Journal of International Dental and Medical Research ISSN 1309-100X Early Therapeutic Interventions for Low Self-esteem http://www.ektodermaldisplazi.com/journal.htm Nurilla Safitri Damanik, and et al Volume ∙ 12 ∙ Number ∙ 1 ∙ 2019 Page 318 Early Therapeutic Interventions for Low Self-esteem among Adolescents with Early Prodromal Signs of Psychosis* Nurilla Safitri Damanik 1 , Budi Anna Keliat 2 **, Herni Susanti 2 1. Graduate Programme, Faculty of Nursing, Universitas Indonesia, Depok 16424, Indonesia. 2. Department of Psychiatry Nursing, Faculty of Nursing, Universitas Indonesia, Depok 16424, Indonesia. Abstract Low self-esteem is an early prodromal sign of psychosis in adolescents. Early intervention is needed to prevent psychosis among this age group. Thus far, no studies have investigated the effects of group cognitive-behavioral therapy (CBT) and family psychoeducation (FPE) on the self- esteem of adolescents in Indonesia. The present study aimed to explore the influence of CBT and FPE on the self-esteem of adolescents with early prodromal signs of psychosis. An experimental study was conducted. Of the 79 participants selected after screening using the prodromal questionnaire and Rosenberg’s self-esteem scale questionnaire, 39 were further classified into the intervention group and 40 into the control group using the random sampling technique. The analysis was performed using the paired t-test and analysis of variance. Results revealed that the RSES score of the CBT and FPE groups was significantly higher than that of the control group (p <.05). CBT and FPE, which are considered early therapeutic interventions, are recommended to increase the self-esteem of adolescents with early prodromal signs of psychosis. Clinical article (J Int Dent Med Res 2019; 12(1): 318-322) Keywords: Adolescents, psychosis. Received date: 25 August 2018 Accept date: 30 September 2018 Introduction Early psychosis is defined as presence of initial signs and symptoms of psychosis. 1 The early prodromal stage of psychosis is characterized by changes in an individual’s behavior after the psychosis phase is observed for the first time. 2 An individual with prodromal psychosis has generally negative or unspecified symptoms, such as depression, anxiety, social isolation, and failure at school or work. 3 Decreased levels of motivation and loss of interest or powerlessness are signs of low self-esteem, and these symptoms are observed during the early prodromal stage of psychosis. Self-esteem is used to describe how an individual perceives himself and his self-worth based on positive and negative values. 4 Negative self-evaluation leads to low self-esteem. Adolescence is a transitional stage; this period can be characterized by discovering or establishing of an individual’s identity and self- confidence. Adolescents aged 12-18 years should successfully achieve their self-identity, which involves roles, personal goals, uniqueness, and personal characteristics. However, those who are unsuccessful are more likely to experience role confusion and present with a fragile personality. This condition causes self- concept disturbances. 5 Interventions are needed to improve low self-esteem, powerlessness, and cognitive distortion in adolescents. Standard nursing intervention for individuals with low self-esteem includes identifying an individual’s capabilities and positive aspects; assessing and discussing skills that can be used; helping individuals in choosing activities, selecting coaching activities according to their abilities, and helping and guiding them in planning activities; and providing proper reinforcement toward their success. 6 The aim of standard nursing intervention is to increase self-confidence according to an individual’s capability. Individuals with low self-esteem usually have negative thoughts, which are more likely related to negative perception, and this **Corresponding author: Budi Anna Keliat Department of Psychiatry Nursing Faculty of Nursing, Universitas Indonesia Depok 16424, Indonesia E-mail: budianna_keliat@yahoo.com *The Research Ethics Committee, Faculty of Nursing Universitas Indonesia approved this study with number 80/UN.F12.D/HKP.02.04/2017