An Integrated Cognitive Behavioral Approach to Address Comorbid Trauma and Psychosis within Coordinated Specialty Care
Poster C21, Wednesday, October%2010, 11:30%20am%20-%201:00%20pm, Essex%20Ballroom
Tara Niendam1, Khalima Bolden1, Angela Sardo1, Brandi Liles2, Dawn Blacker2, Laura Tully1; 1Department of Psychiatry & Behavioral Sciences, University of California-Davis, Sacramento, CA, 2CAARE Center, Department of Pediatrics, University of California-Davis, Sacramento, CA
Purpose: Youth who have trauma related symptoms may be at greater risk of experiencing early psychosis symptoms. However, trauma is often poorly diagnosed in individuals with psychosis, psychosis treatment does not target trauma symptoms, and youth with psychosis are often excluded from trauma-based treatment. We developed a comprehensive model, using evidence-based cognitive behavioral principles, to assess, conceptualize, and treat youth with both psychotic and trauma-related symptoms. Methods: Youth, ages 12-30, enrolled in the UC Davis Early Psychosis Coordinated Specialty Care (CSC) Program and diagnosed with both psychotic and trauma-related symptoms were provided via Trauma Integrated Cognitive Behavioral Therapy for Psychosis (TI-CBTp). The Clinical Global Impressions (CGI) Scale and Global Functioning (GF) Scales were collected at baseline and follow-up to examine impact of treatment on outcomes. Results: Since July 2014, 18 individuals with comorbid psychosis and trauma related symptoms were identified and provided TI-CBTp as part of CSC care. 75% had psychotic disorder diagnoses (onset within past 2 years); 25% were at Clinical High Risk for psychosis. 56% met criteria for PTSD; 44% reported notable trauma symptoms but did not meet PTSD criteria. At baseline, cases demonstrated markedly severe clinical and serious psychosocial impairments. At follow-up (N=7; avg=9.42 months), 86% of cases demonstrated improvement in overall clinical severity on the CGI and 57% improvement in GF. Data on long-term follow-up and additional outcome domains will be presented. Conclusions: Youth with psychotic and trauma-related symptoms can be appropriately treated using TI-CBTp. CSC intervention programs should directly treat trauma to improve client outcomes.
Topic Area: Psychosocial Interventions