Development of a group and family-based cognitive behavioural therapy program for youth at risk for psychosis

Yulia Landa*, Kim T. Mueser, Katarzyna E. Wyka, Erica Shreck, Rachel Jespersen, Michael A. Jacobs, Kenneth W. Griffin, Mark van der Gaag, Valerie F. Reyna, Aaron T. Beck, David A. Silbersweig, John T. Walkup

*Corresponding author for this work

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: The onset of psychosis typically occurs during adolescence or early adulthood and can have a detrimental impact on social and cognitive development. Cognitive behavioural therapy (CBT) shows promise in reducing the risk of psychosis. Teaching families to apply CBT with their offspring may bolster therapeutic gains made in time-limited treatment. We developed a comprehensive group-and-family-based CBT (GF-CBT) program that aims to facilitate psychosocial recovery, decrease symptoms and prevent transition to psychosis in youth at risk. GF-CBT is grounded in ecological systems and cognitive theories, resilience models and research on information processing in delusions. The theoretical rationale and description of GF-CBT are presented together with a pilot study that evaluated the program's feasibility and explored participants' outcomes. Methods: Youth ages 16–21 at risk for psychosis and their families participated in an open trial with pre, post and 3-month follow-up assessments conducted by an independent evaluator. The Comprehensive Assessment of At-Risk Mental States was the primary clinical outcome measure. Results: All enrolled participants (n = 6) completed GF-CBT and all remitted from at-risk mental state (ARMS). As a group participants showed statistically significant decreases in attenuated psychotic symptoms, negative symptoms, depression, cognitive biases and improvements in functioning. Family members showed significant improvements in use of CBT skills, enhanced communication with their offspring, and greater confidence in their ability to help. Gains were maintained at follow-up. Conclusions: GF-CBT may delay or prevent transition to psychosis in youth at risk, and potentially facilitate recovery from ARMS. More rigorous, controlled research is needed to further evaluate this program.

Original languageEnglish (US)
Pages (from-to)511-521
Number of pages11
JournalEarly Intervention in Psychiatry
Volume10
Issue number6
DOIs
StatePublished - Dec 1 2016

Fingerprint

Cognitive Therapy
Psychotic Disorders
Neurobehavioral Manifestations
Aptitude
Delusions
Automatic Data Processing
Research
Ecosystem
Teaching
Communication
Outcome Assessment (Health Care)
Depression
Therapeutics

Keywords

  • adolescent
  • cognitive therapy
  • family
  • prevention
  • psychosis

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Landa, Yulia ; Mueser, Kim T. ; Wyka, Katarzyna E. ; Shreck, Erica ; Jespersen, Rachel ; Jacobs, Michael A. ; Griffin, Kenneth W. ; van der Gaag, Mark ; Reyna, Valerie F. ; Beck, Aaron T. ; Silbersweig, David A. ; Walkup, John T. / Development of a group and family-based cognitive behavioural therapy program for youth at risk for psychosis. In: Early Intervention in Psychiatry. 2016 ; Vol. 10, No. 6. pp. 511-521.
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abstract = "Objective: The onset of psychosis typically occurs during adolescence or early adulthood and can have a detrimental impact on social and cognitive development. Cognitive behavioural therapy (CBT) shows promise in reducing the risk of psychosis. Teaching families to apply CBT with their offspring may bolster therapeutic gains made in time-limited treatment. We developed a comprehensive group-and-family-based CBT (GF-CBT) program that aims to facilitate psychosocial recovery, decrease symptoms and prevent transition to psychosis in youth at risk. GF-CBT is grounded in ecological systems and cognitive theories, resilience models and research on information processing in delusions. The theoretical rationale and description of GF-CBT are presented together with a pilot study that evaluated the program's feasibility and explored participants' outcomes. Methods: Youth ages 16–21 at risk for psychosis and their families participated in an open trial with pre, post and 3-month follow-up assessments conducted by an independent evaluator. The Comprehensive Assessment of At-Risk Mental States was the primary clinical outcome measure. Results: All enrolled participants (n = 6) completed GF-CBT and all remitted from at-risk mental state (ARMS). As a group participants showed statistically significant decreases in attenuated psychotic symptoms, negative symptoms, depression, cognitive biases and improvements in functioning. Family members showed significant improvements in use of CBT skills, enhanced communication with their offspring, and greater confidence in their ability to help. Gains were maintained at follow-up. Conclusions: GF-CBT may delay or prevent transition to psychosis in youth at risk, and potentially facilitate recovery from ARMS. More rigorous, controlled research is needed to further evaluate this program.",
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Landa, Y, Mueser, KT, Wyka, KE, Shreck, E, Jespersen, R, Jacobs, MA, Griffin, KW, van der Gaag, M, Reyna, VF, Beck, AT, Silbersweig, DA & Walkup, JT 2016, 'Development of a group and family-based cognitive behavioural therapy program for youth at risk for psychosis', Early Intervention in Psychiatry, vol. 10, no. 6, pp. 511-521. https://doi.org/10.1111/eip.12204

