Skip to main content

Advertisement

SpringerLink
Log in

Targeting Internalized Stigma in First-Episode Psychosis Services: Treatment Strategies from an Intersectional Perspective

  • Published:
Journal of Health Service Psychology Aims and scope Submit manuscript

Abstract

Young people who first meet criteria for a schizophrenia-spectrum disorder are considered by the field to be experiencing first-episode psychosis (FEP). Early intervention for psychosis saves lives, and specialized early intervention programs have proliferated over the past two decades. However, critical gaps in such care related to access, equity, and inclusion are still being addressed. Within this article, we first provide a composite clinical vignette from our clinical and research experiences, followed by background and history on the early-stage psychosis field. We then focus on discussing evidence-based clinical practices in this area and gaps in current services—especially related to targeting intersectional stigma and related stressors in care. Psychosis is among the most stigmatized and misunderstood health conditions in the world and many young people diagnosed with FEP experience internalized (or self-) stigma (i.e., incorporating negative mental illness stereotypes into one’s identity). Internalized stigma can prevent youth from fully engaging in care and has been consistently associated with a host of negative outcomes, including symptom severity, social isolation, suicidality, and functional deficits. Specific assessment and intervention tools are shared and discussed throughout.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. Note: “James” is not a real patient, but rather a composite to illustrate common clinical presentations and challenges.

  2. For more information on NAVIGATE and treatment manuals, see: http://navigateconsultants.org/

  3. Early Psychosis Intervention Network: https://nationalepinet.org/about-epinet/

  4. Accelerating Medicines Partnership (AMP®): Schizophrenia (SCZ) program: https://www.ampscz.org/

  5. More on Individual Placement and Support can be found here: https://ipsworks.org/

  6. Access the ISMI scale for free here: https://www.mirecc.va.gov/visn5/training/docs/Handout_ISMI.pdf

  7. Access the SSMIS for free here: https://www.montefiore.org/documents/Evaluating-Programs-Meant-to-Erase-the-Stigma-of-Mental-Illness.pdf

  8. Ending Self Stigma (ESS) Resources & Manual: https://www.mirecc.va.gov/visn5/training/ess/ESS.asp

  9. Photovoice resources: https://cpr.bu.edu/research/photovoice-2/

  10. Early psychosis screening considerations and tool: https://www.psychosisscreening.org/

  11. Map of early psychosis programs worldwide: https://iepa.org.au/services/

References

  • Akouri-Shan, L., DeLuca, J. S., Pitts, S. C., Jay, S. Y., Redman, S. L., Petti, E., … & Schiffman, J. (2022). Internalized stigma mediates the relation between psychosis-risk symptoms and subjective quality of life in a help-seeking sample. Schizophrenia Research, 241, 298–305.

  • American Psychiatric Association. (2021, January 18). APA’s Apology to Black, Indigenous and People of Color for Its Support of Structural Racism in Psychiatry. https://www.psychiatry.org/news-room/apa-apology-for-its-support-of-structural-racism

  • American Psychological Association. (2021, October 29). Apology to People of Color for APA’s Role in Promoting, Perpetuating, and Failing to Challenge Racism, Racial Discrimination, and Human Hierarchy in U.S. https://www.apa.org/about/policy/racism-apology

  • Andorko, N. D., Fitzgerald, J., Roemer, C., Solender, E., Petti, E., Rakhshan Rouhakhtar, P., … & DeVylder, J. (2022). Social work training to reduce duration of untreated psychosis: Methodology and considerations of a web‐based training for community providers. Early intervention in psychiatry, 16(4), 393–401.

