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Completed

NCT Number: NCT02751229

Honest Open Proud for Adolescents With Mental Illness

The purpose of the study is to evaluate the efficacy of the group-based intervention 'Honest Open Proud' among adolescents with mental illness.

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Key information

Conditions

Secrecy Versus Disclosure Among Adolescents With Mental Illness Behavior Mental Disorders Social Behavior Social Stigma

Age range

13 year–18 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

Josefinum, Child and Adolescent Psychiatry and Psychotherapy, Augsburg, Germany

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About this study

Both due to fear of public stigma and due to self-stigma or shame, people with mental illness may decide to keep their condition a secret or even to withdraw from other people altogether in order to minimise the risk of being labelled. Secrecy can help on the short term to protect individuals from public stigma, but often it has negative long-term consequences such as social isolation, distress and unemployment. Disclosure, on the other hand, carries the risk to be discriminated by others, but can reduce the burden of secrecy, lead to support by others and reduce public stigma. In this study investigators aim to evaluate whether a group program run both by people with mental illness (peers) and professionals helps to reduce self-stigma and makes it easier for adolescents to handle the necessary choices related to secrecy versus disclosure.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • At least one self-reported current axis I or axis II disorder according to DSM-5 (American Psychiatric Association, 2013), which is not restricted to only substance-related disorder(s)
  • Age 13 to 18
  • Ability to provide written informed consent
  • Fluid in German (needed for self-report measures)
  • At least a moderate level of self-reported disclosure-related distress/difficulty (score 4 or higher on the screening item 'In general, how distressed or worried are you in terms of secrecy or disclosure of your mental illness to others?', rated from 1, not at all, to 7, very much)

Exclusion criteria

  • Self-reported diagnosis of only a substance- or alcohol-related disorder, without non-substance related current psychiatric comorbidity. We will exclude people who only have a substance-/alcohol-related disorder because the disclosure of these disorders is not the topic of the HOP intervention
  • Intellectual disability
  • Organic disorders

Treatment and study plan

Honest Open Proud (HOP)

Behavioral

five lessons in three modules, two for each two-hour session

  • Considering pros and cons of disclosing:
  • hurtful and helpful attitudes about mental illness
  • identify beliefs participants hold about themselves
  • explore five-step process to challenge their personally hurtful beliefs
  • weigh pros and cons of coming out in order to facilitate a decision on whether to disclose
  • Different ways to disclose:
  • different levels of (non-) disclosure and how to weigh the cons and pros
  • disclosure via social media versus disclosing face to face
  • how to find people that are better to disclose to than others and how to 'test them out'
  • participants will discuss how others might respond to their disclosure and how that will affect them
  • Telling your story:
  • how to tell one's story in a personally meaningful way, how to identify peers who might help with the coming out process, to review how telling one's story felt

Other names: Coming Out Proud (COP)

Primary outcomes

  1. Stigma Stress Scale, 8 items (Rüsch, Corrigan, Wassel et al., 2009; Rüsch, Corrigan, Powell et al., 2009)

    Time frame: 3 weeks (T1)

  2. Health-Related Quality of Life Questionnaire KIDSCREEN-10 Index, 10 items (Deighton et al., 2014; Ravens-Sieberer et al., 2010)

    Time frame: 6 weeks (T2)

Secondary outcomes

  1. Satisfaction with intervention questionnaire (according to Keller, Konopka, Fegert, & Naumann, 2003; own development)

    Time frame: 3 weeks

  2. Empowerment Scale, Subscales 'self-esteem' and 'control over the future', 13 items (Rogers, Chamberlin, Ellison, & Crean, 1997)

    Time frame: baseline, 3 and 6 weeks

  3. Attitudes to disclosure, 2 items (Rüsch, Evans-Lacko, Henderson, Flach, & Thornicroft, 2011)

    Time frame: baseline, 3 and 6 weeks

    2 items on attitudes to disclosure, adapted from a UK Dept of Health survey (see above Rüsch et al 2011 reference for further details) with seven-point Likert scale

  4. Disclosure Distress, 1 item ("In general, how distressed or worried are you in terms of secrecy or disclosure of your mental illness to others?', from 1, not at all, to 7, very much) (Rüsch et al., 2014a)

    Time frame: baseline, 3 and 6 weeks

  5. Shame about having a mental illness, 1 item ("Do you feel ashamed about having a mental illness?"; from 1, not at all, to 7, very much) (Rüsch et al., 2014b)

    Time frame: baseline, 3 and 6 weeks

  6. General Help-Seeking Questionnaire, 1 item (Wilson et al., 2005)

    Time frame: baseline, 3 and 6 weeks

  7. Beck Hopelessness Scale (BHS), 4-item short version (Yip, Paul S F & Cheung, 2006)

    Time frame: baseline, 3 and 6 weeks

  8. Self-Stigma of Mental Illness Scale (SSMIS), Subscale 'self-concurrence', 5 items (Corrigan et al., 2012; Rüsch et al., 2006)

    Time frame: baseline, 3 and 6 weeks

  9. Self-Identified Stage of Recovery (SISR), 5 items (Andresen, Caputi, & Oades, 2010)

    Time frame: baseline, 3 and 6 weeks

    brief self-rated assessment of stage of recovery; consists of two parts (A & B): Part A reflects five statements about stages of recovery, participants have to choose one that best reflects their current experience. Part B consists of four statements reflecting recovery processes, rated on a six-point Likert scale

  10. Internalised Stigma of Mental Illness Inventory (ISMI), 10-item short version (Boyd, Otilingam, & Deforge, 2014)

    Time frame: baseline, 3 and 6 weeks

  11. Social withdrawal and secrecy, 12 item-short version (Link et al., 2009)

    Time frame: baseline, 3 and 6 weeks

Other outcomes

  1. Center for Epidemiologic Studies Depression Scale (CES-D), 15 items (Meyer & Hautzinger, 2001)

    Time frame: baseline, 3 and 6 weeks

  2. Strengths and Difficulties Questionnaire (SDQ), Subscale 'peer relationship problems', 5 items (Goodman, 2001)

    Time frame: baseline, 3 and 6 weeks

Sponsors and collaborators

Lead sponsor

University of Ulm

Other

Collaborators

  • Child and Adolescent Psychiatry Weissenau, Centre for Psychiatry in South-Württemberg, Germany
  • Illinois Institute of Technology, Chicago, USA
  • Josefinum, Child and Adolescent Psychiatry and Psychotherapy, Augsburg, Germany

Registry information

Official study title

Adaptation and Evaluation of the Honest Open Proud Program for Adolescents With Mental Illness

Important dates

Study start
2016
Primary completion
2017
Study completion
2017
First posted
Apr 26, 2016
Registry last updated
May 9, 2017

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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