1. Family-focused therapy for individuals at high clinical risk for psychosis: A confirmatory efficacy trial.
- Author
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Miklowitz, David J, Addington, Jean M, O'Brien, Mary P, Denenny, Danielle M, Weintraub, Marc J, Zinberg, Jamie L, Mathalon, Daniel H, Cornblatt, Barbara A, Friedman-Yakoobian, Michelle S, Stone, William S, Cadenhead, Kristin S, Woods, Scott W, Sugar, Catherine A, Cannon, Tyrone D, and Bearden, Carrie E more...
- Subjects
Humans ,Communication ,Social Adjustment ,Psychotic Disorders ,Family Therapy ,Adolescent ,Adult ,Young Adult ,expressed emotion ,family therapy ,prodromal symptoms ,psychotic disorders ,social adjustment ,Clinical Research ,Serious Mental Illness ,Mental Health ,Pediatric ,Prevention ,Clinical Trials and Supportive Activities ,Comparative Effectiveness Research ,Behavioral and Social Science ,6.6 Psychological and behavioural ,Evaluation of treatments and therapeutic interventions ,Mental health ,Good Health and Well Being ,Clinical Sciences ,Psychology ,Psychiatry - Abstract
AimsYoung people with attenuated psychotic symptoms (APS), brief intermittent psychosis, and/or genetic risk and functional deterioration are at high risk for developing psychotic disorders. In a prior trial, family-focused therapy for clinical high risk youth (FFT-CHR) was more effective than brief psychoeducation in reducing APS severity over 6 months. This 7-site trial will compare the efficacy of FFT-CHR to a psychoeducational and supportive intervention (enhanced care) on APS and social functioning in CHR individuals over 18 months.MethodsParticipants (N = 220, ages 13-25 years) with a CHR syndrome will be randomly assigned to FFT-CHR (18 1-h sessions of family psychoeducation and communication/problem-solving skills training) or enhanced care (3 1-h family psychoeducational sessions followed by 5 individual support sessions), both given over 6 months. Participants will rate their weekly progress during treatment using a mobile-enhanced online platform. Family communication will be assessed in a laboratory interactional task at baseline and post-treatment. Independent evaluators will assess APS (primary outcome) and psychosocial functioning (secondary outcome) every 6 months over 18 months.ResultsWe hypothesize that, compared to enhanced care, FFT-CHR will be associated with greater improvements in APS and psychosocial functioning over 18 months. Secondarily, improvements in family communication over 6 months will mediate the relationship between treatment condition and primary and secondary outcomes over 18 months. The effects of FFT-CHR are predicted to be greater in individuals with higher baseline risk for psychosis conversion.ConclusionsResults of the trial will inform treatment guidelines for individuals at high risk for psychosis. more...
- Published
- 2022