Effectiveness of a Self-Stigma Therapy for Reducing Suicidal Thoughts and Behaviours in Early Psychosis
Chris Bowie
Impact
The Be Outspoke and Overcome Stigmatizing Thoughts (BOOST) online group intervention was developed to support individuals experiencing psychosis.
A comprehensive manual is currently in development in collaboration with a clinical advisory group and individuals with lived experience of psychosis. This manual is designed to help clinicians sustain and apply BOOST treatment strategies in their ongoing work with participants.
As the evidence base for BOOST continues to grow – both as a general intervention and as an online therapy – it is increasingly being adopted by clinicians working with this population. The treatment materials are being shared at no cost, accompanied by a dedicated forum for addressing questions.
A formalized training program for therapists and peer support workers is also in development. This program will be offered asynchronously and made available in multiple languages to enhance accessibility and reach.
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Ontario
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Grant
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Queen’s University
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Heads Up!
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Institute for Advancements in Mental Health
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2019-2020
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Children and Youth Mental Health
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Youth (aged 12-18), Family Members
About the Project
The goal of the research project was to further develop and expand a group intervention called “Be Outspoken and Overcome Stigmatizing Thoughts” (BOOST). This intervention combined cognitive behavioral therapy with peer support (a treatment approach that helps people recognize negative thought and behavior patterns), with the objective to enhance the mental health and well-being of young individuals with psychosis, particularly those residing in rural/underserved areas. The expanded intervention addresses suicidality, providing resources for the family/friends of individuals with psychosis and conducting long-term follow-up assessments. The primary objective of the research is to investigate how this group treatment targeting self-stigma can influence and potentially reduce suicidal thoughts and behaviors among individuals with psychosis.
Methodology
The project tested the virtual delivery of BOOST, a group therapy program for young people in the early stages of psychosis. BOOST was co-created and co-led by people with lived experience and focuses on reducing internalized stigma, improving mood and relationships, and lowering suicide risk. The program was delivered via Zoom to participants from 6 early psychosis clinics across Canada, including rural areas in Ontario. A total of four sites in Ontario referred participants to the online sessions.
107 participants were recruited and more than 50% completed surveys at four time points: before starting BOOST, immediately after the group ended, and again at 6 and 12 months. These surveys measured internalized stigma, mood, relationships, hopelessness, and suicidal thoughts and behaviours. The project also introduced new suicide-focused strategies and resources for families and friends to support lasting impact beyond the sessions.
Findings
The BOOST program helped people in the early stages of psychosis feel better in several important ways. After completing the program, participants reported:
Feeling less shame and self-blame related to their mental health (known as internalized stigma)
Improved mood
Fewer challenges in their relationships with others
Less emotional pain connected to their own thoughts (called “psychache”)
These improvements were maintained at follow-up assessments
Project Scaling
The project’s findings and materials have been disseminated to other provinces in Canada (British Columbia, Manitoba and Quebec) and to colleagues internationally to Japan, New Zealand, Ireland, Australia, Turkey and over a dozen sites in USA.
Resources Created
1 paper: click here to access it
Development of a clinical manual
Conference presentations
Infographic developed for family members and caregivers to support the skills they require to take care of someone with psychosis
Training manual and videos