Cognitive behavioral group treatment for low self-esteem in psychosis: a proof of concept study

Elisabeth C D Van Der Stouwe,Chris N W Geraets,Mirjam Rutgers,Wim Veling

doi:10.1186/s12888-021-03579-3

Elisabeth C D Van Der Stouwe, Chris N W Geraets + Show 2 more

Open Access

https://doi.org/10.1186/s12888-021-03579-3

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Abstract

BackgroundPatients with a psychotic disorder often suffer from low self-esteem, which has been related to higher suicidal risk, poor quality of life and, the maintenance of psychotic and depression symptoms. However, intervention studies are scarce and reported interventions concern individual therapies provided by highly educated psychologists. Both the individual setting and the required qualifications of the therapist may contribute to a low level of availability of an intervention. Therefore we aimed to investigate the efficacy of an easily accessible psychological group treatment targeting self-esteem in patients with a psychotic disorder.MethodsThirty patients with a psychotic disorder were included in this pilot study. All participants received nine weekly group sessions of 90 min. The therapy was offered in groups of six to eight patients and was provided by a psychiatry nurse and a graduate psychologist. To assess self-esteem the Rosenberg Self-esteem Scale and the Self-Esteem Rating Scale were used, to measure depression symptoms the Beck Depression Inventory-II was administered. Questionnaires were completed at baseline and post-treatment.ResultsTwenty-seven patients (90%) completed treatment. At post-treatment, self-esteem was significantly increased and depression symptoms were significantly decreased compared to baseline.DiscussionThis pilot study demonstrates the feasibility and treatment potential of a self-esteem group treatment provided by a psychiatry nurse and graduate psychologist in a patient population that receives little psychological treatment. Results suggest that this easily accessible intervention may be effective in improving self-esteem and reducing depression symptoms.

Highlights

Low self-esteem is highly prevalent among patients with a psychotic spectrum disorder, and may be a consequence of symptoms, loss of social roles, experiences of failure, and stigma [1,2,3]
Thirteen of the participants were diagnosed with schizophrenia and seventeen of the participants were diagnosed with another type of psychotic spectrum disorder
Selfesteem assessed with the Rosenberg Self-Esteem Scale (RSES) improved with 7.1 points in patients after the therapy

Summary

Introduction

Low self-esteem is highly prevalent among patients with a psychotic spectrum disorder, and may be a consequence of symptoms, loss of social roles, experiences of failure, and (self) stigma [1,2,3]. Only five studies investigated the effect of psychological interventions on self-esteem in patients with a psychotic disorder. While three of these (pilot) studies reported positive effects on self-esteem [6, 10, 11], others found no such effect [12, 13]. Patients with a psychotic disorder often suffer from low self-esteem, which has been related to higher suicidal risk, poor quality of life and, the maintenance of psychotic and depression symptoms. Intervention studies are scarce and reported interventions concern individual therapies provided by highly educated psychologists Both the individual setting and the required qualifications of the therapist may contribute to a low level of availability of an intervention. We aimed to investigate the efficacy of an accessible psychological group treatment targeting self-esteem in patients with a psychotic disorder

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