Lauren Mizock

The double stigma of obesity and serious mental illnesses: promoting health and recovery.

UNLABELLED This article contrasts the traditional medical approach and size acceptance perspectives on obesity among people with serious mental illnesses. PURPOSE Higher incidences of obesity among populations with serious mental illnesses have been identified. In response, a recent initiative in mental health has urged providers to address the obesity rates among populations with mental illnesses by monitoring weight, prescribing weight loss medication, and recommending bariatric surgery. However, literature is emerging with regards to the double stigma experienced by individuals with obesity and a mental illness. Therefore, the traditional focus on weight loss can benefit from a size acceptance approach to focus on health promotion and avoid stigmatizing size. SOURCES USED Citations of theoretical and behavioral health literature on the experiences of individuals with mental illnesses and obesity are presented. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Recommendations for interventions, training, and future research related to obesity and mental illnesses are provided. Implications are suggested for a size acceptance approach to interventions for individuals in recovery from mental illnesses to promote health at every size within mental health and medical settings.

Recovery narrative photovoice: Feasibility of a writing and photography intervention for serious mental illnesses.

OBJECTIVE The primary purpose of this article is to describe the development and feasibility of the Recovery Narrative Photovoice intervention. The nature of this intervention will be discussed, including facilitating empowerment and a positive sense of identity among people with serious mental illnesses. We will also describe the integration of Photovoice methodology with psychoeducational components, informed by principles of the recovery movement and narrative therapy. METHODS Sixteen participants with serious mental illnesses from a psychosocial rehabilitation and education center in the Northeast participated in a pilot study evaluating this new 10-week intervention with a pre-post test design. To assess feasibility, descriptive statistical analyses were conducted of attendance data and number of works produced. The pilot study was implemented in 2 consecutive waves with 8 participants each. RESULTS High rates of attendance (69%) and production of photovoice works (82%) were demonstrated over the course of the 2 waves of the pilot. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Findings support the feasibility and acceptability of the Recovery Narrative Photovoice for individuals with serious mental illnesses. These results reflect the potential for using this intervention in psychiatric rehabilitation settings to facilitate recovery-related outcomes, including empowerment, positive identity, and community integration. Future research will require a replication of pre-post assessment of this intervention to further establish the efficacy of this program.

Acceptance of mental illness: core components of a multifaceted construct.

The recovery movement has identified acceptance of mental illness as critical to quality of life and illness management. However, there is a general lack of research on the acceptance of mental illness. The present qualitative study was conducted with 30 participants with mental illness to clarify the construct of acceptance. Grounded theory methodology is utilized to analyze the 30 semistructured interviews. Results in the present study reveal acceptance to be a multifaceted construct composed of several core characteristics, including the: (1) identity component, (2) cognitive component, (3) emotional component, (4) behavioral component, and (5) relational component. In addition, when asked to define acceptance of mental illness, some participants noted negative connotations to acceptance. Implications for psychological services and future research will be discussed to guide additional study and practice in this area.

Intersectional Stigma and the Acceptance Process of Women with Mental Illness

Acceptance of mental illness is facilitated by the presence of various resources that are needed to deal with associated stigma, prejudice, and discrimination. However, women with mental illness experience added levels of stigma and intersectional oppression that affect the acceptance process, including higher rates of victimization, unemployment, poverty, homelessness, and clinical disparities. Practitioners and researchers can benefit from sensitivity to intersectional stigma, or overlapping, multiple levels of stigma and discrimination, faced by women with mental illness. Participant case narratives from a qualitative study will be presented in order to demonstrate the impact of intersectional stigma on the process of acceptance for women with mental illness.

