‘We are the change’ - An innovative community-based response to address self-stigma: A pilot study focusing on people living with HIV in Zimbabwe, PLOS One, February 2019 Abstract: Self-stigma–negative self-judgements resulting in shame, worthlessness and self-blame–may play a crucial role in emotional reactions and cause emotional distress among many people living with HIV and other chronic illnesses. Furthermore, self-stigma negatively impacts on self-agency, quality of life, adherence to treatment, and access to services. High levels of self-stigma have been reported across many countries, however few programmes or interventions exist to specifically tackle this phenomenon. This paper reports the findings of a pilot study carried out in Zimbabwe using a programme incorporating “Inquiry-Based Stress Reduction (IBSR): The Work of Byron Katie”–a guided form of self-inquiry which helps users to overcome negative thoughts and beliefs. |
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We Are The Change program launched in Harare, Zimbabwe was designed based on formative research into core beliefs on self-stigma and HIV
The theoretical framework for this work can be seen from the figures below:

Figure 1
Framework for qualitative analysis of interview data. Three main areas of analysis are shown: Categories of core beliefs (A, red), Functions of self-stigma (B, magenta) and Coping strategies (C, blue). Emergent themes were organised into categories (solid boxes), and subcategories where required (open boxes).

Figure 2
Conceptual framework of self-stigma. Designed using concepts from Morrison (2006) [52], the framework comprises three interacting groups of factors (factors listed are non- exhaustive) which influence self-stigma: social factors, contextual factors and self factors. The complex interaction between these factors influences the development and perpetuation of self-stigma.
References to other research using IBSR: The Work of Byron Katie for health:
1. Nye FA. The Work of Byron Katie: The effect of applying principles of inquiry on the reduction of perceived stress. Dissertation Institute of Transpersonal Psychology. 2011.
2. Leufke R, Zilcha-Mano S, Feld A, Lev-Ari S. Effects of “The Work” Meditation on
Psychopathologic Symptoms: A Pilot Study. Journal of Alternative and Complementary Therapies. 2013; 147-152. (doi: 10.1089/act.2013.19303).
3. Lev-ari S, Zilcha-Mano S, Rivo L, Geva R , Ron I. A prospective pilot clinical trial of "The Work" meditation technique for survivors of breast cancer. European Journal of Integrative Medicine. 2013; 5(6): 487-494. [doi:10.1016/j.eujim.2013.07.003).
4. Landau C, Lev-Ari S, Cohen-Mansfield J, Tillinger E, Geva R, Tarrasch R, Mitnik I, Friedman E. Randomized controlled trial of Inquiry-Based Stress Reduction (IBSR) technique for BRCA1/2 mutation carriers. Psychooncology. 2014 Oct 18. (doi: 10.1002/pon.3703).
5. Smernoff E, Mitnik I, Kolodner K, Lev-Ari S. The Effects of "The Work" Meditation (Byron Katie) on Psychological Symptoms and Quality of Life-A Pilot Clinical Study. Explore (NY). 2014 Oct 22. pii: S1550-8307(14)00206-7. (doi: 10.1016/j).
6. Mitnik I, Lev-Ari S. The Effects of The Work meditation technique on psychological scales among a non-clinical sample, Harefuah. January 2015.
2. Leufke R, Zilcha-Mano S, Feld A, Lev-Ari S. Effects of “The Work” Meditation on
Psychopathologic Symptoms: A Pilot Study. Journal of Alternative and Complementary Therapies. 2013; 147-152. (doi: 10.1089/act.2013.19303).
3. Lev-ari S, Zilcha-Mano S, Rivo L, Geva R , Ron I. A prospective pilot clinical trial of "The Work" meditation technique for survivors of breast cancer. European Journal of Integrative Medicine. 2013; 5(6): 487-494. [doi:10.1016/j.eujim.2013.07.003).
4. Landau C, Lev-Ari S, Cohen-Mansfield J, Tillinger E, Geva R, Tarrasch R, Mitnik I, Friedman E. Randomized controlled trial of Inquiry-Based Stress Reduction (IBSR) technique for BRCA1/2 mutation carriers. Psychooncology. 2014 Oct 18. (doi: 10.1002/pon.3703).
5. Smernoff E, Mitnik I, Kolodner K, Lev-Ari S. The Effects of "The Work" Meditation (Byron Katie) on Psychological Symptoms and Quality of Life-A Pilot Clinical Study. Explore (NY). 2014 Oct 22. pii: S1550-8307(14)00206-7. (doi: 10.1016/j).
6. Mitnik I, Lev-Ari S. The Effects of The Work meditation technique on psychological scales among a non-clinical sample, Harefuah. January 2015.
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All materials containing the four questions and the turnarounds © 2016 Byron Katie International Inc., www.thework.com
All materials containing the four questions and the turnarounds © 2016 Byron Katie International Inc., www.thework.com