Group and Family Based Cognitive Behavioral Therapy for Youth at Risk for Psychosis: From Research to Real-Word Practice

Poster B100, Tuesday, October 9, 11:30 am - 1:00 pm, Essex Ballroom

Yulia Landa1,2, Kim Mueser3, Michael Jacobs1, Rachel Jespersen1,2, Katarzyna Wyka4, Carrie Swiderski1, Connie Cahalan5, JJ Gossrau5, Aubrey Doss6, Valerie Reyna7, David Silbersweig8; 1Icahn School of Medicine at Mount Sinai, New York, NY, USA, 2James J. Peters VA Medical Center, Bronx, NY, USA, 3Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA, 4City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA, 5Missouri Department of Mental Health, Division of Behavioral Health, Jefferson City, MO, USA, 6Ozark Center, Joplin, MO, USA, 7Center for Behavioral Economics and Decision Research, Cornell University, NY, USA, 8Brigham and Women's Hospital , Harvard Medical School, Boston, MA, USA

To decrease the severity of symptoms and functional impairment in youth at high risk of developing psychosis we have established a comprehensive Group and Family-based Cognitive Behavioral Therapy Program (GF-CBT). GF-CBT, which is grounded in theory and research on information processing in delusions, decision making, memory and behavioral change, teaches youth at-risk strategies for reducing biased information processing in order to prevent the formation of delusional beliefs. Families learn CBT techniques to support, encourage and maintain use of these skills at home. Two mixed methods studies were completed: a pilot open trial to evaluate the program’s feasibility and a pilot randomized controlled trial to evaluate its efficacy, as compared to symptom monitoring, over a 2-year follow-up. Nineteen youth ages 12-25 and 20 family members participated. Results support the feasibility and preliminary efficacy of GF-CBT, as evidenced by high levels of program satisfaction and significant remission rates among GF-CBT participants, with the majority no longer meeting ARMS criteria post-CBT, and maintaining recovery at the follow-up. At post-treatment GF-CBT group showed greater decreases in positive and negative symptoms (CAARMS) as well as improvements in functioning (SOFAS). The difference between groups increased over time. As part of the SAMHSA funded project to improve outcomes for as many as 2,000 youth and their families affected by, or at risk of, early onset psychosis in the State of Missouri, GF-CBT has been implemented in 3 DMH clinics. GF-CBT state-wide implantation, including clinician training and “Train-the-Trainer” procedures to allow sustainability of the intervention will be discussed.

Topic Area: Ultra High Risk / Prodromal Research

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