Implementation Adherence of a Therapy Group Addressing Internalized Stigma Among Psychiatric Outpatients

Abstract

Problem: Stigma against mental illness brings with it many negative stereotypes that can be internalized by those who live with mental illnesses. The result is called “internalized stigma” or “self-stigma.” The implementation site for this Quality Improvement (QI) project was a 98- patient outpatient clinic providing treatment for schizophrenia-spectrum disorders. An early survey of patients at the site found that nearly half of the patients surveyed (46.94%) experience internalized stigma. There is currently no official treatment approach towards internalized stigma at this site. Purpose: The purpose of this QI project was the implementation of an evidencebased psychoeducational group therapy intervention for the treatment of internalized stigma amongst individuals living with mental illness. The intervention is titled “Ending Self-Stigma” and consists of nine manualized group sessions. Methods: The chosen framework for this QI project was the Promoting Action on Research Implementation in Health Services, or PARIHS model. Implementation included the administration of the nine manualized treatment sessions in addition to one introductory group session and a final feedback session. Attendance at each session as well as availability of each session were measured and analyzed using run charts. Results: Group availability throughout the project implementation period was 100%. Group attendance averaged 94.8%. Program feedback was positive, with participants overwhelmingly reporting enjoyment discussing their experiences with peers. Conclusions: The results show the feasibility and value of implementing this group at the site. High levels of attendance showed patient engagement, and feedback suggested high levels of enjoyment as well as relevance and benefits of the intervention.