title: Outcomes of a Psychoeducational Intervention to Reduce Internalized Stigma Among Psychosocial Rehabilitation Clients.
abstract: OBJECTIVE
  This community-based randomized controlled trial was carried out to test the Ending Self-Stigma (ESS) psychoeducational intervention, which is designed to help adults with serious mental illnesses reduce internalization of mental illness stigma and its effects.
  
  
  METHODS
  A total of 268 adults from five different mental health programs in Maryland took part. After baseline interview, consenting participants were randomly assigned to the nine-week ESS intervention or a minimally enhanced treatment-as-usual control condition. Participants were assessed by using symptom, psychosocial functioning, and self-stigma measures at baseline, postintervention, and six-month follow-up. Demographic characteristics were assessed at baseline.
  
  
  RESULTS
  Compared with participants in the control condition, ESS group participants showed significant decreases on the stereotype agreement and self-concurrence subscales of the Self Stigma of Mental Illness Scale, significant improvement on the alienation and stigma resistance subscales of the Internalized Stigma Mental Illness measure, and a significant increase in recovery orientation from baseline to postintervention. None of these differences were sustained at six-month follow-up.
  
  
  CONCLUSIONS
  Results indicate that ESS was useful in helping to reduce key aspects of internalized stigma among individuals with mental illnesses and that advances in the delivery, targeting, and content of the intervention in the field may be warranted to increase its potency.
authors.affiliation: Dr. Lucksted, Ms. Charlotte, and Ms. Fang are with the Department of Psychiatry, Division of Psychiatric Services Research, and Dr. Brown is with the Department of Epidemiology and Public Health, all at the University of Maryland School of Medicine, Baltimore (e-mail: aluckste@psych.umaryland.edu ). Dr. Drapalski is with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Maryland Health Care System, Baltimore. Ms. Wilson is with the Department of Psychology, University of Maryland Baltimore County, Baltimore. Dr. Mullane is with the Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland.
authors.forename: Alicia
authors.initials: A
authors.lastname: Lucksted
authors.affiliation: Dr. Lucksted, Ms. Charlotte, and Ms. Fang are with the Department of Psychiatry, Division of Psychiatric Services Research, and Dr. Brown is with the Department of Epidemiology and Public Health, all at the University of Maryland School of Medicine, Baltimore (e-mail: aluckste@psych.umaryland.edu ). Dr. Drapalski is with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Maryland Health Care System, Baltimore. Ms. Wilson is with the Department of Psychology, University of Maryland Baltimore County, Baltimore. Dr. Mullane is with the Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Drapalski
authors.affiliation: Dr. Lucksted, Ms. Charlotte, and Ms. Fang are with the Department of Psychiatry, Division of Psychiatric Services Research, and Dr. Brown is with the Department of Epidemiology and Public Health, all at the University of Maryland School of Medicine, Baltimore (e-mail: aluckste@psych.umaryland.edu ). Dr. Drapalski is with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Maryland Health Care System, Baltimore. Ms. Wilson is with the Department of Psychology, University of Maryland Baltimore County, Baltimore. Dr. Mullane is with the Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland.
authors.forename: Clayton H
authors.initials: CH
authors.lastname: Brown
authors.affiliation: Dr. Lucksted, Ms. Charlotte, and Ms. Fang are with the Department of Psychiatry, Division of Psychiatric Services Research, and Dr. Brown is with the Department of Epidemiology and Public Health, all at the University of Maryland School of Medicine, Baltimore (e-mail: aluckste@psych.umaryland.edu ). Dr. Drapalski is with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Maryland Health Care System, Baltimore. Ms. Wilson is with the Department of Psychology, University of Maryland Baltimore County, Baltimore. Dr. Mullane is with the Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland.
authors.forename: Camille
authors.initials: C
authors.lastname: Wilson
authors.affiliation: Dr. Lucksted, Ms. Charlotte, and Ms. Fang are with the Department of Psychiatry, Division of Psychiatric Services Research, and Dr. Brown is with the Department of Epidemiology and Public Health, all at the University of Maryland School of Medicine, Baltimore (e-mail: aluckste@psych.umaryland.edu ). Dr. Drapalski is with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Maryland Health Care System, Baltimore. Ms. Wilson is with the Department of Psychology, University of Maryland Baltimore County, Baltimore. Dr. Mullane is with the Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland.
authors.forename: Melanie
authors.initials: M
authors.lastname: Charlotte
authors.affiliation: Dr. Lucksted, Ms. Charlotte, and Ms. Fang are with the Department of Psychiatry, Division of Psychiatric Services Research, and Dr. Brown is with the Department of Epidemiology and Public Health, all at the University of Maryland School of Medicine, Baltimore (e-mail: aluckste@psych.umaryland.edu ). Dr. Drapalski is with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Maryland Health Care System, Baltimore. Ms. Wilson is with the Department of Psychology, University of Maryland Baltimore County, Baltimore. Dr. Mullane is with the Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland.
authors.forename: Audrina
authors.initials: A
authors.lastname: Mullane
authors.affiliation: Dr. Lucksted, Ms. Charlotte, and Ms. Fang are with the Department of Psychiatry, Division of Psychiatric Services Research, and Dr. Brown is with the Department of Epidemiology and Public Health, all at the University of Maryland School of Medicine, Baltimore (e-mail: aluckste@psych.umaryland.edu ). Dr. Drapalski is with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Maryland Health Care System, Baltimore. Ms. Wilson is with the Department of Psychology, University of Maryland Baltimore County, Baltimore. Dr. Mullane is with the Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland.
authors.forename: Li Juan
authors.initials: LJ
authors.lastname: Fang
mesh_terms: D000328:Adult; D003156:Community Mental Health Services / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D000067250:Psychiatric Rehabilitation / Q000379:methods*; D012649:Self Concept; D057545:Social Stigma
keywords: Outpatient treatment; Psychoeducation; Recovery; Rehabilitation/psychosocial; Serious Mental illness; Stigma