Nicole Capon's design narrative: Stigma ladder

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Nicole Capon
8 April 2017

Title: The Stigma Ladder - how much do people really stigmatise someone with a Personality Disorder (PD)

Narrator: I was a co-facilitator on a course about understanding personality disorders

Situation: There were 12 participants in a snug room sitting. The day was moving through the planned exercises quickly as there was a reluctance by the group to discuss some of the content. The group consisted of clinical staff, criminal justice workers, third sector workers and volunteer staff.

Task: I wanted to slow down the pace of the session, increase energy in the room and encourage more interaction between the participants.

Actions: During the lunch break I wrote some topical conditions, issues and situations on a post-it note - one situation per post-it e.g. other mental health disorders, social issues such as asylum seekers, obesity and crimes. There were approximately 12 post-it notes altogether. I also drew a ladder on the flip chart.

After lunch when the group returned I opened the topic on stigma in general and elicited from the group different areas and people they felt were stigmatised. I then showed the post-it notes in turn and asked them where, as a group they felt the post-it should be placed on the stigma ladder with the less stigmatised at the top and the more stigmatised at the bottom (the bottom rung of the ladder). The final post-it note I showed was the one on PD (the topic of the course) and where they would place that.


The exercise was thought provoking for the group and generated a lot of discussion as it was a whole group exercise so participants were discussing why they felt an issue should be at a certain point of the ladder. It achieved the full aims of the task of being an after-lunch energiser that aided group discussion and slowed the pace of the session. The surprise was people with PD were unanimously placed at the bottom of the ladder beneath all of the crime post-its and equivalent to sex offenders. This helped the group to put in perspective the true picture of how discriminated someone with a PD can feel.

I didn't realise when creating the exercise how much it would resonate with the participants and lead them to think about their own views and any subliminal messages they may give while working with someone. This exercise was listed in the feedback as changing their view and being more mindful in their working practice.


This exercise has been included in all of the training sessions however, it is now completed in two or sometimes three groups depending on the size of the class to encourage movement in the room. The groups generally represent the perspective of the public and the perspective of professionals. I have learnt to give the professionals some guidance on how they approach the exercise e.g. how does a certain group (listed on the post-it) affect their case load? Do they have more or less tolerance for certain groups of people e.g. binge drinkers on a Friday night vs an attack?

This exercise has been successful in blending the learning objectives of the course and creating open and honest discussion to then move forward with a positive approach.

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