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