The Dilemma of Obesity Stigma in Psychotherapy

This paper explores the ways in which the growth of obesity in the United States is likely to impact psychotherapy, particularly in its implications for the management and awareness of obesity stigma in therapists' work with obese clients. Obesity poses a dilemma because no element of an individual's identity should be stigmatized in psychotherapy, and yet obesity impacts the individual's physical health and psychological well-being (Ogden & Clementi, 2010). As stigma specific to obesity is only beginning to be understood, the purpose of this paper is to examine obesity stigma through the lens of Erving Goffman's (1963) theories put forth in his book Stigma: Notes on the Management of Spoiled Identity. A case example is offered as a means of understanding the therapeutic issue of weight loss and psychotherapy with an obese client, particularly from the standpoint of Acceptance and Commitment Therapy.

Reducing Stigma toward Sexual Minorities: Acceptance-Based versus Traditional Safe Zone Training.

Homophobia continues to exist in society. Homonegative attitudes are often implicit and can be acquired without direct training, which makes them particularly resistant to change. Relational Frame Theory (RFT) is a behavior analytic account of learning processes and can explain these processes of indirect learning. RFT also suggests therapeutic processes for dismantling stigma using a therapy model named Acceptance and Commitment Therapy (ACT). This paper reviews previous research on traditional multicultural training, and addresses its shortcomings. Specifically, this paper makes the argument that traditional models encourage experiential avoidance and thus further perpetuate the processes that maintain stigma. While a handful of studies have examined stigma interventions using ACT, no ACT studies have been completed specifically on the stigma towards gay and lesbian individuals. This paper concludes with a research proposal for such a study.

Narrative Therapy and Stigma Management: Restorying the Patient Experience of Being Told, “You have MS

The purpose of this investigation was to determine if the way patients are informed of the diagnosis of multiple sclerosis (MS) affects their feelings about themselves as people with MS. Building on illness narrative, I hoped to examine how patients “storied” their experience of being informed of the diagnosis of MS and whether this “storying” had a lasting impact on their self-concept. The alternative would be that no connection exists between how a neurologist informs a patient of the diagnosis and how a person makes sense of their diagnosis and life with MS. Due to study limitations (e.g., small sample size, threat of response bias), the results are unclear about whether the way in which the news is broken has a lasting effect on patients' perceptions. However, review of the literature and patient responses indicate that there is a need for psychological intervention when patients are diagnosed with MS.