Reconstructing Self-Concept in the Context of Stigmatized Illness: A Comparative Review of Psychotherapeutic Approaches

Illnesses that are accompanied by stigma, such as HIV/AIDS, can have a significant impact on an individual’s identity. Stigmatized illness can lead to changes in self-concept, self-esteem, self-efficacy, and self-worth. People with stigmatized conditions often struggle with internalized stigma, psychological distress, social isolation, and negative self-evaluations, which can impede psychological adjustment and adaptive functioning. Counseling can help individuals maintain emotional equilibrium, foster self-understanding, and enhance adaptive coping by bolstering the core self-processes needed to more effectively meet the demands of their illness.

This literature review examined the psychotherapeutic approaches that can be drawn upon in reconstructing self-concept for those with stigmatized illnesses, based on the theory and concepts included in the uploaded document. Person-Centred Therapy provides a basis for self-acceptance and congruence through the facilitative conditions of empathy, genuineness, and positive regard. Rational-Emotive Behaviour Therapy can also be drawn on for the restructuring of irrational beliefs, reduction of negative self-talk, and the fostering of unconditional self-acceptance and unconditional acceptance of others. The broader psychotherapeutic models of narrative, constructivist, acceptance-based, and group-based approaches are framed through the descriptions of counseling in the uploaded document, as an approach that can foster insight development, emotional expression, cognitive reframing, social learning, and collaborative problem-solving.

This review made some comparisons between these therapeutic models and offered some synthesis of convergent mechanisms of change, including the enhancement of self-awareness, reduction of internalized stigma, reconstruction of personal meaning, and the development of psychosocial resources to promote adjustment. A multilevel integrative model for use by clinicians in supporting the reconstruction of self-concept at the intrapersonal, interpersonal, and contextual levels is also proposed. This review also discusses some of the implications for practice and ideas for future research.