Managing Stigma Effectively: What Social Psychology and Social Neuroscience Can Teach Us

Psychiatric education is confronted with three bar- riers to managing stigma associated with mental health treat- ment. First, there are limited evidence-basedpractices for stig- ma reduction, and interventions to deal with stigma against mental health care providers are especially lacking. Second, there is a scarcity of training models for mental health profes- sionals on how to reduce stigma in clinical services. Third, there is a lack of conceptual models for neuroscience ap- proaches to stigma reduction, which are a requirement for high-tier competency in the ACGME Milestones for Psychi- atry. The George Washington University (GWU) psychiatry residency program has developed an eight-week course on managingstigmathatisbasedonsocialpsychologyandsocial neuroscience research. The course draws upon social neuro- science research demonstrating that stigma is a normal func- tion of normal brains resulting from evolutionary processes in human group behavior. Based on these processes, stigma can be categorized according to different threats that include peril stigma, disruption stigma, empathy fatigue, moral stigma, and courtesy stigma. Grounded in social neuroscience mecha- nisms, residents are taught to develop interventions to manage stigma. Case examples illustrate application to common clin- ical challenges: (1) helping patients anticipate and manage stigma encountered in the family, community, or workplace; (2) ameliorating internalized stigma among patients; (3) conducting effective treatment from a stigmatized position due to prejudice from medical colleagues or patients' family members; and (4) facilitating patient treatment plans when stigma precludes engagement with mental health profes- sionals. This curriculum addresses the need for educating trainees to manage stigma in clinical settings. Future studies are neededtoevaluatechanges inclinicalpractices and patient outcomes as a result of social neuroscience-based training on managing stigma.