The Impact of Strengths-Based Assessment Education on Undergraduate Students’ Knowledge of Disorders and Mental Illness Stigma

Abstract

Background:

While abnormal psychology courses have traditionally focused on psychopathology, there are several benefits to adopting a strengths-based approach.

Objective:

This study examined the teaching of a strengths-based assessment approach (the DICE-PM Model), compared to teaching as usual, in an undergraduate abnormal psychology course.

Method:

Two sections of an abnormal psychology course were taught a strengths-based assessment approach while two sections were taught as usual. All participants completed measures of knowledge of psychological disorders and mental illness stigma at the beginning and end of the semester.

Results:

Both groups demonstrated significant improvements in knowledge of disorders and a significant decrease in mental illness stigma with the exception of one category assessed (recovery), generally with small effect sizes. Those in the strengths group, compared to the control, showed a significantly greater decrease in mental illness stigma involving anxiety related to others with mental illness, though also with a small effect.

Conclusion:

Findings suggest strengths-based assessment education does not compromise the instruction of psychological disorders and is equivalent to a traditional abnormal psychology course in reducing mental illness stigma.

Teaching Implications:

Such an approach may be beneficial early in students’ education to reduce mental illness stigma and promote comprehensive assessment practices.

Keywords

positive psychology strengths assets abnormal psychology psychopathology teaching

Courses in abnormal psychology commonly focus on psychological disorders and pathology (e.g., Magyar-Moe, 2011). A restricted focus on deficits runs the risk of perpetuating mental illness stigma (e.g., Mann & Himelein, 2008) and limits the scope of possibilities related to human flourishing (e.g., Magyar-Moe et al., 2015). Many scholars and educators have argued for a decreased emphasis on deficits in abnormal psychology courses, including critiques of the course’s name (e.g., Magyar-Moe, 2011; Miller, 2015). Instead, the inclusion of human strengths and strengths-based assessment (i.e., assessment designed to identify strengths and resources and promote well-being; Gallagher & Lopez, 2019) in abnormal psychology curriculum could provide a more balanced focus that humanizes people and destigmatizes mental health concerns (e.g., Magyar-Moe, 2011; Owens et al., 2015). Given the prevalence of undergraduate abnormal psychology courses (e.g., Stoloff et al., 2010) and mental health concerns among college students (e.g., Pedrelli et al., 2015), strengths-based abnormal psychology curriculum may provide a unique opportunity to reduce mental illness stigma. As part of a larger investigation of the effects of teaching students a strengths-based assessment approach in an undergraduate abnormal psychology course, we examined to what extent students perceived strengths as valuable in clinical practice, to what extent students inquired about strengths after reading clinical vignettes, and how a strength-based assessment approach influenced students’ well-being, mental illness stigma, and overall knowledge of psychological disorders (see Owens & Motl, 2020). This paper examined the latter two topics—whether instruction in, and application of, a strengths-based assessment approach would decrease mental illness stigma and not detract from knowledge related to psychological disorders.

Strengths-Based Approaches

Research suggests a strengths-based approach can help prevent and address challenges individuals face, as well as promote human growth and well-being (e.g., Gallagher & Lopez, 2019; Magyar-Moe et al., 2015). In the clinical context, counseling approaches that identify and promote the use of strengths have been shown to be beneficial. For example, positive psychotherapy increased clients’ well-being, life satisfaction, and social skills, and decreased depression symptoms (e.g., Lü et al., 2013; Rashid et al., 2013; Seligman et al., 2006). Goal focused positive psychotherapy was found to be equivalent to treatment as usual in addressing clients’ distress, but rated as a more positive experience (Conoley & Scheel, 2018). Clients also experienced greater self-worth, had stronger rapport with their clinician, and were more likely to follow treatment recommendations when strengths were identified and incorporated into treatment (Conoley et al., 1994; Fluckiger & Grosse Holtforth, 2008; Rashid, 2015).

Similarly, the identification of strengths and instruction in strengths assessment appear valuable as well. In a college student sample, strengths knowledge was related to well-being (Govindji & Linley, 2007), and in a longitudinal study, strengths knowledge was related to enhanced strengths use and greater academic satisfaction (Allan et al., 2019a). From a larger data set that corresponded with this study, previous analyses showed students exposed to strengths-based assessment instruction reported: greater perceived importance of strengths-based counseling and assessment services, wanting to know more about a greater number of client strengths in a low pathology vignette, and enhanced life satisfaction (Owens & Motl, 2020).

Mental Illness Stigma and Stigma Interventions

Stigmatized individuals “possess (or are believed to possess) some attribute, or characteristic, that conveys a social identity that is devalued in some particular social context” (Crocker et al., 1998, p. 505). Two main types of stigma have been described—public and self-stigma (Corrigan, 2004). Public stigma involves the general public’s responses to groups based on stigma toward those groups, whereas self-stigma refers to an individual’s response to being part of a stigmatized group and experiencing stigmatized attitudes toward themselves as a result of others’ stigma (Corrigan, 2004). In the case of mental illness stigma, a person is devalued or negatively perceived due to psychological disorders or symptoms present.

