Be outspoken and overcome stigmatizing thoughts (BOOST): a group treatment for internalized stigma in first-episode psychosis

ABSTRACT

Background: Internalized stigma is associated with a broad array of negative outcomes for people experiencing psychosis. The current article provides an overview of a novel group-based intervention for reducing internalized stigma (Be Outspoken and Overcome Stigmatizing Thoughts [BOOST]) that combines cognitive behavioural techniques with peer support in first-episode psychosis.

Methods: BOOST is an eight-session group intervention that combines cognitive restructuring, assertive communication skills and peer support. Results are presented from a small pilot non-controlled open-label study of 15 participants at an early intervention for psychosis programme.

Results: Thirty-three percent of participants discontinued BOOST before completing the intervention. Those who completed BOOST experienced significantly improved internalized stigma (d = .76), self-esteem (d = 1.20) and satisfaction with life (d = 1.27).

Conclusions: Results from this small pilot study suggest that BOOST is not only effective at improving internalized stigma, but also at improving self-esteem and satisfaction with life. Further evaluation of BOOST in a randomized controlled trial is ongoing, and further investigation of the role of combined peer support and cognitive behavioural intervention is warranted as a method of reducing internalized stigma.

KEYWORDS:

• Psychosis
• schizophrenia
• internalized stigma
• peer support
• cognitive behavioural therapy
• early intervention

Acknowledgements

The authors are grateful to the clients and staff of the Heads Up! Early Intervention in Psychosis Program for their participation, feedback, and support of the BOOST intervention.

Disclosure statement

No potential conflict of interest was reported by the authors.