One way to help clients become more Aware of self-stigma is using the Internalized Stigma of Mental Illness (ISMI) to start discussion. It is a 29-item measure with five subscales: alienation, stereotype endorsement, perceived discrimination, social withdrawal, and stigma resistance. The person is asked how much s/he agrees or disagrees with each statement, on a 1-4 scale. A full copy of the ISMI is on the back of this handout. In addition to its use in research, the ISMI is an excellent way to start discussions about self-stigma -- to increase awareness and understanding about how stigma can come up in one’s thinking and one’s life. It can also highlight areas of strength and resilience.