Different roads lead to Rome: Exploring patterns of change among narrative enhancement and cognitive therapy (NECT) participants

Background: Narrative enhancement and cognitive therapy (NECT) is aimed at decreasing self-stigma and promoting recovery. The current study used a mixed-methods approach to explore the process and mechanisms by which NECT affects self-stigma and recovery. Method: Sixty-two participants with serious mental illness (SMI) and enrolled in NECT completed questionnaires assessing self-clarity, recovery, self-stigma, and hope before and after the intervention, and the two latter questionnaires also after completing two defined parts of the intervention. In addition, one group’s transcriptions were qualitatively analyzed and compared with changes in quantitative measures. Results: Quantitative analysis revealed a significant increase in self-clarity and a decrease in self-stigma, which occurred early in the intervention. Qualitative analysis identified factors contributing to such changes. Limitations include lack of a comparison group, bias selection in the qualitative analysis and case record diagnoses. Conclusions: NECT was found to be effective in reducing self-stigma and improving self clarity and the mechanisms and process were identified.