Development of a group and family-based cognitive behavioural therapy program for youth at risk for psychosis. / Landa, Yulia; Mueser, Kim T.; Wyka, Katarzyna E.; Shreck, Erica; Jespersen, Rachel; Jacobs, Michael A.; Griffin, Kenneth W.; van der Gaag, Mark; Reyna, Valerie F.; Beck, Aaron T.; Silbersweig, David A.; Walkup, John T.

In: Early Intervention in Psychiatry, Vol. 10, No. 6, 01.12.2016, p. 511-521.

Research output: Contribution to journalArticle

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T1 - Development of a group and family-based cognitive behavioural therapy program for youth at risk for psychosis

AU - Landa, Yulia

AU - Mueser, Kim T.

AU - Wyka, Katarzyna E.

AU - Shreck, Erica

AU - Jespersen, Rachel

AU - Jacobs, Michael A.

AU - Griffin, Kenneth W.

AU - van der Gaag, Mark

AU - Reyna, Valerie F.

AU - Beck, Aaron T.

AU - Silbersweig, David A.

AU - Walkup, John T.

PY - 2016/12/1

Y1 - 2016/12/1

N2 - Objective: The onset of psychosis typically occurs during adolescence or early adulthood and can have a detrimental impact on social and cognitive development. Cognitive behavioural therapy (CBT) shows promise in reducing the risk of psychosis. Teaching families to apply CBT with their offspring may bolster therapeutic gains made in time-limited treatment. We developed a comprehensive group-and-family-based CBT (GF-CBT) program that aims to facilitate psychosocial recovery, decrease symptoms and prevent transition to psychosis in youth at risk. GF-CBT is grounded in ecological systems and cognitive theories, resilience models and research on information processing in delusions. The theoretical rationale and description of GF-CBT are presented together with a pilot study that evaluated the program's feasibility and explored participants' outcomes. Methods: Youth ages 16–21 at risk for psychosis and their families participated in an open trial with pre, post and 3-month follow-up assessments conducted by an independent evaluator. The Comprehensive Assessment of At-Risk Mental States was the primary clinical outcome measure. Results: All enrolled participants (n = 6) completed GF-CBT and all remitted from at-risk mental state (ARMS). As a group participants showed statistically significant decreases in attenuated psychotic symptoms, negative symptoms, depression, cognitive biases and improvements in functioning. Family members showed significant improvements in use of CBT skills, enhanced communication with their offspring, and greater confidence in their ability to help. Gains were maintained at follow-up. Conclusions: GF-CBT may delay or prevent transition to psychosis in youth at risk, and potentially facilitate recovery from ARMS. More rigorous, controlled research is needed to further evaluate this program.

AB - Objective: The onset of psychosis typically occurs during adolescence or early adulthood and can have a detrimental impact on social and cognitive development. Cognitive behavioural therapy (CBT) shows promise in reducing the risk of psychosis. Teaching families to apply CBT with their offspring may bolster therapeutic gains made in time-limited treatment. We developed a comprehensive group-and-family-based CBT (GF-CBT) program that aims to facilitate psychosocial recovery, decrease symptoms and prevent transition to psychosis in youth at risk. GF-CBT is grounded in ecological systems and cognitive theories, resilience models and research on information processing in delusions. The theoretical rationale and description of GF-CBT are presented together with a pilot study that evaluated the program's feasibility and explored participants' outcomes. Methods: Youth ages 16–21 at risk for psychosis and their families participated in an open trial with pre, post and 3-month follow-up assessments conducted by an independent evaluator. The Comprehensive Assessment of At-Risk Mental States was the primary clinical outcome measure. Results: All enrolled participants (n = 6) completed GF-CBT and all remitted from at-risk mental state (ARMS). As a group participants showed statistically significant decreases in attenuated psychotic symptoms, negative symptoms, depression, cognitive biases and improvements in functioning. Family members showed significant improvements in use of CBT skills, enhanced communication with their offspring, and greater confidence in their ability to help. Gains were maintained at follow-up. Conclusions: GF-CBT may delay or prevent transition to psychosis in youth at risk, and potentially facilitate recovery from ARMS. More rigorous, controlled research is needed to further evaluate this program.

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