Double Stigma Implementing Narrative Enhancement and Cognitive Therapy (NECT) with LGBTQ Individuals with Serious Mental Illness (SMI)

Narrative enhancement and cognitive therapy (NECT) is a group-based intervention aimed at decreasing self-stigma and promoting recovery among people with severe mental illness (SMI). This study describes a pioneer effort to implement NECT with LGBTQ individuals who are also labeled with SMI and thus subject to “double stigma.” Qualitative analysis of 40 detailed written summaries of all sessions of two NECT groups of LGBTQ individuals with SMI explored how they perceive the double self-stigma they experience. The study revealed four main themes: (1) being subject to stigma and double stigma, (2) the perceived connection between sexual identity and mental illness, (3) unique challenges related to disclosure, and (4) from within the group to outside it. Results of this effort to implement NECT with LGBTQ individuals also labeled with an SMI may help raise awareness of some of the specific and unique implications of the double stigma LGBTQ individuals with SMI experience and encourage future development of knowledge and more tailored interventions aimed at reducing the negative effects of double stigma.