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Honest Open Proud for Adolescents With Mental Illness

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ClinicalTrials.gov Identifier: NCT02751229
Recruitment Status : Completed
First Posted : April 26, 2016
Last Update Posted : May 9, 2017
Information provided by (Responsible Party):

Study Description
Brief Summary:
The purpose of the study is to evaluate the efficacy of the group-based intervention 'Honest Open Proud' among adolescents with mental illness.

Condition or disease Intervention/treatment Phase
Secrecy Versus Disclosure Among Adolescents With Mental Illness Behavioral: Honest Open Proud (HOP) Phase 2

Detailed Description:
Both due to fear of public stigma and due to self-stigma or shame, people with mental illness may decide to keep their condition a secret or even to withdraw from other people altogether in order to minimise the risk of being labelled. Secrecy can help on the short term to protect individuals from public stigma, but often it has negative long-term consequences such as social isolation, distress and unemployment. Disclosure, on the other hand, carries the risk to be discriminated by others, but can reduce the burden of secrecy, lead to support by others and reduce public stigma. In this study investigators aim to evaluate whether a group program run both by people with mental illness (peers) and professionals helps to reduce self-stigma and makes it easier for adolescents to handle the necessary choices related to secrecy versus disclosure.

Study Design

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 100 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Participant)
Primary Purpose: Treatment
Official Title: Adaptation and Evaluation of the Honest Open Proud Program for Adolescents With Mental Illness
Study Start Date : May 2016
Primary Completion Date : May 2017
Study Completion Date : May 2017

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Mental Disorders
U.S. FDA Resources

Arms and Interventions

Arm Intervention/treatment
Experimental: Honest Open Proud

The group program is about disclosure ('coming out') versus secrecy of one's mental illness. The groups are facilitated by peers (young adults with mental illness) and mental health professionals. Each group runs for three weeks, one meeting per week, and two hours per meeting.

Fidelity to manual: rated by PhD student in each session as proportion of key topics covered

Behavioral: Honest Open Proud (HOP)

five lessons in three modules, two for each two-hour session

  1. Considering pros and cons of disclosing:

    • hurtful and helpful attitudes about mental illness
    • identify beliefs participants hold about themselves
    • explore five-step process to challenge their personally hurtful beliefs
    • weigh pros and cons of coming out in order to facilitate a decision on whether to disclose
  2. Different ways to disclose:

    • different levels of (non-) disclosure and how to weigh the cons and pros
    • disclosure via social media versus disclosing face to face
    • how to find people that are better to disclose to than others and how to 'test them out'
    • participants will discuss how others might respond to their disclosure and how that will affect them
  3. Telling your story:

    • how to tell one's story in a personally meaningful way, how to identify peers who might help with the coming out process, to review how telling one's story felt
Other Name: Coming Out Proud (COP)
No Intervention: Control Group
treatment as usual (TAU)

Outcome Measures

Primary Outcome Measures :
  1. Stigma Stress Scale, 8 items (Rüsch, Corrigan, Wassel et al., 2009; Rüsch, Corrigan, Powell et al., 2009) [ Time Frame: 3 weeks (T1) ]
  2. Health-Related Quality of Life Questionnaire KIDSCREEN-10 Index, 10 items (Deighton et al., 2014; Ravens-Sieberer et al., 2010) [ Time Frame: 6 weeks (T2) ]

Secondary Outcome Measures :
  1. Satisfaction with intervention questionnaire (according to Keller, Konopka, Fegert, & Naumann, 2003; own development) [ Time Frame: 3 weeks ]
  2. Empowerment Scale, Subscales 'self-esteem' and 'control over the future', 13 items (Rogers, Chamberlin, Ellison, & Crean, 1997) [ Time Frame: baseline, 3 and 6 weeks ]
  3. Attitudes to disclosure, 2 items (Rüsch, Evans-Lacko, Henderson, Flach, & Thornicroft, 2011) [ Time Frame: baseline, 3 and 6 weeks ]
    2 items on attitudes to disclosure, adapted from a UK Dept of Health survey (see above Rüsch et al 2011 reference for further details) with seven-point Likert scale

