Adapting cognitive behavioural therapy for adolescents with psychosis: insights from the Managing Adolescent first episode in psychosis study (MAPS)

Abstract

Background Onset of psychosis commonly occurs in adolescence, and long-term prognosis can be poor. There is growing evidence, largely from adult cohorts, that Cognitive Behavioural Therapy for Psychosis (CBTp) and Family Interventions (FI) can play a role in managing symptoms and difficulties associated with psychosis. However, adolescents have distinct developmental needs that likely impact their engagement and response to talking therapy. There is limited guidance on adapting CBTp to meet the clinical needs of under-eighteens experiencing psychosis. Method This educational clinical practice article details learnings from therapists and supervisors working with young people (aged 14–18 years) with psychosis during the Managing Adolescent first-episode Psychosis: a feasibility Study (MAPS) randomised clinical treatment trial, supplemented by findings from nested qualitative interviews with young people receiving CBTp. Results Suggested are given for tailoring CBTp assessment, formulation and interventions to meet the developmental and clinical needs of adolescents with psychosis. Developmentally appropriate techniques and resources described. Conclusions Early indications from MAPS study indicate this developmentally tailored approach is an acceptable, safe and helpful treatment for young people with psychosis. Further research is needed to develop empirically grounded and evaluated CBTp for adolescents.

Preferences of Young Adults With Psychosis for Cannabis-Focused Harm Reduction Interventions: A Cross-Sectional Study: Préférences des jeunes adultes souffrant de psychose pour les interventions de réduction des méfaits axées sur le cannabis : une étude transversale

“…9,10 Some interventions, both for people with psychosis and for people with substance use disorders, have also integrated post-intervention booster sessions with the aim of extending intervention benefits. These have shown promising results, such as improvements in long-term outcomes relating to psychiatric symptomatology, 11 engagement 12,13 and substance use. 14,15 Beyond the aforementioned adaptations to existing interventions, another strategy may include exploring alternative outcomes, like harm reduction, to assess intervention effectiveness in addressing problematic cannabis use.…”

“… 9 , 10 Some interventions, both for people with psychosis and for people with substance use disorders, have also integrated post-intervention booster sessions with the aim of extending intervention benefits. These have shown promising results, such as improvements in long-term outcomes relating to psychiatric symptomatology, 11 engagement 12 , 13 and substance use. 14 , 15 …”