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Group Intervention for Improving Stigma Coping and Empowerment of People With Mental Illness (STEM) (STEM)

This study has been completed.
German Federal Ministry of Education and Research
Information provided by (Responsible Party):
Wolfgang Gaebel, Professor, Heinrich-Heine University, Duesseldorf Identifier:
First received: June 14, 2012
Last updated: June 14, 2016
Last verified: June 2016
This multi-center, 2-arm interventional study within different mental health care settings (psychiatry: in-patient, day-unit and out-patient, as well as psychiatric rehabilitation) evaluates a psychotherapeutic group intervention to improve stigma coping and empowerment using a psychotherapeutic module embedded in a psychoeducational group therapy.

Condition Intervention
Behavioral: psychotherapeutic STEM modules
Behavioral: Interventional control of normal psychoeducational treatment

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Group Intervention for Improving Stigma Coping and Empowerment of People With Mental Illness (STEM)

Resource links provided by NLM:

Further study details as provided by Wolfgang Gaebel, Professor, Heinrich-Heine University, Duesseldorf:

Primary Outcome Measures:
  • subjective quality of life [ Time Frame: 12 months after intervention ]

    subjective quality of life 12 months after intervention determined by WHOQOL-BREF total score.

    To impart coping-strategies in handling stigmatization and to develop empowerment by embedding a psychotherapeutic module in psychoeducational groups.

Secondary Outcome Measures:
  • self-stigma (ISMI) [ Time Frame: after 6 weeks, 6 months, 12 months ]
  • empowerment (BUES) [ Time Frame: after 6 weeks, 6 months, 12 months ]
  • health care utilization (CSSRI, EQ5-D, SF-36) [ Time Frame: after 6 weeks, 6 months, 12 months ]

Enrollment: 486
Study Start Date: May 2012
Study Completion Date: June 2015
Primary Completion Date: June 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Interventional: STEM modules
8 sessions of psychoeducation + 3 sessions + 1 booster session of STEM module (for schizophrenia or depression)
Behavioral: psychotherapeutic STEM modules
psychoeducational and psychotherapeutical group intervention. 8 sessions of psychoeducation + 3 sessions + 1 booster session of STEM module for schizophrenia or depression)
Interventional Control
11 sessions + 1 booster session of psychoeducation for schizophrenia or depression)
Behavioral: Interventional control of normal psychoeducational treatment
11 sessions + 1 booster session of psychoeducation (for schizophrenia or depression)

Detailed Description:

People with mental illness suffer both from the burden of disease itself and from the social stigma related to mental illness, hence impeding their treatment (Sartorius et al. 2005, Link et al. 1999). Negative attitudes towards and discriminating behavior against people with mental illness negatively affect health care utilization, the course of disease, compliance, self-esteem, and social functioning (Sirey et al. 2001, Link et al. 2001, Perlick et al. 2001). Internalizing negative social stereotypes (self-stigmatization; Ritsher et al. 2003, Watson et al. 2007) impairs the quality of life and leads to social withdrawal (Rüesch 2005). Furthermore, self stigma is associated with lower empowerment (Ritsher et al. 2004), a poorer social network (Lysaker et al. 2007), lower compliance (Fung et al. 2008) and a higher extent of symptoms (Corrigan et al. 2006). The stigma of mental illness leads to an impaired pursuance of individual life goals, as job-related ambitions or living in a relationship (Rüesch 2005).

Current approaches targeting the stigma of mental illness primarily focus on education about mental illness in different target groups (e.g. Gaebel et al. 2003, 2004) and can be successful, if appropriately implemented (Gaebel et al. 2008). Yet there is a lack of RCT-tested psychotherapeutic approaches which directly address patients with mental illness improving their skills of coping with stigma and discrimination. Therefore it is intended to develop, manualise, and to evaluate such a psychotherapeutic group intervention within a randomized clinical control group design.

In this context, group-based cognitive-behavioral psychotherapy has been proved as efficient therapeutic approach for patients with depression (cf. McDermut et al. 2006) and with schizophrenia (cf. Lawrence et al. 2006, Barrowclough et al. 2006) in different settings. Patients can serve each other as role models and will modify negative self-related cognitions, thus developing new cognitions supporting self-esteem (Corrigan et al. 2001). The following interventional effects should improve the patients' quality of life and also result in a reduction of frequency and length of inpatient stays and sickness-related absenteeism:

  • improved skills to cope with negative stigmatizing experiences,
  • a reduced burden through of self-stigmatizing cognitions,
  • a better utilization of resources for disease managing in coherence with reduced self-stigmatization, and
  • an improved coping with stigma-related conflicts at work.

