Overview
This study is intended to test the feasibility of an integrated cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) skills group for adolescents and young adults at clinical high-risk (CHR) for psychosis. The current study applies a skills group drawing from evidence-based practices (e.g., cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT)) to those at CHR for psychosis. Up to 30 CHR individuals (starting with a minimum of 3 participants, N accounts for attrition as well), aged 13-18, already receiving clinical services within the HOPE team at University of Pittsburgh will be offered a weekly skills group. Data collected on feasibility and outcome measures will occur within 1 month of the start of the group, at the midpoint (approximately 3-4 months after baseline), and at the end of the group (approximately 6-7 months after). Some measures will be collected continuously. Furthermore, measures will be collected after each group by the participants and leaders to assess feasibility. Taken together, the aim of the proposed group intervention is to provide novel insights regarding the utility of a newly developed intervention that integrates both CBT and DBT skills for those at CHR for psychosis.
Description
The goal of the current study is to integrate cognitive behavioral therapy and dialectical behavioral therapy skills and implement in a group format to a sample of individuals at risk for developing a psychotic disorder. These data have the potential to provide a foundation for intervention development in this area. The group will include weekly sessions for 90 minutes with up to 8 members in the group at a time. Each session will include mindfulness, homework review, and skill development. Each individual in the group will be asked to complete the group for 6 months. In the first section of the group, skills will be taught to manage and reduce stress. The second set of skills will include teaching individuals how to increase cognitive flexibility. The final section of the group will include helping participants improve social skills. Furthermore, parents will be asked to participate in a parent/guardian session 1x a month and will also be asked to also fill out a post-group surveys although this is not mandatory.
It is important to note that all hypotheses are exploratory given the feasibility nature of this study and the sample size. Even so, it is predicted, in an exploratory fashion, that this group will be feasible to implement and there will be improvements in symptoms and functioning at the midpoint (approximately 3-4 months after the start of the group) and post group (approximately 6-7 months from baseline).
Eligibility
Participant Inclusion Criteria:
- 13-18 years of age
- Meet criteria for clinical high-risk syndrome (i.e., at clinical high risk for developing a psychotic disorder). CHR status is determined based off of scoring a 3 (moderate) - 5 (severe) on the Structured Interview for Psychosis-Risk Syndromes and/or having a first degree relative with psychotic disorder and/or the individual meets criteria for schizotypal personality disorder. Additionally individuals with a brief intermittent psychotic symptoms can be included as well (e.g., frankly psychotic symptoms that are very brief)
- Individuals must be enrolled in the HOPE team at the University of Pittsburgh since this group is embedded within that service
Participation Exclusion Criteria:
- Group member meeting criteria for a current/past psychotic disorder
Inclusion Criteria for Parents or Legal Guardians:
- Must be the parent, legal guardian of a 13-18 year-old
- For parents of CHR adolescents, their adolescent must meet criteria for a psychosis-risk syndrome