Barriers to and Facilitators of the Acceptance Process for Individuals With Serious Mental Illness

The process of acceptance of mental illness is a central component of recovery and has been linked to functioning, illness management, and quality of life. A number of barriers and facilitators have been theorized as impacting this process. This study was conducted with 30 participants with serious mental illness (a major psychiatric disorder with impairment in multiple areas of functioning) to elicit the barriers to and facilitators of the acceptance of mental illness. Grounded theory methodology was utilized to analyze the 30 semistructured interviews. Results revealed barriers to and facilitators of acceptance of mental illness at the micro level (cognitive, emotional, behavioral, identity-related), meso level (relational), and macro level (cultural, systemic). Clinical and research implications are discussed with regard to facilitating acceptance of mental illness.

Lesbian, Gay, and Transgender Individuals with Mental Illness: Narratives of the Acceptance Process

Lesbian, gay, bisexual, and transgender (LGBT) individuals with mental illness encounter double stigma of mental illness and LGBT identity that can uniquely impact the process of acceptance of mental illness. Acceptance of mental illness is essential to promoting recovery and may be one of the most crucial and difficult steps in this process. Qualitative case narrative methodology was used to identify themes related to the facilitators and barriers in the acceptance process for lesbian, gay, and transgender (LGT) individuals in the present study. Three participant narratives are presented to assist practitioners in applying these findings to clinical practice. Selected case narratives represent participants with LGT identities to illustrate facilitators and barriers in the acceptance process among individuals within this group. Identified themes included identity factors at the micro level, relational factors at the meso level, and systemic factors at the macro level. Notably, identity-related facilitators of acceptance of mental illness included developing preferred terminology and self-defined language. Implications are suggested for psychotherapy and research pertaining to the process of acceptance of mental illness for LGBT individuals with mental illness.

Transphobia in the Workplace: A Qualitative Study of Employment Stigma.

Transgender individuals report frequent encounters with transphobia in the workplace, although relatively few studies have investigated this phenomenon. The present grounded theory analysis was conducted with 45 transgender and gender diverse participants to delineate their different experiences with bias and discrimination in the workplace. Qualitative data analysis revealed the following themes pertaining to work transphobia: lack of social support, workplace gender policing, personal safety threats, acquisition and advancement barriers, intersectional discrimination, intuited stigma, and lack of inclusive policy. Results suggest the diverse challenges faced by transgender individuals in the workplace and the need for further interventions, supports, and policy to counteract work-related transphobia.

Transgender and Gender Diverse Clients with Mental Disorders: Treatment Issues and Challenges

A number of transgender and gender diverse individuals face risks of mental health problems and suicidality, often as a result of transphobia and gender minority stress. There are many resilience and protective factors that transgender individuals use to cope with mental distress and thrive. In this article, a review of the literature on transgender and gender diverse individuals with mental health problems is provided, as well as a discussion of the protective factors that enhance resilience.

Economic Challenges Associated With Transphobia and Implications for Practice With Transgender and Gender Diverse Individuals.

Transgender and gender diverse (TGD) individuals face economic challenges as a result of the impact of transphobia. The present article includes case narratives from a qualitative study with TGD individuals. An overview of the literature on economic challenges faced by TGD individuals is presented as well as associated clinical implications.

The transgender awareness webinar: Reducing transphobia among undergraduates and mental health providers

ABSTRACT The present two-part study involved the development, dissemination, and pre- and post-assessment of the effectiveness of the Transgender Awareness Webinar to reduce transphobia—stigma towards transgender individuals. The goal of the webinar was to educate undergraduates and mental health providers about transgender individuals and reduce transphobic attitudes. In Study 1, 303 undergraduates at a state university in the Northeastern U.S. completed electronic pretest and posttest measures of the Transphobia Scale before and after participating in the webinar. In Study 2, the Transgender Awareness Webinar was expanded to include mental health content and disseminated to 158 mental health providers. Results from Study 1 and Study 2 revealed that the transphobic attitudes significantly reduced from pretest to posttest test scores on the Transphobia Scale after completing the webinar. Findings suggest that transgender awareness training can be effective for reducing transphobia among various groups, with potential differences in baseline transphobic attitudes depending on demographic variables, prior contact with and prior education about transgender individuals.