Mental illness stigma is a challenging issue, as individuals with and without mental health concerns, including those with mental health training, commonly hold negative implicit biases toward people with psychological disorders (e.g., Eisenberg et al., 2010; Wahl & Aroesty-Cohen, 2010). Those who face mental illness stigma experience a number of negative outcomes, such as discrimination, stress, and reduced quality of life, and are less likely to seek mental health care (e.g., Abdullah & Brown, 2011; Schnyder et al., 2017).

Overall, research largely suggests stigma interventions—including those provided in undergraduate psychology classes—result in less stigma and a shift in attitudes toward seeking treatment (e.g., Corrigan et al., 2012; Kosyluk et al., 2016). Previously, one intervention made an attempt to “humanize” mental health concerns by using assignments designed to foster empathy (Mann & Himelein, 2008). It is possible a strengths-based assessment approach would similarly be effective, as positive psychological techniques often strive to humanize others by providing a well-rounded perspective of people (e.g., Magyar-Moe et al., 2015; Owens et al., 2015).

The Present Study

The present study examined the impact of providing instruction about and employing a strengths-based assessment approach (i.e., the Balanced Diagnostic Impressions [DICE-PM] Model; see the procedure section), compared to teaching as usual in an undergraduate abnormal psychology course, on students’ knowledge of psychological disorders and public mental illness stigma. The research questions included: Do students who learned about and used a strengths-based assessment approach (a) demonstrate at least equivalent knowledge of psychological disorders and their symptoms, and (b) experience reductions in mental illness stigma?

Method

Participants

Participants included 131 undergraduate students (M_age = 21.37, SD = 2.11) from a midwestern public university in the United States. Over two semesters, abnormal psychology class sections were randomly assigned to the strengths (n = 66) or control (n = 65) groups, with one strengths group and one control group each semester, by using a random number generator. Participants included 79% women and 21% men, and identified as White (93.9%), Asian/Asian American (3.1%), Black (.8%), Latino/a/x (.8%), Native American (.8%), and Other (.8%).

Ten students missed the first class and did complete the first activity, which involved describing an individual with a psychological disorder (see the procedure section). Subsequently, there was a slightly lower participant number (control group = 62; strengths group = 59) for the psychological disorder knowledge analysis.

Measures

To measure psychological disorder knowledge, at the beginning and end of the semester, students were asked to: “describe someone you know who has a psychological disorder or someone you believe has a psychological disorder that hasn’t been officially diagnosed.” The primary author, a licensed psychologist, read each description and identified what disorder appeared to be described. This was done by looking for multiple symptoms that collectively align with a given disorder and/or descriptions of symptoms that align with the core criteria (i.e., Criteria A in the DSM 5) of a given disorder. The participants’ group assignment was kept blind. Following, two pairs of raters, not including the primary author, independently coded each students’ descriptions using the DSM 5 for: (a) the percentage of total correct criteria described (number of correct criteria divided by the total number of possible criteria for the disorder; T1 = 83% agreement; T2 = 67% agreement), and (b) percentage of incorrect criteria (number of incorrect criteria divided by the total number of possible correct criteria for the disorder; T1 = 93% agreement; T2 = 97% agreement). Coding discrepancies were resolved through rater discussion and consensus.

To measure mental illness stigma, the Day’s Mental Illness Stigma Scale (DMISS; Day et al., 2007) was used. It consists of seven subscales: anxiety, relationship disruption, hygiene, visibility, treatability, professional efficacy, and recovery. For this study, the internal consistencies ranged from .41 to .90, with the majority over .70. Treatability had the lowest score. See Owens et al. (2021) for a detailed description.

Procedure

During the 1st week of class and at the end of the semester, participants completed the measures described. The data from the current study was drawn from a larger data set and has not been previously included elsewhere. Given the variety and number of outcomes examined related to the larger study, additional findings (perceived importance of strengths-based services, strengths assessed in clinical vignettes, and students’ life satisfaction) were reported in Owens and Motl (2020).

All of the students were taught psychological disorders and diagnostic criteria from the DSM 5 (American Psychiatric Association, 2013), etiologic factors, and possible interventions. The strengths group received a lecture about strengths, read two assigned readings about strengths and participated in two corresponding in-class discussions about strengths, and strengths were a main focus in all homework assignments. The strengths group also used the DICE-PM Model frequently throughout the entire semester, including during all in-class diagnostic activities.

The DICE-PM Model is a strengths-based assessment tool designed to help assess for and conceptualize clients’ strengths and challenges (Owens et al., 2015; Owens & Woolgar, 2018). In this model, assessment data is summarized across a number of domains: Diagnosis, Individual Strengths and Weaknesses, Cultural Assets and Struggles, Environmental Resources and Deficits, Physical Wellness and Health Concerns, and Mental Health Category (a domain summarizing overall functioning from the Complete State Model of Mental Health [see Keyes & Lopez, 2002]; flourishing, floundering, languishing, or struggling).