  • Anglin, D. M., Ereshefsky, S., Klaunig, M. J., Bridgwater, M. A., Niendam, T. A., Ellman, L. M., DeVylder, J., Thayer, G., Bolden, K., Musket, C. W., Grattan, R. E., Lincoln, S. H., Schiffman, J., Lipner, E., Bachman, P., Corcoran, C. M., Mota, N. B., & van der Ven, E. From womb to neighborhood: A racial analysis of social determinants of psychosis in the United States. (2021). American Journal of Psychiatry, 178(7), 599–610. Appi. Ajp. 2020.20071091. https://doi.org/10.1176/appi.ajp.2020.20071091

  • Ajnakina, O., Stubbs, B., Francis, E., Gaughran, F., David, A. S., Murray, R. M., & Lally, J. (2021). Employment and relationship outcomes in first-episode psychosis: A systematic review and meta-analysis of longitudinal studies. Schizophrenia Research, 231, 122-133.

    Article  PubMed  Google Scholar 

  • Alonso, M., Guillén, A. I., & Muñoz, M. (2019). Interventions to reduce internalized stigma in individuals with mental illness: A systematic review. The Spanish journal of psychology, 22, E27.

    Article  PubMed  Google Scholar 

  • Azrin, S. T., Goldstein, A. B., & Heinssen, R. K. (2015). Early intervention for psychosis: the recovery after an initial schizophrenia episode project. Psychiatric Annals, 45(11), 548-553.

    Article  Google Scholar 

  • Ben‐David, S., Kealy, D., Hanson, J., & Ortiz, R. (2021). Perspectives on personal identity in the early stages of psychosis: A survey of Canadian clinicians. Early Intervention in Psychiatry, 15(4), 1038-1043.

    Article  PubMed  Google Scholar 

  • Breitborde, N. J., Srihari, V. H., & Woods, S. W. (2009). Review of the operational definition for first‐episode psychosis. Early intervention in psychiatry, 3(4), 259-265.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bertolote, J., & McGorry, P. (2005). Early intervention and recovery for young people with early psychosis: consensus statement. The British Journal of Psychiatry, 187(S48), s116-s119.

    Article  Google Scholar 

  • Best, M. W., Grossman, M., Milanovic, M., Renaud, S., & Bowie, C. R. (2018). Be outspoken and overcome stigmatizing thoughts (BOOST): A group treatment for internalized stigma in first-episode psychosis. Psychosis, 10(3), 187-197.

  • Birchwood, M., Todd, P., & Jackson, C. (1998). Early intervention in psychosis: the critical period hypothesis. The British journal of psychiatry, 172(S33), 53-59.

    Article  CAS  PubMed  Google Scholar 

  • Blajeski, S. M., Klodnick, V. V., Caruso, N., & Sale, T. G. (2022). How early stigmatizing experiences, peer connections, and peer spaces influenced pathways to employment or education after a first-episode of psychosis. Psychiatric Rehabilitation Journal, 45(2), 144–152. https://doi.org/10.1037/prj0000502

    Article  PubMed  Google Scholar 

  • Bornheimer, L. A., Tarrier, N., Brinen, A. P., Li, J., Dwyer, M., & Himle, J. A. (2021). Longitudinal predictors of stigma in first‐episode psychosis: Mediating effects of depression. Early Intervention in Psychiatry, 15(2), 263-27

    Article  PubMed  Google Scholar 

  • Boyd, J. E., Adler, E. P., Otilingam, P. G., & Peters, T. (2014a). Internalized Stigma of Mental Illness (ISMI) scale: a multinational review. Comprehensive psychiatry, 55(1), 221-231.

    Article  PubMed  Google Scholar 

  • Boyd, J. E., Otilingam, P. G., & DeForge, B. R. (2014b). Brief version of the Internalized Stigma of Mental Illness (ISMI) scale: psychometric properties and relationship to depression, self esteem, recovery orientation, empowerment, and perceived devaluation and discrimination. Psychiatric rehabilitation journal, 37(1), 17.

    Article  PubMed  Google Scholar 

  • Chamberlin, J. (1978). On our own: Patient-controlled alternatives to the mental health system. McGraw-Hill.

  • Correll, C. U., Galling, B., Pawar, A., Krivko, A., Bonetto, C., Ruggeri, M., ... & Kane, J. M. (2018). Comparison of early intervention services vs treatment as usual for early-phase psychosis: a systematic review, meta-analysis, and meta-regression. JAMA psychiatry, 75(6), 555–565.

