How Early Stigmatizing Experiences, Peer Connections, and Peer Spaces Influenced Pathways to Employment or Education After a First-Episode of Psychosis
How Early Stigmatizing Experiences, Peer Connections, and Peer Spaces Influenced Pathways to Employment or Education After a First-Episode of Psychosis
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DOI：
10.1037/prj0000502
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发表时间：
2021-10-07
影响因子：
1.9
通讯作者：
Sale, Tamara G.
中科院分区：
文献类型：
--
作者：
Blajeski, Shannon M.;Klodnick, Vanessa V.;Sale, Tamara G.
影响和意义-这项研究说明了年轻人如何经历自我污名在应对精神病诊断在年轻的成年人，这是如何延迟他们的职业道路。自然的同伴支持对于恢复患有首发精神病的年轻人的自我认同和职业道路至关重要。研究结果的影响，以提高协调专业护理的做法，包括同行为基础的和其他反污名干预措施，为年轻的成年人与首发Psychosis.Objective：本研究探讨了就业的途径，教育，和/或残疾的年轻人与首发精神病（FEP）的意图，以减少贫困和残疾在这一人群中。方法：采用关键案例设计，10名年轻人（年龄21-28岁）完成了两次定性访谈，探讨了影响他们在经历第一次精神病发作后就业和教育或残疾途径的关键时刻。参与者有FEP的生活经验，完成了协调专业护理（CSC）计划，并是早期评估和支持联盟的青年领导理事会（YALC）的成员。定性分析采用四步模板方法和焦点小组完成。结果如下：医院工作人员的早期污名化行为和精神病的诊断标签挑战了参与者的自我认同和自信，导致职业活动暂停。会见同行（即，其他经历过第一次精神病发作的人）通过他们的CSC计划使他们的精神病诊断正常化，并减轻了自我耻辱感;这是重返并开始新的就业和教育目标不可或缺的。青年法律中心的参与提供了练习工作技能的机会，如公开演讲，以及进一步消除自我羞辱和改善就业联系的其他同伴支持。结论和实践的影响：CSC模型的影响包括广泛考虑的方式，早期的精神病标签可以构建自我耻辱，以及这种现象如何阻碍追求就业和教育目标所需的自信心。具体建议包括利用同伴联系、同伴空间和同伴提供的反污名干预措施，以改善就业和教育途径。
Impact and Implications This study illustrates how young adults experienced self-stigma in response to a psychosis diagnosis in young adulthood and how this delayed their career pathways. Natural peer support was critical in restoring self-identity and career pathways among young people with first-episode psychosis. Study findings have implications for improving Coordinated Specialty Care practice to include peer-based and other anti-stigma interventions for young adults with first-episode psychosis.Objective: This study explored the pathways to employment, education, and/or disability among young adults with First-Episode Psychosis (FEP) with the intent to reduce poverty and disability among this population. Method: Using a critical case design, 10 young adults (ages 21-28) completed two qualitative interviews exploring the key moments that influenced their pathway toward employment and education or disability after experiencing a first-episode of psychosis. Participants had lived experience of an FEP, had completed a Coordinated Specialty Care (CSC) program, and were members of the Early Assessment and Support Alliance's Young Adult Leadership Council (YALC). Qualitative analysis was completed using a four-step template approach and focus group. Results: Early stigmatizing behavior by hospital staff and the diagnostic label of psychosis challenged participants' self-identity and self-confidence which led to a pause in vocational activities. Meeting peers (i.e., other individuals who had experienced a first-episode of psychosis) through their CSC program normalized their psychosis diagnosis and alleviated feelings of self-stigma; this was integral in returning to and initiating new employment and education goals. YALC involvement provided opportunities for practicing work skills, such as public speaking, and additional peer support that further eradicated self-stigma and improved connection to employment. Conclusions and Implications for Practice: Implications for CSC models include broad consideration of the ways that early psychiatric labeling can construct self-stigma, and how this phenomenon stunts the self-confidence needed to pursue employment and education goals. Specific recommendations include utilizing peer connections, peer spaces, and peer-delivered anti-stigma interventions to enhance employment and education pathways.