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The Stigma of Having Psychological Problems: Relations With Engagement, Working Alliance, and Depression in Psychotherapy

机译：有心理问题的污名：与参与，工作同盟和心理治疗中的抑郁的关系

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The stigma of having psychological problems is a barrier to seeking mental health treatment, but little research has examined whether this stigma influences the experiences of those in treatment. In a sample of 42 psychotherapy clients, we explored links over the first few sessions between 2 facets of stigma (self-stigma and perceived public stigma) and 3 variables germane to the therapeutic process (depression, working alliance, and engagement). Initial self-stigma (SS) level was positively associated with initial depression, negatively associated with initial working alliance, and unrelated to initial engagement. Initial perceived public stigma (PPS) level was unrelated to initial levels in the 3 outcome variables. Initial SS and PPS levels were both generally unrelated to linear changes in the outcomes over the initial phase of counseling. Relations between stigma and outcome variables often differed within- and between-persons. For example, the association between PPS and engagement was negative at the between-person level but positive at the within-person level. Finally, on average, PPS decreased over the first few sessions but SS remained constant. Such findings may help therapists better understand the role of stigma in their clinical work, and stimulate research examining how to address stigmatization in psychotherapy.
机译：有心理问题的污名是寻求心理健康治疗的障碍，但是很少有研究检查这种污名是否会影响接受治疗的人的经历。在42位心理治疗服务对象的样本中，我们探索了前几个疗程中两个阶段的污名（自我污名和感知到的公众污名）与与治疗过程密切相关的三个变量（抑郁，工作联盟和参与）之间的联系。初始自我耻辱（SS）水平与初始抑郁症呈正相关，与初始工作联盟呈负相关，与初始参与度无关。最初的公众耻辱感（PPS）水平与3个结果变量的初始水平无关。在咨询的初始阶段，初始SS和PPS水平通常都与结果的线性变化无关。耻辱感和结果变量之间的关系通常在人与人之间和人与人之间有所不同。例如，PPS和敬业度之间的关联在人际层面上为负，而在人际层面上为正。最后，平均而言，PPS在前几个会话中有所下降，但SS保持不变。这些发现可能有助于治疗师更好地了解耻辱感在临床工作中的作用，并刺激研究如何在心理治疗中解决污名化的研究。

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