  • Corrigan, P. W. (2022). Coming out proud to erase the stigma of mental illness. World Psychiatry, 21(3), 388.

    Article  PubMed  PubMed Central  Google Scholar 

  • Corrigan, P. W., Michaels, P. J., Vega, E., Gause, M., Watson, A. C., & Rüsch, N. (2012). Self-stigma of mental illness scale—short form: Reliability and validity. Psychiatry research, 199(1), 65-69.

    Article  PubMed  PubMed Central  Google Scholar 

  • Corrigan, P. W., Watson, A. C., & Barr, L. (2006). The self–stigma of mental illness: Implications for self–esteem and self–efficacy. Journal of social and clinical psychology, 25(8), 875-884.

    Article  Google Scholar 

  • Crenshaw, K. (1989). Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine. University of Chicago Legal Forum, 139–168.

  • Das-Munshi, J., Stewart, R., Morgan, C., Nazroo, J., Thornicroft, G., & Prince, M. (2016). Reviving the ‘double jeopardy’hypothesis: physical health inequalities, ethnicity and severe mental illness. The British Journal of Psychiatry, 209(3), 183-185.

    Article  PubMed  Google Scholar 

  • Davis, B., Anglin, D. M., Oluwoye, O., & Keshavan, M. (2022). The unfulfilled promise of equitable first episode care for Black-Americans: A way forward. Schizophrenia research, 241, 171.

    Article  PubMed  Google Scholar 

  • Del Pino, H. E., Steers, W. N., Lee, M., McCuller, J., Hays, R. D., & Harawa, N. T. (2022). Measuring gender role conflict, internalized stigma, and racial and sexual identity in behaviorally bisexual Black men. Archives of sexual behavior, 51(2), 1019-1030.

    Article  PubMed  Google Scholar 

  • Del Rosal, E., González-Sanguino, C., Bestea, S., Boyd, J., & Muñoz, M. (2021). Correlates and consequences of internalized stigma assessed through the Internalized Stigma of Mental Illness Scale for people living with mental illness: A scoping review and meta-analysis from 2010. Stigma and Health, 6(3), 324.

    Article  Google Scholar 

  • DeLuca, J. S., Novacek, D. M., Adery, L. H., Herrera, S. N., Landa, Y., Corcoran, C. M., & Walker, E. F. (2022). Equity in mental health services for youth at clinical high risk for psychosis: considering marginalized identities and stressors. Evidence-Based Practice in Child and Adolescent Mental Health, 7(2), 176-197.

    Article  PubMed  PubMed Central  Google Scholar 

  • DeLuca, J. S., Akouri-Shan, L., Jay, S. Y., Redman, S. L., Petti, E., Lucksted, A., ... & Schiffman, J. (2021). Predictors of internalized mental health stigma in a help-seeking sample of youth: The roles of psychosis-spectrum symptoms and family functioning. Journal of abnormal psychology, 130(6), 587.

  • Deriu, V., Moro, M. R., & Benoit, L. (2018). Early intervention for everyone? A review of cross‐cultural issues and their treatment in ultra‐high‐risk (UHR) cohorts. Early intervention in psychiatry, 12(5), 796-810

    Article  PubMed  Google Scholar 

  • DeVylder, J. E., Oh, H. Y., Yang, L. H., Cabassa, L. J., Chen, F. P., & Lukens, E. P. (2013). Acculturative stress and psychotic-like experiences among Asian and Latino immigrants to the United States. Schizophrenia research, 150(1), 223-228.

    Article  PubMed  Google Scholar 

  • Dubreucq, J., Plasse, J., & Franck, N. (2021). Self-stigma in serious mental illness: A systematic review of frequency, correlates, and consequences. Schizophrenia Bulletin, 47(5), 1261-1287.

    Article  PubMed  PubMed Central  Google Scholar 

  • Estrellado, J. E., Felipe, L. S., Celestial, J. E. (2022). Clinical Interventions for Internalized Oppression. Cognella.

