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Secrecy Versus Disclosure Among Adolescents With Mental IllnessPhase 2NCT02751229

Honest Open Proud for Adolescents With Mental Illness

A Phase 2 study testing Honest Open Proud (HOP) in people with Secrecy Versus Disclosure Among Adolescents With Mental Illness, run by University of Ulm at 5 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of the study is to evaluate the efficacy of the group-based intervention 'Honest Open Proud' among adolescents with mental illness. Read more about this study

Who is it for?
Ages 13 to 18 years
What is being tested?
Honest Open Proud (HOP)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
100 participants
Where
5 sitesin 2 countries
Study dates
May 2016to May 2017
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 13 to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • 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)

Who cannot join

  • 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

Trial locations and contacts

5 sites in 2 countries.

5 sites in 2 countries

Germany4 sites
  • Josefinum, Child and Adolescent Psychiatry and Psychotherapy

    Augsburg

  • Department of Psychiatry II, Section Public Mental Health, Ulm University, Bezirkskrankenhaus Günzburg

    Ulm, 89073

  • Child and Adolescent Psychiatry and Psychotherapy, University of Ulm

    Ulm

  • Child and Adolescent Psychiatry Weissenau, Centre for Psychiatry in South-Württemberg

    Weißenau

Other trials in Germany

United States1 site
  • Illinois Institute of Technology

    Chicago, Illinois

Other trials in United States

About this study

Official title: Adaptation and Evaluation of the Honest Open Proud Program for Adolescents With Mental Illness

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

Read the 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.

Being tested
Honest Open Proud (HOP)
Keywords
Mental illness, adolescents, intervention, stigma, disclosure, secrecy
Medical subject headings
Mental Disorders, Social Stigma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Honest Open Proud (HOP)Behavioural

    Also called Coming Out Proud (COP)

    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
    1. 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
    1. 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
Study groups in NCT02751229
Study groupRoleWhat they receive
Honest Open ProudExperimentalThe 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
Receives: Behavioral: Honest Open Proud (HOP)
Control GroupNo interventiontreatment as usual (TAU)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Stigma Stress Scale, 8 items (Rüsch, Corrigan, Wassel et al., 2009; Rüsch, Corrigan, Powell et al., 2009)

    Measured: 3 weeks (T1)

  2. Health-Related Quality of Life Questionnaire KIDSCREEN-10 Index, 10 items (Deighton et al., 2014; Ravens-Sieberer et al., 2010)

    Measured: 6 weeks (T2)

Secondary outcomes (11)
  1. Satisfaction with intervention questionnaire (according to Keller, Konopka, Fegert, & Naumann, 2003; own development)

    Measured: 3 weeks

  2. Empowerment Scale, Subscales 'self-esteem' and 'control over the future', 13 items (Rogers, Chamberlin, Ellison, & Crean, 1997)

    Measured: baseline, 3 and 6 weeks

  3. Attitudes to disclosure, 2 items (Rüsch, Evans-Lacko, Henderson, Flach, & Thornicroft, 2011)

    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

    Measured: baseline, 3 and 6 weeks

  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)

    Measured: 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)

    Measured: baseline, 3 and 6 weeks

  6. General Help-Seeking Questionnaire, 1 item (Wilson et al., 2005)

    Measured: baseline, 3 and 6 weeks

  7. Beck Hopelessness Scale (BHS), 4-item short version (Yip, Paul S F & Cheung, 2006)

    Measured: 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)

    Measured: baseline, 3 and 6 weeks

  9. Self-Identified Stage of Recovery (SISR), 5 items (Andresen, Caputi, & Oades, 2010)

    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

    Measured: baseline, 3 and 6 weeks

  10. Internalised Stigma of Mental Illness Inventory (ISMI), 10-item short version (Boyd, Otilingam, & Deforge, 2014)

    Measured: baseline, 3 and 6 weeks

  11. Social withdrawal and secrecy, 12 item-short version (Link et al., 2009)

    Measured: baseline, 3 and 6 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Apr 2016 (estimated)
  2. Study startMay 2016
  3. Primary completionMay 2017
  4. Study completionMay 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02751229
Sponsor's protocol ID
HOP-Adolescents
Status last verified
Mar 2017
First submitted
24 Mar 2016
Last updated
9 May 2017
Results posted
No

Publications

  • Andresen R, Caputi P, Oades LG. Do clinical outcome measures assess consumer-defined recovery? Psychiatry Res. 2010 May 30;177(3):309-17. doi: 10.1016/j.psychres.2010.02.013. Epub 2010 Mar 15.