  4. Disclosure Distress, 1 item ("In general, how distressed or worried are you in terms of secrecy or disclosure of your mental illness to others?', from 1, not at all, to 7, very much) (Rüsch et al., 2014a) [ Time Frame: baseline, 3 and 6 weeks ]
  5. Shame about having a mental illness, 1 item ("Do you feel ashamed about having a mental illness?"; from 1, not at all, to 7, very much) (Rüsch et al., 2014b) [ Time Frame: baseline, 3 and 6 weeks ]
  6. General Help-Seeking Questionnaire, 1 item (Wilson et al., 2005) [ Time Frame: baseline, 3 and 6 weeks ]
  7. Beck Hopelessness Scale (BHS), 4-item short version (Yip, Paul S F & Cheung, 2006) [ Time Frame: baseline, 3 and 6 weeks ]
  8. Self-Stigma of Mental Illness Scale (SSMIS), Subscale 'self-concurrence', 5 items (Corrigan et al., 2012; Rüsch et al., 2006) [ Time Frame: baseline, 3 and 6 weeks ]
  9. Self-Identified Stage of Recovery (SISR), 5 items (Andresen, Caputi, & Oades, 2010) [ Time Frame: baseline, 3 and 6 weeks ]
    brief self-rated assessment of stage of recovery; consists of two parts (A & B): Part A reflects five statements about stages of recovery, participants have to choose one that best reflects their current experience. Part B consists of four statements reflecting recovery processes, rated on a six-point Likert scale

  10. Internalised Stigma of Mental Illness Inventory (ISMI), 10-item short version (Boyd, Otilingam, & Deforge, 2014) [ Time Frame: baseline, 3 and 6 weeks ]
  11. Social withdrawal and secrecy, 12 item-short version (Link et al., 2009) [ Time Frame: baseline, 3 and 6 weeks ]

Other Outcome Measures:
  1. Center for Epidemiologic Studies Depression Scale (CES-D), 15 items (Meyer & Hautzinger, 2001) [ Time Frame: baseline, 3 and 6 weeks ]
  2. Strengths and Difficulties Questionnaire (SDQ), Subscale 'peer relationship problems', 5 items (Goodman, 2001) [ Time Frame: baseline, 3 and 6 weeks ]

Eligibility Criteria

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

Ages Eligible for Study:   13 Years to 18 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • At least one self-reported current axis I or axis II disorder according to DSM-5 (American Psychiatric Association, 2013), which is not restricted to only substance-related disorder(s)
  • Age 13 to 18
  • Ability to provide written informed consent
  • Fluid in German (needed for self-report measures)
  • At least a moderate level of self-reported disclosure-related distress/difficulty (score 4 or higher on the screening item 'In general, how distressed or worried are you in terms of secrecy or disclosure of your mental illness to others?', rated from 1, not at all, to 7, very much)

Exclusion Criteria:

  • Self-reported diagnosis of only a substance- or alcohol-related disorder, without non-substance related current psychiatric comorbidity. We will exclude people who only have a substance-/alcohol-related disorder because the disclosure of these disorders is not the topic of the HOP intervention
  • Intellectual disability
  • Organic disorders
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02751229

United States, Illinois
Illinois Institute of Technology
Chicago, Illinois, United States
Josefinum, Child and Adolescent Psychiatry and Psychotherapy
Augsburg, Germany
Department of Psychiatry II, Section Public Mental Health, Ulm University, Bezirkskrankenhaus Günzburg
Ulm, Germany, 89073
Child and Adolescent Psychiatry and Psychotherapy, University of Ulm
Ulm, Germany
Child and Adolescent Psychiatry Weissenau, Centre for Psychiatry in South-Württemberg
Weissenau, Germany
Sponsors and Collaborators
University of Ulm
Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Germany
Child and Adolescent Psychiatry Weissenau, Centre for Psychiatry in South-Württemberg, Germany
Josefinum, Child and Adolescent Psychiatry and Psychotherapy, Augsburg, Germany
Illinois Institute of Technology, Chicago, USA
Principal Investigator: Nicolas Rüsch, Professor Department of Psychiatry II, Section Public Mental Health, Ulm University, Bezirkskrankenhaus Günzburg, Germany
More Information

Wilson, CJ, Deane, FP, Ciarrochi, J, Rickwood, D. Measuring help-seeking intentions: Properties of General Help-Seeking Questionnaire. Canadian Journal of Counselling, 39(1), 15-28, 2005.
Keller, F, Konopka, L, Fegert, JM, Naumann, A . Prozessaspekte der Zufriedenheit von Jugendlichen in stationär-psychiatrischer Behandlung [Patient satisfaction of adolescents during in-patient psychiatric treatment: a process-oriented approach]. Nervenheilkunde 22: 40-46, 2003.
Meyer, TD, & Hautzinger, M. Allgemeine Depressions-Skala (ADS) [Center for Epidemiological Studies - Depression Scale (CES-D) - Norms for adolescents and extension for the assessment of manic symptoms]. Diagnostica, 47(4): 208-215, 2001.

Responsible Party: Nicolas Rüsch, Professor, University of Ulm
ClinicalTrials.gov Identifier: NCT02751229     History of Changes
Other Study ID Numbers: HOP-Adolescents
First Posted: April 26, 2016    Key Record Dates
Last Update Posted: May 9, 2017
Last Verified: March 2017

Keywords provided by Nicolas Rüsch, University of Ulm:
Mental illness

Additional relevant MeSH terms:
Mental Disorders