Ages Eligible for Study:   18 Years to 65 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Age 18 - 65 years
  • ICD-10 diagnosis of F2, F31.3-31.5, F32-34, F34.2, F43.2
  • patients who would participate in a psychoeducational group therapy in their regular treatment
  • written informed consent of the patient willing to participate
  • capacity of giving consent (as diagnosed by the investigator)

Exclusion Criteria:

  • insufficient knowledge of german language (reading, understanding and speaking not sufficient, as judged by the investigator)
  • acute psychotic or dissociative condition
  Contacts and Locations
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Please refer to this study by its identifier: NCT01655368

Klinik für Psychiatrie und Psychotherapie der RWTH
Aachen, Germany, 52074
Facharztpraxis Dr. Mönter
Berlin, Germany, 10589
Facharztpraxis Gereke
Berlin, Germany, 10589
Facharztpraxis Alicia Navarro Urena
Berlin, Germany, 12203
MediClin Bliestal Kliniken, Fachklinik für psychosomatische Medizin
Blieskastel, Germany, 66440
Mittelrhein-Klinik Bad Salzig der DRV
Boppard-Bad Salzig, Germany, 56154
Klinik für Psychiatrie und Psychotherapie, Universität zu Köln
Cologne, Germany, 50937
Facharztpraxis, Dr. Frosch
Düsseldorf, Germany, 40211
Facharztpraxis Dr. Kuhlbusch
Düsseldorf, Germany, 40227
LVR-Klinikum Düsseldorf - Kliniken der Heinrich-Heine Universität
Düsseldorf, Germany, 40629
Klinik für Psychiatrie und Psychotherapie, Uniklinik Göttingen
Göttingen, Germany, 37075
Klinik für Psychiatrie und Psychotherapie, UKE
Hamburg, Germany, 20246
Oberhavel Kliniken Hennigsdorf
Hennigsdorf, Germany, 16761
Berolina Klinik
Löhne, Germany, 32584
Klinik für Psychiatrie und Psychotherapie der Uniklinik Marburg
Marburg, Germany, 35039
Klinik für Psychiatrie und Psychotherapie, LMU
Munich, Germany, 80336
Reha-Zentrum Seehof der DRV
Teltow, Germany, 14513
Psychiatrisch-psychotherapeutisches Rehabilitationszentrum grund.stein
Tübingen, Germany, 72072
Klinik für Psychiatrie und Psychotherapie
Tübingen, Germany, 72076
AHG Klinik Waren
Waren (Müritz), Germany, 17192
Sponsors and Collaborators
Wolfgang Gaebel, Professor
German Federal Ministry of Education and Research
Principal Investigator: Wolfgang Gaebel, Prof. Dr. LVR-Klinikum Düsseldorf Kliniken der Heinrich-Heine-Universität Düsseldorf
  More Information

Additional Information:
Corrigan P, Lundin R. Don´t call me nuts: Coping with the stigma of mental illness. Recovery Press, Chicago 2001
Corrigan PW, Watson AC, Barr L (2006) The Self-Stigma of Mental Illness: Implications for Self-Esteem and Self-Efficacy. J Soc Clin Psychol 25: 875-884
Gaebel W, Zäske H, Baumann A (2004) Stigma erschwert Behandlung und Integration. Dtsch Ärztebl 101: A3253-3255
Link BG, Phelan JC. Labeling and stigma. In: The Handbook of the Sociology of Mental Health, Hrsg. CS Aneshensel, JC Phelan. Plenum, New York 1999
McDermut W, Miller IW, Brown RA (2006) The Efficacy of Group Psychotherapy for Depression: A Meta-analysis and Review of the Empirical Research. Clinical Psychol: Science and Practice 8: 98-116
Rüesch P. Soziale Netzwerke und Lebensqualität. In: Gaebel W, Möller HJ, Rössler W (Hrsg). Stigma - Diskriminierung - Bewältigung. Kohlhammer, Stuttgart 2005
Sartorius N, Schulze H. Reducing the stigma of mental illness. Cambridge University Press, Cambridge 2005

Responsible Party: Wolfgang Gaebel, Professor, Professor Dr., Heinrich-Heine University, Duesseldorf Identifier: NCT01655368     History of Changes
Other Study ID Numbers: STEM
Study First Received: June 14, 2012
Last Updated: June 14, 2016

Additional relevant MeSH terms:
Mental Disorders
Schizophrenia Spectrum and Other Psychotic Disorders
Psychotropic Drugs processed this record on May 25, 2017