The control group did not receive any instruction about strengths or the DICE-PM Model. All students were taught by the same instructor and used the same abnormal psychology textbook (Rosenberg & Kosslyn, 2014). See Table 1 for a summary of differences between groups and Owens et al. (2021) for an extended discussion of the procedures, an example DICE-PM Model, and a discussion of the analysis plan and preliminary analyses.

Table 1.
Differences in Instruction Between the Strengths and Control Groups.

Component Strengths Group Control Group

Lecture During the 2nd week of class, a lecture was provided that introduced diagnostic assessment. During this lecture, students were introduced to the DICE-PM Model.
Students were provided with a 45-minute lecture on strengths. During the second week of class, a lecture was provided that introduced diagnostic assessment.

Discussions Students participated in two, 30-minute in-class discussions about strengths; one based on an assigned reading involving positive psychological assessment (Snyder et al., 2003) and one based on an assigned reading about strength-based intervention (Bowers, 2008). Students participated in two 30-minute in-class discussions, with one related to a reading about the history of the DSM (Klegg, 2012) and the other related to a reading on diagnostic cultural considerations (White Kress et al., 2005).

In-class Activities Students in the strengths condition consistently used the DICE-PM Model during all in-class diagnostic activities. During the activities, the students would read a case vignette that focused on a specific disorder, and then the students were asked to complete a worksheet that included a list of each category of the DICE-PM Model. To complete the worksheets, students were asked to list information from the vignette that corresponded to each category from the DICE-PM Model. The completed worksheet would look similar to the completed “Example Balanced Diagnostic Impressions Model,” which can be found in Owens et al. (2021). During the in-class activities, the control group read the same vignettes as the strengths group; however, they did not use the DICE-PM Model and instead identified what disorder was portrayed in the vignettes and listed what corresponding diagnostic criteria from the DSM 5 aligned with the symptoms described in the vignettes.

Homework Students completed three worksheets involving the DICE-PM Model and clinical vignettes they read. The worksheet assignments were identical to the in-class activity worksheets, except they were provided as homework and were completed independently by the students.
Students completed three written assignments. The first involved reading a vignette and aligning information described in the vignette with the DICE-PM Model categories, as well as discussing how attending to strengths and weaknesses are helpful in the diagnostic process.
The second written assignment involved selecting a movie from a list provided that featured characters with psychological disorders and identifying what disorder was present, identifying examples of symptoms presented, and identifying inconsistencies of symptoms presented with those that align with the disorder. Students were also asked to complete the DICE-PM Model based on their observations from the movie.
The third written assignment involved discussing how identifying clients’ strengths and strengths use might be helpful to clients, as well as generating ideas of how clients could capitalize on their strengths.
Students completed three worksheets involving diagnostic impressions related to clinical vignettes. The worksheet assignments were identical to the in-class diagnostic activities, except they were provided as homework and were completed independently by the students.
Students completed three written assignments. The first involved summarizing information from a clinical vignette into categories typically found in an intake assessment report.
The second written assignment involved selecting a movie from a list provided that featured characters with psychological disorders and identifying what disorder was present, identifying examples of symptoms presented, and identifying inconsistencies of symptoms presented with those that align with the disorder.
The third written assignment involved comparing and contrasting personality traits to personality disorders and how one might distinguish extreme ends of personality traits from personality disorders.

Results

To examine psychological disorders knowledge, a 2(time: T1 and T2) × 2(condition: strengths and control) mixed design analysis of variance (ANOVA) was conducted. A main effect emerged for time, as students, regardless of condition, were able to describe a significantly larger percentage of correct total DSM 5 criteria at T2, F(1, 119) = 13.53; p < .001, $η_{p}^{2}$ = .10 ( $η_{p}^{2}$ < .059 = small; $η_{p}^{2}$ between .06 and .139 = medium; $η_{p}^{2}$ > .14 = large; see Cohen, 1992; Kneer, 2017). The main effect for condition and the interaction were not significant. A main effect also emerged for time for incorrect DSM 5 criteria described. Students in both conditions included significantly fewer incorrect DSM 5 criteria in their vignette descriptions at T2, F(1, 119) = 4.02; p = .047, $η_{p}^{2}$ = .03. There was not a significant main effect for condition or an interaction. See Table 2 for descriptive statistics.

Table 2.
Means and Standard Deviations of Outcome Variables.

Condition

Control Group Strengths Group

Variable T1 M(SD) T2 M(SD) T1 M(SD) T2 M(SD)

Percentage of total correct criteria 21.73(18.40) 28.68(17.55) 20.79(17.40) 28.35(14.94)

Percentage of incorrect criteria 0.54(4.23) 0.00(0.00) 2.05(6.43) 0.55(2.38)

DMISS—Anxiety 2.13(0.72) 2.09(0.73) 2.23(0.68) 1.96(0.71)

DMISS—Relationship Disruption 2.17(0.60) 2.06(0.67) 2.09(0.64) 1.99(0.63)

DMISS—Hygiene 1.87(0.69) 1.66(0.69) 1.80(0.64) 1.75(0.67)

DMISS—Visibility 2.87(0.61) 3.16(0.70) 2.66(0.60) 2.82(0.66)

DMISS—Treatability 4.06(0.59) 4.18(0.45) 4.10(0.54) 4.25(0.51)

DMISS—Professional Efficacy 3.98(0.73) 4.15(0.75) 4.07(0.65) 4.21(0.64)

DMISS—Recovery 3.99(0.83) 3.98(0.89) 3.88(0.74) 3.92(0.81)

Note. DMISS = Day’s Mental Illness Stigma Scale.