    PubMed 20227768
  • Boyd JE, Otilingam PG, Deforge BR. Brief version of the Internalized Stigma of Mental Illness (ISMI) scale: psychometric properties and relationship to depression, self esteem, recovery orientation, empowerment, and perceived devaluation and discrimination. Psychiatr Rehabil J. 2014 Mar;37(1):17-23. doi: 10.1037/prj0000035.

    PubMed 24660946
  • Corrigan PW, Michaels PJ, Vega E, Gause M, Watson AC, Rusch N. Self-stigma of mental illness scale--short form: reliability and validity. Psychiatry Res. 2012 Aug 30;199(1):65-9. doi: 10.1016/j.psychres.2012.04.009. Epub 2012 May 10.

    PubMed 22578819
  • Deighton J, Croudace T, Fonagy P, Brown J, Patalay P, Wolpert M. Measuring mental health and wellbeing outcomes for children and adolescents to inform practice and policy: a review of child self-report measures. Child Adolesc Psychiatry Ment Health. 2014 Apr 29;8:14. doi: 10.1186/1753-2000-8-14. eCollection 2014.

    PubMed 24834111
  • Ravens-Sieberer U, Erhart M, Rajmil L, Herdman M, Auquier P, Bruil J, Power M, Duer W, Abel T, Czemy L, Mazur J, Czimbalmos A, Tountas Y, Hagquist C, Kilroe J; European KIDSCREEN Group. Reliability, construct and criterion validity of the KIDSCREEN-10 score: a short measure for children and adolescents' well-being and health-related quality of life. Qual Life Res. 2010 Dec;19(10):1487-500. doi: 10.1007/s11136-010-9706-5. Epub 2010 Jul 30.

    PubMed 20668950
  • Rogers ES, Chamberlin J, Ellison ML, Crean T. A consumer-constructed scale to measure empowerment among users of mental health services. Psychiatr Serv. 1997 Aug;48(8):1042-7. doi: 10.1176/ps.48.8.1042.

    PubMed 9255837
  • Rusch N, Corrigan PW, Heekeren K, Theodoridou A, Dvorsky D, Metzler S, Muller M, Walitza S, Rossler W. Well-being among persons at risk of psychosis: the role of self-labeling, shame, and stigma stress. Psychiatr Serv. 2014 Apr 1;65(4):483-9. doi: 10.1176/appi.ps.201300169.

    PubMed 24382666
  • Rusch N, Corrigan PW, Powell K, Rajah A, Olschewski M, Wilkniss S, Batia K. A stress-coping model of mental illness stigma: II. Emotional stress responses, coping behavior and outcome. Schizophr Res. 2009 May;110(1-3):65-71. doi: 10.1016/j.schres.2009.01.005. Epub 2009 Feb 23.

    PubMed 19237266
  • Rusch N, Corrigan PW, Wassel A, Michaels P, Olschewski M, Wilkniss S, Batia K. A stress-coping model of mental illness stigma: I. Predictors of cognitive stress appraisal. Schizophr Res. 2009 May;110(1-3):59-64. doi: 10.1016/j.schres.2009.01.006. Epub 2009 Mar 6.

    PubMed 19269140
  • Rusch N, Evans-Lacko SE, Henderson C, Flach C, Thornicroft G. Knowledge and attitudes as predictors of intentions to seek help for and disclose a mental illness. Psychiatr Serv. 2011 Jun;62(6):675-8. doi: 10.1176/ps.62.6.pss6206_0675.

    PubMed 21632739
  • Rusch N, Holzer A, Hermann C, Schramm E, Jacob GA, Bohus M, Lieb K, Corrigan PW. Self-stigma in women with borderline personality disorder and women with social phobia. J Nerv Ment Dis. 2006 Oct;194(10):766-73. doi: 10.1097/01.nmd.0000239898.48701.dc.

    PubMed 17041289
  • 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.

  • Yip PS, Cheung YB. Quick assessment of hopelessness: a cross-sectional study. Health Qual Life Outcomes. 2006 Mar 1;4:13. doi: 10.1186/1477-7525-4-13.

    PubMed 16509984
  • 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.

  • Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry. 2001 Nov;40(11):1337-45. doi: 10.1097/00004583-200111000-00015.

    PubMed 11699809

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Honest Open Proud (HOP) in people with Secrecy Versus Disclosure Among Adolescents With Mental Illness, run by University of Ulm at 5 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 9 May 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in Germany, United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Stigma Stress Scale, 8 items (Rüsch, Corrigan, Wassel et al., 2009; Rüsch, Corrigan, Powell et al., 2009) (time frame: 3 weeks (T1)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02751229, which also lists 18 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 May 2017.

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