Applying the cultural adaption framework to the Early Youth Engagement (EYE-2) approach to early intervention in psychosis.

OBJECTIVES: Disengagement from Early Intervention in Psychosis (EIP) services is pronounced in individuals from racially minoritized or diverse ethnic backgrounds, lesbian, gay, bisexual, transgender, and queer or questioning individuals, and individuals from some religious or spiritual backgrounds. The Early Youth Engagement in first episode psychosis study (EYE-2) is a cluster randomized controlled trial that tests a new engagement intervention. The current study aimed to (i) explore perspectives of service users from diverse backgrounds in relation to spirituality, ethnicity, culture and sexuality on engagement and the EYE-2 approach and (ii) use an evidence-based adaptation framework to incorporate their needs and perspectives into the EYE-2 resources and training. METHODS: This qualitative study used semi-structured interviews to explore service users' experiences and perspectives on EYE-2 approaches and resources. The study was conducted within EIP teams across three inner-city sites in England chosen to reflect diverse urban populations. Topic guides covered participant's identity, perceptions of EYE-2 resources, and experience of using mental health services. Transcribed interviews underwent thematic analysis. RESULTS: In this study, 21 service users aged 18 to 35 (M = 25.4; SD = 5.5) participated in semi-structured interviews. Seven key themes were identified across the four domains of the cultural adaptation framework: Differing cognitions and beliefs; multiple facets of culture; language as a barrier to engagement; stigma and discrimination; adaptations to EYE-2 resources; trust in therapeutic alliance; and individual differences in therapeutic preferences. CONCLUSIONS: The emergent themes highlighted a need to cater to various aspects of cultural diversity when developing EIP materials and services.

Combined individual and family therapy in comparison to treatment as usual for people at-risk of psychosis: A feasibility study (IF CBT): Trial rationale, methodology and baseline characteristics.

AIMS: Current National Institute for Health and Care Excellence (NICE) guidelines for psychosis recommend psychological therapy with or without family intervention for individuals at-risk of developing psychosis. NICE guidelines have a specific research recommendation to investigate the clinical and cost effectiveness of combined individual and family intervention. We report the rationale, design and baseline characteristics of a feasibility study which aimed to investigate combined Individual and Family Cognitive Behavioural Therapy (IFCBT) for those at-risk of developing psychosis. METHODS: The IFCBT study was a single blind, pilot randomized controlled trial (RCT) to compare a combined individual and family Cognitive Behavioural Therapy (CBT) intervention to treatment as usual. Participants were assessed using the Comprehensive Assessment of the At-risk Mental State (CAARMS) and randomly allocated to either therapy or enhanced treatment as usual (ETAU). All participants were followed up at 6 and 12 months. Primary feasibility outcomes were recruitment and retention of participants. Secondary outcomes included transition to psychosis and assessment of mood, anxiety and the relationship of the individual and nominated family member. RESULTS: We report data showing entry into the study from initial enquiry to randomization. We report the characteristics of the recruited sample of individuals (n = 70) and family members (n = 70) at baseline. CONCLUSIONS: The study recruited to 92% of target demonstrating it is feasible to identify and recruit participants. Our study aimed to add to the current evidence base regarding the utility of family interventions for people at-risk of psychosis.