  • Ferrari, M., Flora, N., Anderson, K. K., Haughton, A., Tuck, A., Archie, S., ... & ACE Project Team. (2018). Gender differences in pathways to care for early psychosis. Early intervention in psychiatry, 12(3), 355-361.

  • Firmin, R. L., Lysaker, P. H., Luther, L., Yanos, P. T., Leonhardt, B., Breier, A., & Vohs, J. L. (2019). Internalized stigma in adults with early phase versus prolonged psychosis. Early Intervention in Psychiatry, 13(4), 745-751.

    Article  PubMed  Google Scholar 

  • Fusar-Poli, P., Sunkel, C., Larrauri, C. A., Kéri, P., McGorry, P., Thornicroft, G., & Patel, V. (2023). Violence and schizophrenia: who is the perpetrator and who is the victim?. World Psychiatry.

  • Gallo, K. M. (1994). First person account: Self-stigmatization. Schizophrenia Bulletin, 20(2), 407-410.

    Article  CAS  PubMed  Google Scholar 

  • Golembo‐Smith, S., Denenny, D., Kishimoto, E., & Schiffman, J. (2011). Training service‐providers regarding youth at risk for psychosis. Asia‐Pacific Psychiatry, 3(1), 17-22.

    Article  Google Scholar 

  • GovTribe (2022, May 19). Project grant R34MH122500: Development of a stage-specific adaptation of a self-stigma intervention for people recovering from a first episode of psychosis. https://govtribe.com/award/federal-grant-award/project-grant-r34mh122500

  • Gronholm, P. C., Thornicroft, G., Laurens, K. R., & Evans-Lacko, S. (2017). Mental health-related stigma and pathways to care for people at risk of psychotic disorders or experiencing first-episode psychosis: a systematic review. Psychological medicine, 47(11), 1867-1879.

    Article  CAS  PubMed  Google Scholar 

  • Hache‐Labelle, C., Abdel‐Baki, A., Lepage, M., Laurin, A. S., Guillou, A., Francoeur, A., ... & Lecomte, T. (2021). Romantic relationship group intervention for men with early psychosis: A feasibility, acceptability and potential impact pilot study. Early Intervention in Psychiatry, 15(4), 753–761.

  • Hansson, L., Lexén, A., & Holmén, J. (2017). The effectiveness of narrative enhancement and cognitive therapy: a randomized controlled study of a self-stigma intervention. Social psychiatry and psychiatric epidemiology, 52, 1415-1423.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hemmings, C., & Evans, A. M. (2018). Identifying and treating race‐based trauma in counseling. Journal of Multicultural Counseling and Development, 46(1), 20-39.

    Article  Google Scholar 

  • Ho, R. W. H., Chang, W. C., Kwong, V. W. Y., Lau, E. S. K., Chan, G. H. K., Jim, O. T. T., ... & Chen, E. Y. H. (2018). Prediction of self-stigma in early psychosis: 3-year follow-up of the randomized-controlled trial on extended early intervention. Schizophrenia Research, 195, 463–468.

  • Howes, O. D., Whitehurst, T., Shatalina, E., Townsend, L., Onwordi, E. C., Mak, T. L. A., ... & Osugo, M. (2021). The clinical significance of duration of untreated psychosis: an umbrella review and random‐effects meta‐analysis. World Psychiatry, 20(1), 75–95.

  • Iyer, S. N., Mangala, R., Anitha, J., Thara, R., & Malla, A. K. (2011). An examination of patient‐identified goals for treatment in a first‐episode programme in Chennai, India. Early Intervention in Psychiatry, 5(4), 360-365.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jacob, L., Smith, L., McDermott, D., Haro, J. M., Stickley, A., & Koyanagi, A. (2021). Relationship between sexual orientation and psychotic experiences in the general population in England. Psychological Medicine, 51(1), 138-146.