A 2(time: T1 and T2) × 2(condition: strengths and control) mixed design ANOVA was used to examine the DMISS subscales. Main effects emerged for time, with the exception of the subscale recovery. From T1 to T2, participants showed significant decreases in anxiety, F(1, 129) = 8.96; p = .003, $η_{p}^{2}$ = .07; relationship disruption, F(1, 129) = 4.29; p = .04, $η_{p}^{2}$ = .03; hygiene, F(1, 129) = 6.72; p = .011, $η_{p}^{2}$ = .05; visibility, F(1, 129) = 16.37; p < .001, $η_{p}^{2}$ = .11; treatability, F(1, 129) = 7.13; p = .009, $η_{p}^{2}$ = .05; and professional efficacy, F(1, 129) = 5.74; p = .02, $η_{p}^{2}$ = .04. A main effect for condition emerged for visibility, F(1, 129) = 7.86; p = .006, $η_{p}^{2}$ = .06. A follow up independent samples t-test revealed at T1 there was no significant difference between the control and strengths groups’ scores on visibility. At T2, the control group scored significantly higher (M = 3.16, SD = .70) than the strengths group (M = 2.82, SD = .66) on visibility, t(129) = 2.86, p = .005. However, importantly, the interaction was not significant. A significant interaction was found for anxiety, F(1, 129) = 4.93; p = .03; $η_{p}^{2}$ = .04, with lower scores from students in the strengths group from T1 to T2.

Discussion

The current study investigated the impact of a strengths-based assessment approach in an undergraduate abnormal psychology course on knowledge of psychological disorders and mental illness stigma. Students in both the strengths and control groups showed increased knowledge of psychological disorders (i.e., significantly greater correct DSM 5 criteria and significantly fewer incorrect DSM 5 criteria) from the beginning to the end of the semester with medium and small effect sizes, respectively. This suggests equivalence among the two groups and that the inclusion of strengths in abnormal psychology curriculum does not deter from learning about disorders. Given the many benefits of using strengths-based approaches for students, clinicians, and clients (e.g., Allan et al., 2019b; Owens & Motl, 2020; Rashid, 2015), it appears the incorporation of strength-based assessment in abnormal psychology courses holds promise.

Results also showed both groups had a significant decrease in all types of public stigma measured, except the recovery subscale, with nearly all small effect sizes. Past studies involving mental illness stigma interventions in abnormal psychology classes have demonstrated success in reducing mental illness stigma (e.g., Barney et al., 2017; Ferrari, 2016; Strassle, 2018); thus, equivalent results between the strengths and control groups is encouraging. These findings are also consistent with previous literature. Past research has generally shown gaining knowledge about psychological disorders—which occurred in both groups in this study—reduces mental illness stigma (e.g., Maranzan, 2016; Strassle, 2018). However, these findings should be interpreted tentatively, as all but two of the effect sizes were small. The anxiety and visibility mental illness subscales had medium effect sizes. The anxiety subscale examines feelings of nervousness or fear related to others with mental health concerns, and the visibility subscale measures the perceived ability to recognize symptoms of mental illness. The bigger effect sizes for these subscales could be due to the nature of the course, which focused on learning about psychological symptoms, which likely led to more comfort with disorders. Together, results suggest the strengths assessment approach used in this study provides another alternative to the mental illness reduction interventions available, with the unique inclusion of learning about and focusing on strengths. However, future studies that examine how the DICE-PM Model compares to other specific mental illness reduction interventions would be worthwhile.

As noted, the only subscale that did not show a significant decrease over time was recovery, which measures beliefs about the potential for others to recover from mental illness(es). Past research has found that the stigmatization of some forms of mental illness is higher than others (e.g., schizophrenia compared to depression; Mann & Himelein, 2004). It is possible because students learned about a variety of psychological disorders, including severe mental illness and chronic disorders, this may have influenced their perceptions related to recovery.

Results also showed those in the strengths group had a significantly greater decrease in the anxiety mental illness stigma subscale compared to the control group. However, the effect size was small. Past research has shown students who learned about psychological disorders experienced decreased anxiety about their own mental health, but experienced increased anxiety about the mental health of their family members (Hardy & Calhoun, 1997). In this study, only anxiety toward others’ mental illness was assessed. Additional research examining the impact of strengths-based approaches on anxiety about mental illness would be beneficial.

Overall, these findings might be of interest to those who work in educational settings. For instance, given the notable presence of mental illness among college students (e.g., Pedrelli et al., 2015) and negative outcomes related to mental illness stigma, additional approaches and research aimed at destigmatizing mental illness could be valuable. Further, targeting undergraduate education may provide a unique opportunity to help address public mental illness stigma early among future mental health professionals, which in turn could impact self-stigma. Undergraduate classes help form the foundation of learning from which future information builds upon. If future clinicians or assessment technicians are initially taught assessment from a strength-based approach, this knowledge may shape them to conceptualize clients from a more holistic and comprehensive perspective (Owens & Motl, 2020) and improve self-perceptions. However, future research is needed to examine these considerations.

Limitations and Future Directions

There were some limitations to this study. First, the sample lack diversity. Second, it is possible Type I error could explain the significant differences between the intervention and control groups. Given the pilot nature of this study, it is possible the significant effects were false positives. Thus, replication studies with larger samples involving multiple institutions nationwide could broaden the identities represented and help to address these concerns.

Third, some measurement concerns were noted. The inter-rater reliability for the percentage of total correct DSM 5 criteria at T2 was lower than desirable; however, careful discussion of disagreements and a consensus of final answers were reached among raters prior to analyzing the data. Additionally, the treatability subscale from the DMISS showed low internal consistency. It is unclear why the treatability subscale had lower reliability for this sample as past samples have found adequate reliability (α = .71; Day et al., 2007). One possible explanation may be that some students were not paying close attention to the wording on this subscale, as it was the only subscale with two reverse-scored items. Another possibility was students were asked to think about mental illness broadly and not a specific psychological disorder (e.g., depression, bipolar disorder, schizophrenia; an option with the DMISS). Since the effectiveness of treatment for different psychological disorders ranges (Kopta et al., 1994), and different portrayals of diagnoses have been shown to impact the perception of treatability (McGinty et al., 2015), this could have affected the reliability. Future research could also examine stigma related to specific disorders, as research has shown that not all forms of mental illness are stigmatized equally (Mann & Himelein, 2004).

Fourth, the interaction between condition and time on the anxiety stigma subscale had a small effect. In the future, revisions to the intervention could be made to increase the dosage or potency of the strengths-based assessment instructional approach used, as this intervention was rather small in scope and short in duration. Further, previous research has shown that contact with those with mental illness leads to greater reductions in mental illness stigma than knowledge-based interventions (Maranzan, 2016); future research could examine a strengths-based contact intervention. For instance, volunteer work with those with mental illness that incorporates the promotion of their strengths might result in more robust effects.

This study also presents opportunities for additional future directions. The DICE-PM Model not only emphasized strengths, but was multifaceted and interdisciplinary in nature, including mental health, physical health, environmental, and cultural considerations. Although students in the control group were exposed to each of these topics through lectures, assigned readings, and in-class discussions, they were not asked to intentionally focus on these factors and their intersection to the same extent as the intervention group. Thus, it is possible some of the findings from this study were influenced by this interdisciplinary focus. Future research could examine how an interdisciplinary focus both with and without a strengths component compare to one another.

Conclusion

Given the limited research examining teaching and using strengths-based assessment, the present study offers a starting point for future research. The results of this study suggest that teaching abnormal psychology from a strengths-based perspective is generally equivalent to traditional abnormal psychology instruction in regard to decreased mental illness stigma and knowledge of disorders. While not stronger in these domains, it shows promise in that students show equivalent benefits while also learning about strengths-based assessment. This may lay the foundation for a more inclusive, comprehensive, and humanizing understanding of others, though future research is necessary.

Component	Strengths Group	Control Group
Lecture	During the 2nd week of class, a lecture was provided that introduced diagnostic assessment. During this lecture, students were introduced to the DICE-PM Model. Students were provided with a 45-minute lecture on strengths.	During the second week of class, a lecture was provided that introduced diagnostic assessment.
Discussions	Students participated in two, 30-minute in-class discussions about strengths; one based on an assigned reading involving positive psychological assessment (Snyder et al., 2003) and one based on an assigned reading about strength-based intervention (Bowers, 2008).	Students participated in two 30-minute in-class discussions, with one related to a reading about the history of the DSM (Klegg, 2012) and the other related to a reading on diagnostic cultural considerations (White Kress et al., 2005).
In-class Activities	Students in the strengths condition consistently used the DICE-PM Model during all in-class diagnostic activities. During the activities, the students would read a case vignette that focused on a specific disorder, and then the students were asked to complete a worksheet that included a list of each category of the DICE-PM Model. To complete the worksheets, students were asked to list information from the vignette that corresponded to each category from the DICE-PM Model. The completed worksheet would look similar to the completed “Example Balanced Diagnostic Impressions Model,” which can be found in Owens et al. (2021).	During the in-class activities, the control group read the same vignettes as the strengths group; however, they did not use the DICE-PM Model and instead identified what disorder was portrayed in the vignettes and listed what corresponding diagnostic criteria from the DSM 5 aligned with the symptoms described in the vignettes.
Homework	Students completed three worksheets involving the DICE-PM Model and clinical vignettes they read. The worksheet assignments were identical to the in-class activity worksheets, except they were provided as homework and were completed independently by the students. Students completed three written assignments. The first involved reading a vignette and aligning information described in the vignette with the DICE-PM Model categories, as well as discussing how attending to strengths and weaknesses are helpful in the diagnostic process. The second written assignment involved selecting a movie from a list provided that featured characters with psychological disorders and identifying what disorder was present, identifying examples of symptoms presented, and identifying inconsistencies of symptoms presented with those that align with the disorder. Students were also asked to complete the DICE-PM Model based on their observations from the movie. The third written assignment involved discussing how identifying clients’ strengths and strengths use might be helpful to clients, as well as generating ideas of how clients could capitalize on their strengths.	Students completed three worksheets involving diagnostic impressions related to clinical vignettes. The worksheet assignments were identical to the in-class diagnostic activities, except they were provided as homework and were completed independently by the students. Students completed three written assignments. The first involved summarizing information from a clinical vignette into categories typically found in an intake assessment report. The second written assignment involved selecting a movie from a list provided that featured characters with psychological disorders and identifying what disorder was present, identifying examples of symptoms presented, and identifying inconsistencies of symptoms presented with those that align with the disorder. The third written assignment involved comparing and contrasting personality traits to personality disorders and how one might distinguish extreme ends of personality traits from personality disorders.

