AgingUP: A Pilot Program to Reduce Self-Ageism and Self-Stigma in Older Adults With Severe Mental Illness

Universidad Pontificia Comillas36 enrolled

Overview

The goal of this pilot clinical trial is to learn whether AgingUP, a 10-session psychosocial program, helps reduce self-ageism and self-stigma and fosters more positive and realistic views of aging in older adults (≥50 years) living with severe mental illness. The main questions it aims to answer are: * Does participation in AgingUP reduce self-directed ageism compared to usual care? * Does it reduce internalized stigma related to mental illness? * Does it increase self-compassion? * Does it improve their perception of their own aging? Researchers will compare the AgingUP group with a control group receiving treatment as usual to see if participants in AgingUP show more adaptive perceptions of aging and self-concept. Participants will: * Attend 10 weekly group sessions (60-75 min each) focused on cognitive-behavioral techniques, acceptance and commitment strategies, self-compassion exercises, and empowerment (as a transversal element). * Complete brief questionnaires about their experiences and attitudes before and after the program.

This research aims to generate preliminary evidence on the feasibility and potential effectiveness of AgingUP, a 10-session psychosocial program designed to reduce self-ageism and self-stigma and to foster more positive and realistic views of aging among older adults with severe mental illness (SMI). The program integrates Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), self-compassion training, positive narrative work, and social support. The intervention is structured to progressively build cognitive, emotional, and social skills. The initial sessions provide psychoeducation and cognitive restructuring to help participants identify and challenge negative thoughts related to aging and mental illness. Mid-program sessions introduce values clarification and committed action from ACT, encouraging participants to act in alignment with personally meaningful goals. Later sessions focus on cultivating self-compassion and reconstructing positive life narratives that counter internalized stereotypes. The program concludes with a session on social connection and maintenance strategies. AgingUP is implemented in group format within residential settings and compared to a control group receiving treatment as usual. Participants complete assessments at baseline and immediately after the 10-week intervention. The study will examine changes in self-directed ageism, self-stigma, self-compassion, symptoms, recovery and perception of successful aging. The 3- and 6-month follow-up assessments described in the original protocol were not conducted.

Study Type

Eligibility

Sex: ALLMin age: 50 Years

Medical Language ↔ Plain English

Inclusion Criteria: Age: ≥ 50 years (preventive/therapeutic focus on early and late aging in Severe Mental Illness). Diagnosis: Having a clinical diagnosis of Severe Mental Illness (SMI) such as schizophrenia, bipolar disorder, psychotic spectrum disorders, or severe affective disorders. Active Treatment: Currently receiving psychiatric or psychosocial treatment in a mental health center, rehabilitation unit, or community service. Legal Status: Not having a court-appointed legal representative. Voluntariness: Participation must be completely voluntary, without coercion or obligation. Language and Communication: Able to communicate in the language used for the study/intervention (e.g., Spanish). Availability: Willing to attend the scheduled sessions and activities according to the study/intervention design. Exclusion Criteria: * Severe Cognitive Impairment: Presence of advanced dementia or severe neurodegenerative disease that limits understanding or informed consent. Active Psychiatric Crisis: Experiencing an acute psychotic episode, manic crisis, or severe depression with high suicide risk at the time of assessment. Severe Medical Conditions: Having medical illnesses that prevent participation in study activities. Concurrent Study Participation: Participation in another ongoing study that may interfere with the objectives of this intervention. Legal Incapacity: Having a legal incapacity that prevents free and voluntary participation. Severe Cognitive Difficulties: Difficulties that significantly impair understanding of information or participation in group or digital activities. Language Barrier: Inability to understand the language in which the intervention is conducted, limiting comprehension of study content. Informed Consent: Failure to sign the informed consent form or expressing significant doubts about voluntary participation. Lack of Availability: Unwillingness or inability to attend the sessions according to the structure and duration of the study. Concurrent Participation: Participation in another study that could interfere with the goals of this intervention.

Outcomes

Primary Outcomes

WHO Self-Directed Ageism Scale (15-item)

The scale evaluates self-directed ageism, defined as internalized stereotypes, prejudice, and discrimination related to one's own age. It includes 15 items rated on a 6-point Likert-type scale (from strongly disagree to strongly agree). Higher scores indicate higher levels of self-ageism.

Time frame: Baseline, Week 10 (end of intervention)

Internalized Stigma of Mental Illness Scale (ISMI-29)

The ISMI-29 evaluates self-stigma associated with mental illness. It comprises 29 items rated on a 4-point Likert scale (from strongly disagree to strongly agree). The scale assesses five domains: alienation, stereotype endorsement, discrimination experience, social withdrawal, and resistance to stigma. Higher scores indicate greater internalized stigma.

Time frame: Baseline, Week 10 (end of intervention)

Secondary Outcomes

Self-Compassion Scale (SCS-12)

The scale evaluates self-compassion, defined as a kind, understanding, and mindful attitude toward oneself in times of suffering. It includes 12 items rated on a 5-point Likert-type scale (from almost never to almost always). Higher scores indicate greater self-compassion.

Time frame: Baseline, Week 10 (end of intervention)

Perception of Aging

This measure assesses participants' subjective perception of aging through three items: (1) a 10-point scale of perceived successful aging, (2) a 5-point Likert item ("I am aging well"), and (3) self-reported perceived physical and mental age. Higher ratings indicate more positive perceptions of aging.

Time frame: Baseline and Week 10 (end of intervention)

AgingUP: A Pilot Program to Reduce Self-Ageism and Self-Stigma in Older Adults With Severe Mental Illness

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes