Developing a cognitive behavioural therapy model to assist women to deal with HIV and stigma

Abstract

A model of cognitive behavioural therapy (CBT) was developed, implemented, and assessed, in order to assist HIV-positive women deal with HIV and internalised stigma. Interviews with HIV-positive women revealed five common themes in the experience of HIV: feelings of powerlessness; anger and guilt; destructive behaviour; experience of stigma; and uncertainty about the future. These themes were used in the development of an intervention. The intervention was implemented and evaluated. Twenty HIV-positive women were randomly assigned to an experimental group who received eight sessions of individual therapy, and a control group who were placed on a waiting list. Pre- and post-assessments of the two groups were compared using five quantitative scales measuring coping skills, internalised stigma, enacted stigma, self-esteem, and depression. Additionally, a qualitative analysis was made of transcripts of the therapy sessions to explore the effect of various therapeutic techniques. Non-parametric Mann-Whitney tests show that after therapy the experimental group experienced lower levels of depression, internalised stigma and negative coping, and higher levels of self-esteem and positive coping, compared to the control group. Techniques that were effectively used were identified. It is recommended that practising psychologists explore and develop this CBT model with their HIV-positive clients.