Increasing Access to Evidence-Based CHR-P Assessment and Treatment Via Stepped-Care in Community-based Settings
University of California, Davis
Summary
This is a dissemination and implementation study that is evaluating a stepped-care intervention for identifying and treating youths at clinical high-risk for psychosis within multiple community mental health centers.
Description
The study aims to increase the capacity to identify and treat youths at clinical high-risk for psychosis (CHRp) across Sacramento, CA by disseminating and implementing in community mental health clinics (CMHCs) universal screening and a stepped-care, team-based intervention that includes training and ongoing support in a Cognitive Behavioral Therapy package called Cognitive Behavioral Case Management (CBCM). The study is being conducted in nine non-psychosis specialty CMHCs across 5 agencies, all of which treat young people with public insurance (Medi-Cal/Medicaid) or no insurance. All youths…
Eligibility
- Age range
- 12–25 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: 1. Clinical High Risk for Psychosis Syndrome as assessed by the mini-SIPS 2. Aged between 12-25 years old 3. Receiving care in one of six identified community mental health clinics 4. Eligibility for Sacramento County Medicare 5. Ability to provide informed consent Exclusion Criteria: 1. Intellectual disability (IQ\<70) 2. Urgent clinical need for a higher level of care
Interventions
- BehavioralStepped-Care including Cognitive Behavioral Case Management
Step 1:assessment and feedback, general engagement strategies, assessment of needs and social determinants of health, begin case management, goal setting. Step 2: TAU. Initiation of team-based care at community clinics and 'enhanced monitoring'. Step 3: atheoretically-based stress management skills (stress thermometer, coping skills and coping plans), problem solving strategies. Step 4: targeted intervention for CHRp. Initiation of formulation-based CBT modules, therapy consultation groups with the UC Davis team (UCD), regular meetings between clinic leadership and UCD. Participants may switch providers to increase level of early psychosis specialization. Step 5: add prescriber consultation groups with UCD. Step 6: assessment of trauma and family conflict then Family-Focused Therapy, Trauma-Focused Cognitive Behavioral Therapy, or CBT for CHR at UCD. Termination: At 24 months, referral to UCD coordinated specialty care clinic or other appropriate service for those still CHRp+.
Locations (6)
- River Oak Center for ChildrenElk Grove, California
- Turning Point Community ProgramsElk Grove, California
- University of California Department of Psychiatry and Behavioral Sciences; Early Psychosis ProgramsSacramento, California
- University of California-Davis CAARE Diagnostic and Treatment CenterSacramento, California
- Capital Star Community ServicesSacramento, California
- Heartland Child and Family ServicesSacramento, California