Richelene Cesar, Psy.D., is a 2022 graduate of the Psy.D. Program in Clinical Psychology at Antioch University, New England

Dissertation Committee:

  • Monique Bowen, PhD, Committee Chair
  • Kelly Fricker, PsyD, Committee Member
  • Philip T. Yanos, PhD, Committee Member


self-stigma, forensic psychiatric patients, correctional psychiatric patients, self-efficacy, self-esteem, Narrative Enhancement and Cognitive Therapy, NECT, anti-stigma

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Narrative Enhancement and Cognitive Therapy (NECT) is a manualized, group-based intervention that was originally developed to treat self-stigma among individuals who present with severe and persistent mental illnesses (SPMIs; Roe, Lysaker, & Yanos, 2013). NECT has been shown to effectively reduce these individuals’ experience of self-stigma, and diminish its negative effects on their hope, self-esteem, self-efficacy, and quality of life (Yanos, Roe, & Lysaker, 2011). Supportive literature is scarce regarding NECT’s efficacy with people who have multiple stigmatized identities. For the purposes of this pilot study, NECT was implemented with a correctional psychiatric population. Research supports this population is doubly, and sometimes triply, stigmatized, which increases their likelihood of experiencing self-stigma and its negative implications (West, Yanos, & Mulay, 2014). The current study sought to ascertain if mental illness self-stigma and criminality self-stigma scores reduced within this population between the start and end of NECT treatment. This study also explored whether NECT would have a beneficial impact on self-efficacy and self-esteem over the course of the treatment. To address the research questions posed, pre- and post-NECT treatment differences were explored through paired samples t-tests. A repeated measures ANOVA was also completed to evaluate patterns in self-esteem and self-efficacy scores across treatment. Finally, a repeated measures correlation (rmcorr) was conducted to analyze within-individual relationships between self-efficacy, self-esteem, and self-stigma. Results demonstrated improvements in reported mental health self-stigma, self-esteem, and self-efficacy. Criminality self-stigma increased posttreatment. Results regarding common within-individual patterns between variables were mixed.


Richelene Cesar

ORCID Scholar ID# 0000-0001-5650-2446