    Article  PubMed  Google Scholar 

  • Jarvis, G. E., Kirmayer, L. J., Gómez-Carrillo, A., Aggarwal, N. K., & Lewis-Fernández, R. (2020). Update on the cultural formulation interview. Focus, 18(1), 40-46.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jones, N., Kamens, S., Oluwoye, O., Mascayano, F., Perry, C., Manseau, M., & Compton, M. T. (2021). Structural disadvantage and culture, race, and ethnicity in early psychosis services: International provider survey. Psychiatric services, 72(3), 254-263.

  • Kane, J. M., Schooler, N. R., Marcy, P., Correll, C. U., Brunette, M. F., Mueser, K. T., ... & Robinson, D. G. (2015). The RAISE early treatment program for first-episode psychosis: background, rationale, and study design. The Journal of clinical psychiatry, 76(3), 16590.

  • Killackey, E., Allott, K., Jackson, H. J., Scutella, R., Tseng, Y. P., Borland, J., ... & Cotton, S. M. (2019). Individual placement and support for vocational recovery in first-episode psychosis: randomised controlled trial. The British Journal of Psychiatry, 214(2), 76–82.

  • Knight, S., Jarvis, G. E., Ryder, A. G., Lashley, M., & Rousseau, C. (2022). Ethnoracial differences in coercive referral and intervention among patients with first-episode psychosis. Psychiatric Services, 73(1), 2-8.

    Article  PubMed  Google Scholar 

  • Lally, S. J. (1989). Does being in here mean there is something wrong with me?. Schizophrenia bulletin, 15(2), 253-265.

    Article  CAS  PubMed  Google Scholar 

  • Lucksted, A., Drapalski, A., Calmes, C., Forbes, C., DeForge, B., & Boyd, J. (2011). Ending self-stigma: pilot evaluation of a new intervention to reduce internalized stigma among people with mental illnesses. Psychiatric rehabilitation journal, 35(1), 51.

    Article  PubMed  Google Scholar 

  • McCay, E., Beanlands, H., Leszcz, M., Goering, P., Seeman, M. V., Ryan, K., & Vishnevsky, T. (2006). A group intervention to promote healthy self-concepts and guide recovery in first episode schizophrenia: A pilot study. Psychiatric Rehabilitation Journal, 30(2), 105.

    Article  PubMed  Google Scholar 

  • Metzl, J. M. (2010). The protest psychosis: How schizophrenia became a black disease. Beacon Press.

  • Misra, S., Etkins, O. S., Yang, L. H., & Williams, D. R. (2022). Structural racism and inequities in incidence, course of illness, and treatment of psychotic disorders among Black Americans. American Journal of Public Health, 112(4), 624-632.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mueser, K. T., DeTore, N. R., Kredlow, M. A., Bourgeois, M. L., Penn, D. L., & Hintz, K. (2020). Clinical and demographic correlates of stigma in first‐episode psychosis: the impact of duration of untreated psychosis. Acta Psychiatrica Scandinavica, 141(2), 157-166.

    Article  CAS  PubMed  Google Scholar 

  • Nagendra, A., Schooler, N. R., Kane, J. M., Robinson, D. G., Mueser, K. T., Estroff, S. E., ... & Penn, D. L. (2018). Demographic, psychosocial, clinical, and neurocognitive baseline characteristics of Black Americans in the RAISE-ETP study. Schizophrenia Research, 193, 64–68.

  • Nagendra, A., Weiss, D. M., Merritt, C., Cather, C., Sosoo, E. E., Mueser, K. T., & Penn, D. L. (2023). Clinical and psychosocial outcomes of Black Americans in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) study. Social psychiatry and psychiatric epidemiology, 58(1), 77-89.

    Article  PubMed  Google Scholar 

  • O’Connor, L. K., & Yanos, P. T. (2021). Where are all the psychologists? A review of factors impacting the underrepresentation of psychology in work with serious mental illness. Clinical Psychology Review, 86, 102026.

