Evidence-Based Early Interventions for Individuals at Clinical High Risk for Psychosis

Abstract

Youth and young adults at clinical high risk (CHR) for psychosis experience a broad range of difficulties, including attenuated psychotic symptoms, comorbid concerns, functional impairments, and family and interpersonal stress. Given emerging evidence that early interventions may improve functioning and reduce symptomatology while also lowering risk of transition to full-threshold psychosis, several randomized controlled trials have systematically evaluated the efficacy of CHR treatment approaches. This article describes and summarizes psychosocial intervention approaches that have demonstrated efficacy in treating people at CHR, with a focus on distilling individual components of these treatments. On the basis of the existing literature, we propose an empirically based, flexible, and comprehensive modularized approach to early intervention that meets the varying needs of individuals experiencing CHR-related distress and dysfunction, many of whom may be on a trajectory toward psychosis.

Four-Year Cost-effectiveness of Cognitive Behavior Therapy for Preventing First-episode Psychosis: The Dutch Early Detection Intervention Evaluation (EDIE-NL) Trial

“…The ultra-high risk (UHR) state is characterized by attenuated positive symptoms and/or a familial liability for psychotic disorders and by increased social isolation and functional decline. 2,3 In line with recent findings, [4][5][6][7][8] …”

Emotional and behavioral symptomatology reported by help-seeking youth at clinical high-risk for psychosis

“…Interventions that take a flexible approach to treatment could provide a model of care that can be tailored to the unique and dynamic needs of individuals at CHR by offering clinicians an array of evidence-based modules to use as needed to address psychosisspecific symptoms as well as co-occurring difficulties (Thompson et al, 2015). In line with the current findings, treatment modules focused on psychosis-risk could be complemented by strategies designed to address factors such as attention, locus of control, depression, and relationships with parents.…”

The Common Elements of treatment engagement for clinically high‐risk youth and youth with first‐episode psychosis

“…It is not possible to draw conclusions from the literature about the extent to which any practice is necessary or sufficient for improvements in treatment engagement . To draw those inferences would require the execution of dismantling studies.…”

“…Interventions that targeted caregivers of youth/young adults with CHR/FEP were included provided they met all other criteria. From this search, as well as a search of reference lists from review papers, [39][40][41] we identified 18 eligible studies published between 2002 and 2014 (see Table 2 for more details). [42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] Coding…”