	Condition
Percentage of total correct criteria	21.73(18.40)	28.68(17.55)	20.79(17.40)	28.35(14.94)
Percentage of incorrect criteria	0.54(4.23)	0.00(0.00)	2.05(6.43)	0.55(2.38)
DMISS—Anxiety	2.13(0.72)	2.09(0.73)	2.23(0.68)	1.96(0.71)
DMISS—Relationship Disruption	2.17(0.60)	2.06(0.67)	2.09(0.64)	1.99(0.63)
DMISS—Hygiene	1.87(0.69)	1.66(0.69)	1.80(0.64)	1.75(0.67)
DMISS—Visibility	2.87(0.61)	3.16(0.70)	2.66(0.60)	2.82(0.66)
DMISS—Treatability	4.06(0.59)	4.18(0.45)	4.10(0.54)	4.25(0.51)
DMISS—Professional Efficacy	3.98(0.73)	4.15(0.75)	4.07(0.65)	4.21(0.64)
DMISS—Recovery	3.99(0.83)	3.98(0.89)	3.88(0.74)	3.92(0.81)

Footnotes

Acknowledgments

Special thanks to Megan Vogt, Anita Sun, and Lindsey Letourneau for their assistance in conducting this study.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Rhea L. Owens

References

Abdullah

Brown

T. L.

(2011). Mental illness stigma and ethnocultural beliefs, values, and norms: An integrative review. Clinical Psychology Review, 31(6), 932–948. https://doi.org/10.1016/j.cpr.2011.05.003

Allan

B. A.

Owens

R. L.

Douglass

(2019b). Character strengths in counselors: Relations with meaningful work and burnout. Journal of Career Assessment, 27(1), 151–166. https://doi.org/10.1177/1069072717748666

Allan

B. A.

Owens

R. L.

Kim

Douglass

R. P.

Hintz

(2019a). Strengths and satisfaction in first year undergraduate students: A longitudinal study. The Journal of Positive Psychology. Advance online publication. https://doi.org/10.1080/17439760.2019.1676458

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.

Barney

S. T.

Corser

G. C.

Strosser

G. L.

Hatch

D. L.

LaFrance

(2017). Service-learning in abnormal psychology: Softening the implicit stigma against the mentally ill. Scholarship of Teaching and Learning in Psychology, 3(2), 151–162. https://dx.doi.org/10.1037/stl0000083

Bowers

(2008). Making the most of human strengths. In Lopez

S. J.

(Ed.), Positive psychology: Exploring the best in people (Vol. 1., pp. 23–36). Praeger.

Cohen

(1992). A power primer. Psychological Bulletin, 112(1), 155–159. https://doi.org/10.1037/0033-2909.112.1.155

Conoley

C. W.

Padula

M. A.

Payton

D. S.

Daniels

J. A.

(1994). Predictors of client implementation of counselor recommendations: Match with problem, difficulty level, and building on client strengths. Journal of Counseling Psychology, 41(1), 3–7. https://doi.org/10.1037/0022-0167.41.1.3

Conoley

C. W.

Scheel

M. J.

(2018). Goal focused positive psychotherapy: A strengths-based approach. Oxford University Press.

10.

Corrigan

(2004). How stigma interferes with mental health care. American Psychologist, 59(7), 614–625. https://doi.org/10.1037/0003-066X.59.7.614

11.

Corrigan

P. W.

Morris

S. B.

Michaels

P. J.

Rafacz

J. D.

Rüsch

(2012). Challenging the public stigma of mental illness: A meta-analysis of outcome studies. Psychiatric Services, 63(10), 963–973. https://doi.org/10.1176/appi.ps.201100529

12.