    Article  PubMed  Google Scholar 

  • Oh, H., Susser, E., Volpe, V. V., Lui, F., Besecker, M., Zhou, S., & Anglin, D. M. (2022). Psychotic experiences among Black college students in the United States: The role of socioeconomic factors and discrimination. Schizophrenia Research, 248, 198-205.

    Article  PubMed  Google Scholar 

  • Oluwoye, O., Davis, B., Kuhney, F. S., & Anglin, D. M. (2021). Systematic review of pathways to care in the US for Black individuals with early psychosis. Npj Schizophrenia, 7(1), 58.

    Article  PubMed  PubMed Central  Google Scholar 

  • Oluwoye, O., Stiles, B., Monroe-DeVita, M., Chwastiak, L., McClellan, J. M., Dyck, D., ... & McDonell, M. G. (2018). Racial-ethnic disparities in first-episode psychosis treatment outcomes from the RAISE-ETP study. Psychiatric Services, 69(11), 1138–1145.

  • Pescosolido, B. A., Manago, B., & Monahan, J. (2019). Evolving public views on the likelihood of violence from people with mental illness: stigma and its consequences. Health Affairs, 38(10), 1735-1743.

    Article  PubMed  Google Scholar 

  • Pescosolido, B. A., Medina, T. R., Martin, J. K., & Long, J. S. (2013). The “backbone” of stigma: identifying the global core of public prejudice associated with mental illness. American journal of public health, 103(5), 853-860.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ramsay, C. E., Broussard, B., Goulding, S. M., Cristofaro, S., Hall, D., Kaslow, N. J., ... & Compton, M. T. (2011). Life and treatment goals of individuals hospitalized for first-episode nonaffective psychosis. Psychiatry research, 189(3), 344–348.

  • Read, H., & Kohrt, B. A. (2022). The history of coordinated specialty care for early intervention in psychosis in the United States: A review of effectiveness, implementation, and fidelity. Community Mental Health Journal, 58(5), 835–846. https://doi.org/10.1007/s10597-021-00891-w

  • Ritsher, J. B., Otilingam, P. G., & Grajales, M. (2003). Internalized stigma of mental illness: psychometric properties of a new measure. Psychiatry research, 121(1), 31-49.

  • Roe, D., Hasson‐Ohayon, I., Mashiach‐Eizenberg, M., Derhy, O., Lysaker, P. H., & Yanos, P. T. (2014). Narrative enhancement and cognitive therapy (NECT) effectiveness: A quasi‐experimental study. Journal of clinical psychology, 70(4), 303-312.

    Article  PubMed  Google Scholar 

  • Ross, L. E., Doctor, F., Dimito, A., Kuehl, D., & Armstrong, M. S. (2007). Can talking about oppression reduce depression? Modified CBT group treatment for LGBT people with depression. Journal of Gay & Lesbian Social Services, 19(1), 1-15.

    Article  Google Scholar 

  • Russinova, Z., Rogers, E. S., Gagne, C., Bloch, P., Drake, K. M., & Mueser, K. T. (2014). A randomized controlled trial of a peer-run antistigma photovoice intervention. Psychiatric Services, 65(2), 242-246.

    Article  PubMed  Google Scholar 

  • Schiffman, J., Ellman, L. M., & Mittal, V. A. (2019). Individual differences and psychosis-risk screening: Practical suggestions to improve the scope and quality of early identification. Frontiers in Psychiatry, 10, 6.

  • Simonsen, C., Aminoff, S. R., Vaskinn, A., Barrett, E. A., Faerden, A., Ueland, T., ... & Melle, I. (2019). Perceived and experienced stigma in first-episode psychosis: A 1-year follow-up study. Comprehensive Psychiatry, 95, 152134.

  • Shinn, A. K., Cawkwell, P. B., Bolton, K., Healy, B. C., Karmacharya, R., Yip, A. G., ... & Pinder-Amaker, S. (2020). Return to college after a first episode of psychosis. Schizophrenia Bulletin Open, 1(1), sgaa041.

