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Schizophrenia: Practical Strategies for Relapses & Reducing Symptoms
10 CEUs Schizophrenia: Practical Strategies for Relapses & Reducing Symptoms

Section 4
Stigma of Schizophrenia

Question 4 | Test | Table of Contents | Schizophrenia CEU Courses
Social Worker CEU, Psychologist CE, Counselor CEU, & MFT CEU

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In the last two sections, we examined negative symptoms of schizophrenia.  We looked at five common negative symptoms of schizophrenia.  These five negative symptoms are apathy, incongruous emotional responses, reductions in speech,  social withdrawal, and reduced social performance.

In this section,we will discuss the stigma of schizophrenia.  Three topics included on this section are prejudice, stereotypes, and whom to tell. We will also discuss how clients can deal with prejudice and stereotypes.  As you listen to this section, you might consider playing it for a client you are treating, or perhaps in a group setting if applicable. As you play this section, think of a client or family member that has some inaccurate stereotypes about schizophrenia, who might benefit from listening to this section.

Stigma of Schizophrenia - 3 Considerations

♦ #1  Stereotypes
First, let’s review stereotypes.  As you know, probably the most common stereotype of schizophrenia is that of multiple personalities.  Lisa, age 28, was a client of mine with schizophrenia.  Lisa stated, "I thought schizophrenia was a disorder where a person would have multiple, split personalities, like ten or fifteen personalities.  I was completely wrong about that.  But I know I read it somewhere.  I wonder why so many people think it’s that?  I heard it or read it somewhere.  I didn’t come up with the conclusion that schizophrenia is multiple personality disorder on my own!" 

In addition to multiple personalities, other stereotypes Lisa heard included retarded, drug addicted, homeless, dangerous, crazy, evil, and weak.  Lisa found these labels hard to live with, especially because they were no more true for her than for anyone else.  Do you agree that, like Lisa, many people do not understand schizophrenia?  Would you also agree that this lack of understanding is what leads the general public to consider schizophrenia in terms of stereotypes?

♦ #2  Prejudice
As you are well aware stereotyping almost inevitably leads to prejudice. Typically, we see the evolution of prejudice begin with a lack of understanding, but that doesn’t make it any easier on our clients. 

Lisa adequately described prejudice when she stated, "Of course there is stigma and prejudice.  People just think you are crazy and you are somebody they shouldn’t get to know because of fear. They just fear for themselves that you might turn around and do something. I know even myself, before I was diagnosed, I would look at a person with mental illness as different.  I probably wouldn’t want to know them.  I would be afraid of them because I’d think that they aren’t all there in the head.  Now I think differently.  I think it could happen to anybody, anytime.  I think people with mental illness are the same as anybody else."  Are you currently treating a client or family member that could benefit by hearing this information?

As you can see, Lisa found herself struggling not only with the symptoms of schizophrenia, but also with stereotypes and prejudice.  Lisa asked herself many questions, such as "How can I go on with my life?";  "How can I tell my family and friends?";  "How can I go to work?"   Does your client share Lisa’s concerns?  If so, you might try introducing your client to the following coping strategies for dealing with prejudice and stereotypes.

♦ Technique:  4 Coping Strategies for Dealing with Prejudice and Stereotypes
To help Lisa in dealing with prejudice and stereotypes, I gave her four coping strategies. 

--1. First, I asked Lisa to learn all that she could about schizophrenia.  This step serves two therapeutic purposes. First, education gives the client a knowledge base from which to dispute stereotypes.  Second, while learning about schizophrenia, clients usually find information relating case studies in which treatment was successful. 

--2. Lisa’s second coping strategy for dealing with prejudice and stereotypes was to put her feelings of shame behind her.  Lisa stated, "It is easier to feel better about my illness now that I know about it." 

--3. In addition to education and overcoming shame, the third coping strategy Lisa used was surrounding herself with support.  For some clients, family and friends are sufficient.  Other clients require more structured support, such as that found in group therapy.  Lisa found support through her church. 

--4. The fourth strategy for dealing with prejudice and stereotypes was for Lisa to decide who she wanted to tell and who she needed to tell about her schizophrenia.

♦ #3  Whom to Tell
In addition to stereotypes and prejudice, the third topic we will discuss regarding the stigma of schizophrenia is whom to tell.  For Lisa, the decision of whom to tell about her schizophrenia was personal.  However, I feel that clients should know their rights regarding who they have to tell.  Do you agree? 

For example, I stated to Lisa, "As a rule, most employers are not allowed to ask you if you have a history of mental illness when you are applying for a job.  However, there are some special jobs, like law enforcement or armed services positions, where employers are allowed to ask you about mental illness.  In those cases, the employer must ask each applicant the same questions.  Once you are hired, you may disclose your illness in order to get special accommodations.  Special accommodations might include a flexible schedule for therapy, a special office setup to help you concentrate, or even a job coach if you need one.  They can’t fire you for telling your employer about your schizophrenia.  If for any reason, you think you are being treated unfairly, tell me, or you can contact the Equal Employment Opportunity Commission at 1-800-669-4000." 

Think of your Lisa.  Could knowledge of Equal Opportunity help your client feel more comfortable regarding the stigma of schizophrenia? Could it also benefit your client to be familiar with state laws that can protect them?

Due to the nature of schizophrenia, do you agree that an ability to cope with the attached stigma can aid our clients in coping with relapses and reducing symptoms?

In this section, we have discussed the stigma of schizophrenia.  Three topics included on this section are prejudices, stereotypes, and who to tell.  We also discussed how clients can deal with prejudice and stereotypes.

In the next section, we will discuss avoiding relapses.  Three aspects of avoiding relapse that we will examine are signs of relapse, decreasing stress and dating, and other healthy habits that can help prevent relapse.

Peer-Reviewed Journal Article References:
Aakre, J. M., Klingaman, E. A., & Docherty, N. M. (2015). The relationship between stigma sentiments and self-identity of individuals with schizophrenia. Psychiatric Rehabilitation Journal, 38(2), 125–131. 

Lampropoulos, D., Troïan, J., D'Amico, C., Bentata, L., & Apostolidis, T. (2018). Evidence for the influence of social dominance orientation and intergroup relations on the stigma of schizophrenia. European Journal of Health Psychology, 25(4), 133–139.

Riehle, M., & Lincoln, T. M. (2018). Investigating the social costs of schizophrenia: Facial expressions in dyadic interactions of people with and without schizophrenia. Journal of Abnormal Psychology, 127(2), 202–215.

Sum, M. Y., Chan, S. K. W., Tse, S., Bola, J. R., & Chen, E. Y. H. (2021). Internalized stigma as an independent predictor of employment status in patients with schizophrenia. Psychiatric Rehabilitation Journal, 44(3), 299–302.

Thibodeau, R. (2017). Continuum beliefs and schizophrenia stigma: Correlational and experimental evidence. Stigma and Health, 2(4), 266–270. 

What are three topics regarding the stigma of schizophrenia? To select and enter your answer go to Test.
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