Kendra Matthew S, Mohr Jonathan J, Pollard Jeffrey W
Department of Psychology, George Mason University.
Psychotherapy (Chic). 2014 Dec;51(4):563-573. doi: 10.1037/a0036586. Epub 2014 May 26.
The stigma of having psychological problems is a barrier to seeking mental health treatment, but little research has examined whether this stigma influences the experiences of those in treatment. In a sample of 42 psychotherapy clients, we explored links over the first few sessions between 2 facets of stigma (self-stigma and perceived public stigma) and 3 variables germane to the therapeutic process (depression, working alliance, and engagement). Initial self-stigma (SS) level was positively associated with initial depression, negatively associated with initial working alliance, and unrelated to initial engagement. Initial perceived public stigma (PPS) level was unrelated to initial levels in the 3 outcome variables. Initial SS and PPS levels were both generally unrelated to linear changes in the outcomes over the initial phase of counseling. Relations between stigma and outcome variables often differed within- and between-persons. For example, the association between PPS and engagement was negative at the between-person level but positive at the within-person level. Finally, on average, PPS decreased over the first few sessions but SS remained constant. Such findings may help therapists better understand the role of stigma in their clinical work, and stimulate research examining how to address stigmatization in psychotherapy.
存在心理问题的污名化是寻求心理健康治疗的一个障碍，但很少有研究探讨这种污名化是否会影响接受治疗者的体验。在一个由42名心理治疗客户组成的样本中，我们在最初的几次治疗过程中，探究了污名化的两个方面（自我污名和感知到的公众污名）与治疗过程中三个相关变量（抑郁、工作联盟和参与度）之间的联系。初始自我污名（SS）水平与初始抑郁呈正相关，与初始工作联盟呈负相关，与初始参与度无关。初始感知到的公众污名（PPS）水平与这三个结果变量的初始水平无关。初始SS和PPS水平通常与咨询初始阶段结果的线性变化无关。污名与结果变量之间的关系在个体内部和个体之间往往有所不同。例如，PPS与参与度之间的关联在个体间水平上是负相关，但在个体内水平上是正相关。最后，平均而言，PPS在最初几次治疗过程中有所下降，但SS保持不变。这些发现可能有助于治疗师更好地理解污名化在他们临床工作中的作用，并激发关于如何在心理治疗中解决污名化问题的研究。