Crocker

Major

Steele

(1998). Social stigma. In Gilbert

D. T.

Fiske

S. T.

Lindzey

(Eds.), The handbook of social psychology: Vol. 2. Special fields and applications (4th ed., pp. 504–553). McGraw-Hill.

13.

Day

E. N.

Edgren

Eshleman

(2007). Measuring stigma toward mental illness: Development and application of the Mental Illness Stigma Scale. Journal of Applied Social Psychology, 37(10), 2191–2219. https://doi.org/10.1111/j.1559-1816.2007.00255.x

14.

Eisenberg

Downs

M. F.

Golberstein

Zivin

(2010). Stigma and help seeking for mental health among college students. Medical Care Research and Review, 66(5), 522–541. https://doi.org/10.1177/1077558709335173

15.

Ferrari

(2016). Using celebrities in abnormal psychology as teaching tools to decrease stigma and increase help seeking. Teaching of Psychology, 43(4), 329–333. https://doi.org/10.1177/0098628316662765

16.

Flückiger

Grosse Holtforth

(2008). Focusing the therapist’s attention on the patient’s strengths: A preliminary study to foster a mechanism of change in outpatient psychotherapy. Journal of Clinical Psychology, 64(7), 876–890. https://doi.org/10.1002/jclp.20493

17.

Gallagher

M. W.

Lopez

S. J.

(Eds.) (2019). Positive psychological assessment: A handbook of models and measures (2nd ed.). American Psychological Association.

18.

Govindji

Linley

P. A.

(2007). Strengths use, self-concordance and well-being: Implications for strengths coaching and coaching psychologists. International Coaching Psychology Review, 2(2), 143–153.

19.

Hardy

M. S.

Calhoun

L. G.

(1997). Psychological distress and the “medical student syndrome” in abnormal psychology students. Teaching of Psychology, 24(3), 192–193. https://doi.org/10.1207/s15328023top2403_10

20.

Keyes

C. L. M.

Lopez

S. J.

(2002). Toward a science of mental health: Positive directions in diagnosis and intervention. In Snyder

C. R.

Lopez

S. J.

(Eds.), Handbook of positive psychology (pp. 45–62). Oxford University Press.

21.

Klegg

J. W.

(2012). Teaching about mental health and illness through the history of the DSM. History of Psychology, 15(4), 364–370. https://doi.org/10.1037/a0027249

22.

Kneer

(2017). Effect sizes. In Allen

(Ed.), The Sage encyclopedia of communication research methods (pp. 406–408). Sage.

23.

Kopta

S. M.

Howard

K. I.

Lowry

J. L.

Beutler

L. E.

(1994). Patterns of symptomatic recovery in psychotherapy. Journal of Consulting and Clinical Psychology, 62(5), 1009–1016. https://doi.org/10.1037/0022-006X.62.5.1009

24.

Kosyluk

K. A.

Al-Khouja

Bink

Buchholz

Ellefson

Fokuo

Goldberg

Kraus

Leon

Michaels

Powell

Schmidt

Corrigan

P. W.

(2016). Challenging the stigma of mental illness among college students. Journal of Adolescent Health, 59, 325–331. https://dx.doi.org/10.1016/j.jadohealth.2016.05.005

25.

Lü

Wang

Liu

(2013). A pilot study on changes of cardiac vagal tone in individuals with low trait positive affect: The effect of positive psychotherapy. International Journal of Psychophysiology, 88, 213–217. https://doi.org/10.1016/j.ijpsycho.2013.04.012

26.

Magyar-Moe

J. L.

(2011). Incorporating positive psychology content and applications into various psychology courses. The Journal of Positive Psychology, 6(6), 451–456. https://doi.org/10.1080/17439760.2011.634821

27.

Magyar-Moe

J. L.

Owens

R. L.

Conoley

C. W.

(2015). Positive psychological interventions in counseling: What every counseling psychologist should know. The Counseling Psychologist, 43(4), 508–557. https://doi.org/10.1177/0011000015573776

28.

Mann

C. E.

Himelein

M. J.

(2004). Factors associated with stigmatization of persons with mental illness. Psychiatric Services, 55(2), 185–187. https://doi.org/10.1176/appi.ps.55.2.185

29.

Mann

C. E.

Himelein

M. J.

(2008). Putting the person back into psychopathology: An intervention to reduce mental illness stigma in the classroom. Social Psychiatry and Psychiatric Epidemiology, 43(7), 545–551. https://doi.org/10.1007/s00127-008-0324-2

30.

Maranzan

K. A.

(2016). Addressing mental illness stigma in the psychology classroom. Psychology Learning & Teaching, 15(3), 235–249. https://doi.org/10.1177/1475725716666804

31.

McGinty

E. E.

Goldman

H. H.

Pescosolido

Barry

C. L.

(2015). Portraying mental illness and drug addiction as treatable health conditions: Effects of a randomized experiment on stigma and discrimination. Social Science & Medicine, 126, 73–85. https://doi.org/10.1016/j.socscimed.2014.12.010

32.

Miller

R. B.

(2015). Not so abnormal psychology: A pragmatic view of mental illness. American Psychological Association.

