Dispelling the stigma of schizophrenia: II. The impact of information on dangerousness.

This study addressed a relatively neglected topic in schizophrenia: identifying methods to reduce stigma directed toward individuals with this disorder. The study investigated whether presentation of information describing the association between violent behavior and schizophrenia could affect subjects' impressions of the dangerousness of both a target person with schizophrenia and individuals with mental illness in general. Subjects with and without previous contact with individuals with a mental illness were administered one of four "information sheets" with varying information about schizophrenia and its association with violent behavior. Subjects then read a brief vignette of a male or female target individual with schizophrenia. Results showed that subjects who reported previous contact with individuals with a mental illness rated the male target individual and individuals with mental illness in general as less dangerous than did subjects without previous contact. Subjects who received information summarizing the prevalence rates of violent behavior among individuals with schizophrenia and other psychiatric disorders (e.g., substance abuse) rated individuals with a mental illness as less dangerous than did subjects who did not receive this information. Implications of the findings for public education are discussed.

Staff attitudes that impede the implementation of behavioral treatment programs.

Staff who have negative attitudes about behavioral treatments are less likely to implement them. Previous research suggests that negative attitudes are associated with staff burnout and perceived collegial support. A path analysis is conducted in this study to determine the direction of these effects. Ninety staff members who work in treatment programs for severely mentally ill adults completed measures of attitudes about behavior therapy, experience with behavior therapy, burnout, and collegial support. Results of the path analysis yielded a model with good fit that confirmed our hypotheses; namely, burnout leads to negative attitudes and experience with behavior therapy yields positive attitudes. Insufficient collegial support leads to negative attitudes through burnout. Implications of these findings for improving the use of behavior treatments in real-world programs are discussed.

Staff training to improve implementation and impact of behavioral rehabilitation programs.

Staff who provide services for persons with severe mental illness often have pessimistic attitudes about adopting behavioral innovations for their programs. Thirty-five staff members in psychiatric residential programs participated in eight months of interactive staff training, an organizational development strategy that helps the rehabilitation team develop behavioral approaches to changing clients' behavior. After the training, staff members reported significant improvement in their attitudes about behavioral interventions and increased perceptions of collegial support. Direct care staff reported significantly less emotional exhaustion. Interactive staff training may facilitate implementation of behavioral strategies by improving attitudes toward these interventions.