to CT, in comparison with TAU, including internalised shame, hopelessness and self-rated recovery. Stigma-focused CT appears feasible and acceptable in people with psychosis who have high levels of internalised stigma. A larger, definitive trial is required.

Citation

Morrison, A. P., Burke, E., Murphy, E., Pyle, M., Bowe, S., Varese, F., Dunn, G., Chapman, N., Hutton, P., Welford, M., & Wood, L. J. (2016). Cognitive therapy for internalised stigma in people experiencing psychosis: A pilot randomised controlled trial. Psychiatry Research, 240(30), 96-102. https://doi.org/10.1016/j.psychres.2016.04.024

• Journal Article Type: Article
• Acceptance Date: Apr 10, 2016
• Online Publication Date: Apr 11, 2016
• Publication Date: 2016-06
• Deposit Date: Dec 15, 2016
• Publicly Available Date: Apr 12, 2017
• Journal: Psychiatry Research
• Print ISSN: 0165-1781
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 240
• Issue: 30
• Pages: 96-102
• DOI: https://doi.org/10.1016/j.psychres.2016.04.024
• Keywords: Cognitive therapy; Psychosis; Schizophrenia; Stigma
• Public URL: http://researchrepository.napier.ac.uk/Output/454723
• Contract Date: Feb 15, 2017