Be outspoken and overcome stigmatizing thoughts (BOOST): a group treatment for internalized stigma in first-episode psychosis

Background: Internalized stigma is associated with a broad array of negative outcomes for people experiencing psychosis. The current article provides an overview of a novel group-based intervention for reducing internalized stigma (Be Outspoken and Overcome Stigmatizing Thoughts [BOOST]) that combines cognitive behavioural techniques with peer support in first-episode psychosis. Methods: BOOST is an eight-session group intervention that combines cognitive restructuring, assertive communication skills and peer support. Results are presented from a small pilot non-controlled open-label study of 15 participants at an early intervention for psychosis programme. Results: Thirty-three percent of participants discontinued BOOST before completing the intervention. Those who completed BOOST experienced significantly improved internalized stigma (d=.76), self-esteem (d=1.20) and satisfaction with life (d=1.27). Conclusions: Results from this small pilot study suggest that BOOST is not only effective at improving internalized stigma, but also at improving self-esteem and satisfaction with life. Further evaluation of BOOST in a randomized controlled trial is ongoing, and further investigation of the role of combined peer support and cognitive behavioural intervention is warranted as a method of reducing internalized stigma.