  • Tsang, H. W., Ching, S. C., Tang, K. H., Lam, H. T., Law, P. Y., & Wan, C. N. (2016). Therapeutic intervention for internalized stigma of severe mental illness: A systematic review and meta-analysis. Schizophrenia Research, 173(1-2), 45-53.

    Article  PubMed  Google Scholar 

  • van der Ven, E., Jones, N., Bareis, N., Scodes, J. M., Dambreville, R., Ngo, H., ... & Wall, M. M. (2022). An Intersectional Approach to Ethnoracial Disparities in Pathways to Care Among Individuals With Psychosis in Coordinated Specialty Care. JAMA Psychiatry, 79(8), 790–798.

  • Williams, M. T., Osman, M., Gallo, J., Pereira, D. P., Gran-Ruaz, S., Strauss, D., ... & Litman, L. (2022a). A clinical scale for the assessment of racial trauma. Practice Innovations, 7(3), 223–240. https://doi.org/10.1037/pri0000178

  • Williams, M. T., Holmes, S., Zare, M., Haeny, A., & Faber, S. (2022b). An evidence-based approach for treating stress and trauma due to racism. Cognitive and Behavioral Practice. https://doi.org/10.1016/j.cbpra.2022.07.001

  • Yang, L. H., Blasco, D., Lieff, S. A., Le, P. D., Li, Y., Broeker, M., ... & Dixon, L. (2021). Stigma of Treatment Stages for First-Episode Psychosis: A Conceptual Framework for Early Intervention Services. Harvard Review of Psychiatry, 29(2), 131–141.

  • Yanos, P. T., DeLuca, J. S., Roe, D., & Lysaker, P. H. (2020). The impact of illness identity on recovery from severe mental illness: A review of the evidence. Psychiatry research, 288, 112950.

    Article  PubMed  Google Scholar 

  • Yanos, P. T., Lysaker, P. H., Silverstein, S. M., Vayshenker, B., Gonzales, L., West, M. L., & Roe, D. (2019). A randomized-controlled trial of treatment for self-stigma among persons diagnosed with schizophrenia-spectrum disorders. Social psychiatry and psychiatric epidemiology, 54, 1363-1378.

    Article  PubMed  PubMed Central  Google Scholar 

  • Yanos, P. T., Lucksted, A., Drapalski, A. L., Roe, D., & Lysaker, P. (2015). Interventions targeting mental health self-stigma: A review and comparison. Psychiatric rehabilitation journal, 38(2), 171.

    Article  PubMed  Google Scholar 

  • Yanos, P. T., Roe, D., & Lysaker, P. H. (2011). Narrative enhancement and cognitive therapy: a new group-based treatment for internalized stigma among persons with severe mental illness. International journal of group psychotherapy, 61(4), 576-595.

    Article  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Fairfield, CT, USA

    Joseph S. DeLuca

  2. New York, NY, USA

    Philip T. Yanos

Authors
  1. Joseph S. DeLuca
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Philip T. Yanos
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joseph S. DeLuca.

Ethics declarations

Conflicts of Interest, External Funding, and Other Disclosures

Dr. DeLuca currently has external funding from the American Psychological Association’s Early Career Service Grant, and he is a consultant for Dr. Yanos’ NIMH R34 grant, focused on internalized stigma in first-episode psychosis. Dr. DeLuca also serves as a Consulting Editor for JHSP. He has no conflicts of interests or other disclosures to report.

Dr. Yanos is currently the Principal Investigator of a National Institute of Mental Health grant (R34MH122500; “Development of a stage-specific adaptation of a self-stigma intervention for people recovering from a first episode of psychosis”). He has no conflicts of interests or other disclosures to report.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

DeLuca, J.S., Yanos, P.T. Targeting Internalized Stigma in First-Episode Psychosis Services: Treatment Strategies from an Intersectional Perspective. J Health Serv Psychol 49, 101–111 (2023). https://doi.org/10.1007/s42843-023-00084-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s42843-023-00084-x

Keywords

Search

Navigation