(PS12-B48) Preliminary Evidence for an Online Group Therapy for Reducing Internalized Stigma in Early Psychosis

Background: Internalization of stigma is a common and functionally disabling experience for the majority of individuals living with psychosis. To date, few interventions have been created to address internalized stigma in mental illness, and evidence for the utility of existing interventions in early psychosis specifically, is lacking. We sought to examine the efficacy of Be Outspoken and Overcome Stigmatizing Thoughts (BOOST), a group-based, remotely delivered intervention integrating cognitive behavioural therapy (CBT) and peer support to reduce internalized stigma.

Method: Developed alongside and co-facilitated by individuals with lived experience, BOOST is an 8-session treatment, delivered remotely, over 4-weeks. Thirty-eight individuals in the early stages of psychosis have completed BOOST as part of a multi-site open treatment trial. Participants completed the Internalized Stigma of Mental Illness Inventory (Ritsher et al., 2003), Interpersonal Hopelessness Scale (Tucker et al., 2018), Questionnaire about the Process of Recovery (Neil et al., 2014), and Rosenberg Self-Esteem Scale (Rosenberg, 1965), before and after completing BOOST. 

Results: Individuals who completed BOOST demonstrated significant reductions in internalized stigma (p < .001, d = .78) and interpersonal hopelessness (p=.002, d = .54) and significant improvements in their belief of their own recovery (p< .001, d = -.99). Self-esteem did not improve to a statistically significant degree (p = .076, d = -.29).

Implications: Preliminary results support the utility of a remote intervention for reducing internalized stigma in a highly vulnerable population. Effects appear in both proximal (self-stigma) and distal (recovery and hope) measures following treatment.