33.

Owens

R. L.

Heaslip

Thombre

(2021). The impact of strengths-based assessment education on undergraduate students’ knowledge of disorders and mental illness stigma online supplemental material. Figshare. https://figshare.com/s/f0ae728e575833fcd920

34.

Owens

R. L.

Magyar-Moe

J. L.

Lopez

S. J.

(2015). Finding balance via positive psychological assessment: Recommendations for practice. The Counseling Psychologist, 43(5), 634–670. https://doi.org/10.1177/0011000015584956

35.

Owens

R. L.

Motl

T. C.

(2020). Highlighting clients’ strengths: The benefits of using the Balanced Diagnostic Impressions (DICE-PM) Model. International Journal of Applied Positive Psychology. Advance online publication. https://doi.org/10.1007/s41042-020-00042-8

36.

Owens

R. L.

Woolgar

S. R.

(2018). Moving past pathology: Clinical applications of the Balanced Diagnostic Impressions (DICE-PM) Model. Translational Issues in Psychological Science, 4(3), 304–313. https://doi.org/10.1037/tps0000163

37.

Pedrelli

Nyer

Yeung

Zulauf

Wilens

(2015). College students: Mental health problems and treatment considerations. Academic Psychiatry, 39, 503–511. https://doi.org/10.1007/s40596-014-0205-9

38.

Rashid

(2015). Positive psychotherapy: A strengths-based approach. The Journal of Positive Psychology, 10(1), 25–40. https://doi.org/10.1080/17439760.2014.920411

39.

Rashid

Anjum

Quinlin

Niemiec

Mayerson

Kazemi

(2013). Assessment of positive traits in children and adolescents. In Linley

Proctor

(Eds.), Research, applications and interventions for children and adolescents: A positive psychology perspective (pp. 81–116). Springer.

40.

Rosenberg

R. S.

Kosslyn

S. M.

(2014). Abnormal psychology (2nd ed.). Macmillan.

41.

Schnyder

Panczak

Groth

Schultze-Lutter

(2017). Association between mental health-related stigma and active help-seeking: Systematic review and meta-analysis. The British Journal of Psychiatry, 210(4), 261–268. https://doi.org/10.1192/bjp.bp.116.189464

42.

Seligman

M. E.

Rashid

Parks

A. C.

(2006). Positive psychotherapy. American Psychologist, 61(8), 774–788.

43.

Snyder

C. R.

Lopez

S. J.

Edwards

L. M.

Teramoto Pedrotti

Prosser

E. C.

Walton

S. L.

Spalitto

S. V.

Ulven

J. C.

(2003). Measuring and labeling the positive and the negative. In Lopez

S. J.

Snyder

C. R.

(Eds.), Positive psychological assessment: A handbook of models and measures. American Psychological Association.

44.

Stoloff

McCarthy

Keller

Varfolomeeva

Lynch

Makara

Simmons

Smiley

(2010). The undergraduate psychology major: An examination of structure and sequence. Teaching of Psychology, 37(4), 4–15. https://doi.org/10.1080/00986280903426274

45.

Strassle

C. G.

(2018). Reducing mental illness stigma in the classroom: An expanded methodology. Teaching of Psychology, 45(4), 351–357. https://doi.org/10.1177/0098628318796922

46.

Wahl

Aroesty-Cohen

(2010). Attitudes of mental health professionals about mental illness: A review of the recent literature. Journal of Community Psychology, 38(1), 49–62. https://doi.org/10.1002/jcop.20351

47.

White Kress

V. E.

Eriksen

K. P.

Dixon Rayle

Ford

S. J. W.

(2005). The DSM-IV-TR and culture: Considerations for counselors. Journal of Counseling & Development, 83(1), 97–104. https://doi.org/10.1002/j.1556-6678.2005.tb00584.x

	Condition
	Control Group		Strengths Group
Variable	T1 M(SD)	T2 M(SD)	T1 M(SD)	T2 M(SD)
Percentage of total correct criteria	21.73(18.40)	28.68(17.55)	20.79(17.40)	28.35(14.94)
Percentage of incorrect criteria	0.54(4.23)	0.00(0.00)	2.05(6.43)	0.55(2.38)
DMISS—Anxiety	2.13(0.72)	2.09(0.73)	2.23(0.68)	1.96(0.71)
DMISS—Relationship Disruption	2.17(0.60)	2.06(0.67)	2.09(0.64)	1.99(0.63)
DMISS—Hygiene	1.87(0.69)	1.66(0.69)	1.80(0.64)	1.75(0.67)
DMISS—Visibility	2.87(0.61)	3.16(0.70)	2.66(0.60)	2.82(0.66)
DMISS—Treatability	4.06(0.59)	4.18(0.45)	4.10(0.54)	4.25(0.51)
DMISS—Professional Efficacy	3.98(0.73)	4.15(0.75)	4.07(0.65)	4.21(0.64)
DMISS—Recovery	3.99(0.83)	3.98(0.89)	3.88(0.74)	3.92(0.81)