Psychotherapy for Self-Stigma among Rural Clients

Illinois Institute of Technology, 3424 S. State, First Floor, Room 1B9-2, Chicago, IL 60616, USA.
Journal of Clinical Psychology (Impact Factor: 2.12). 01/2010; 66(5):524-36. DOI: 10.1002/jclp.20679
Source: PubMed

ABSTRACT The stigma of mental disorders and psychological treatment afflicts rural clients more than most. This article provides practitioners with guidance in selecting and utilizing effective treatments for self-stigma in rural settings. We review both public stigma and self-stigma. Public stigma explains society's negative impact on individuals, while self-stigma describes an individual's internalization of public stigma. We review treatment principles and empirical research on psychotherapy for self-stigma rural settings. We finish with a case illustration of cognitive therapy with a rural client suffering from self-stigma.

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    • "The rural practitioner knows that if she does not add the person to her current caseload (e.g., because she is going to be using time that would usually be assigned to clients to spend on advocacy efforts), the client will not receive services for what may be a substantial period of time, if the client is even willing to return at a later date. Given the well-documented stigma associated with receiving mental health care in rural areas (Larson & Corrigan, 2010; Pullman et al., 2010; Schank & Skovholt, 2006; Stamm et al., 2003), not accepting a client immediately may mean that the psychologist has lost the window of opportunity with this person. Thus, because rural practitioners are expected to be ready and able to see any client presenting with any issue at any point in time, the therapist may find it difficult to justify to clients or herself that time is better spent in advocacy efforts than in sessions with clients. "
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