# Development of a stage-specific adaptation of a self-stigma intervention for people recovering from a first episode of psychosis

> **NIH NIH R34** · JOHN JAY COLLEGE OF CRIMINAL JUSTICE · 2022 · $216,143

## Abstract

Abstract
Self-stigma develops when people diagnosed with severe mental illnesses (SMI) become aware of negative
stereotypes endorsed by many in society (e.g., dangerousness, incompetence, inability to work), perceive them
as legitimate, and apply them to themselves. Clinically significant self-stigma affects roughly 1/3 or more of
persons with SMI, and there is substantial evidence that it is strongly negatively linked to treatment engagement,
as well as critical objective (e.g., social functioning) and subjective (e.g., self-esteem) dimensions of recovery.
First Episodes of Psychosis (FEPs) typically occur during youth (between ages 15 and 24, corresponding with
late adolescence/early adulthood), a time of heightened self-consciousness and a crucial period for identity
formation. Developmental theory posits that identity disruptions, such as psychosis (with its associated negative
stereotypes), may diminish one’s sense of purpose, decreasing treatment engagement and impacting pursuit of
life goals (school/work). Research with people who have recently experienced a FEP finds that clinically
significant self-stigma is common at this stage and associated with diminished treatment engagement and
impaired social functioning. The FEP period is therefore a critical time for addressing self-stigma given the
potentially profound implications of self-stigma for identity development. Despite encouraging findings, treatment
engagement and other outcomes are still suboptimal for targeted FEP services such as “Coordinated Specialty
Care” [CSC]. Given the documented relationship between self-stigma and service engagement, it is plausible
that targeted self-stigma intervention can increase engagement in CSC services and improve outcomes among
youth with FEP. Narrative Enhancement and Cognitive Therapy (NECT) is an intervention designed to reduce
self-stigma that was found to be effective compared to treatment as usual in recent randomized controlled-trials
(RCTs) with middle-aged adults. NECT might serve as an effective adjunct to CSC, but it is not suitable for use
with people with FEP in its current form, and may also be amenable to telehealth modification to better engage
youth. The overall purpose of the proposed exploratory intervention development application, consistent with the
aims of RFA-MH-18-706, is to conduct research that will inform the adaptation and preliminary testing of NECT
modified for youth (aged 15-24) with FEP, targeting self-concept and illness conceptions to increase treatment
engagement. The specific aims of the project are to: 1) Conduct a qualitative study to characterize experiences
of stigma concern, self-stigma and associated intervention preferences among youth with FEP and their family
members, 2) adapt NECT to be responsive to the needs and preferences of youth with FEP, and 3) Assess the
feasibility, acceptability and preliminary effectiveness of the modified intervention (NECT-YA) combined with
CSC services, compared to CSC ...

## Key facts

- **NIH application ID:** 10452612
- **Project number:** 5R34MH122500-02
- **Recipient organization:** JOHN JAY COLLEGE OF CRIMINAL JUSTICE
- **Principal Investigator:** PHILIP T YANOS
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $216,143
- **Award type:** 5
- **Project period:** 2021-07-16 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10452612

## Citation

> US National Institutes of Health, RePORTER application 10452612, Development of a stage-specific adaptation of a self-stigma intervention for people recovering from a first episode of psychosis (5R34MH122500-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10452612. Licensed CC0.

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