Psychotherapy for Psychosis, Adverse Events, and Substance Misuse

• Status: Not yet recruiting
• Trial end date: 2023-01-15
• Target enrollment: 0
• Participant gender: All

Summary

Research has found that adversity (e.g., abuse) and substance use (i.e., drug and alcohol use) influence an individual with a psychotic disorder's recovery: people with psychosis have significantly higher rates of adversity and substance use than people with other mental illnesses. Currently, there are few treatment options for people living with psychosis, substance misuse, and adversity-related symptoms (e.g. anxiety, depression). This is especially true for young adults who are in the first years of a psychotic illness (i.e., early phase psychosis; EPP) who may be in the best position to benefit from treatment. Research has demonstrated that Prolonged Exposure (PE), a psychological therapy, may be appropriate for people in EPP, although there is limited evidence regarding its adaptation from use in chronic psychosis to EPP. The aim of the proposed study is to adapt and optimize PE therapy for young adults in EPP. We aim to recruit 20 individuals from the Nova Scotia Early Psychosis Program (NSEPP) aged 19-35 who will participate in 15 sessions of adapted PE; we will compare their scores before and after treatment on measures of psychotic symptoms, amount and frequency of substance use, and adversity-related problems. Our goal is to improve two qualities that may be contributing to worse outcomes: avoidance and hopelessness. These are addressed by facing feared reminders of adversity and learning new ways to think about adverse experiences and mental health problems. The application of this evidence-based intervention has the potential to create a new treatment avenue for EPP, reducing impairment and distress, and improving recovery rates.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Nova Scotia Health Authority
• Collaborators: Killam Laureates; Queen Elizabeth II Health Sciences Centre Foundation; Research Nova Scotia
• Treatments: Antipsychotic Agents

Criteria

Inclusion Criteria:

• Current patient at the Nova Scotia Early Psychosis Program (NSEPP)

• Aged 19-35 years

• Diagnosis of a primary psychotic disorder (i.e., schizophrenia, schizoaffective disorder, schizophreniform disorder, delusional disorder, brief psychotic disorder, other specified schizophrenia spectrum and other psychotic disorder, unspecified schizophrenia spectrum and other psychotic disorder)

• Diagnosis of a primary psychotic disorder within the past 5 years; participants must not surpass this 5-year diagnostic window whilst enrolled in the study

• Have experienced 1 or more negative, distressing lifetime adverse events (e.g., child abuse, discrimination) listed on the Trauma and Life Events (TALE) checklist that the participant indicates still affects them now

• At least one score within the "moderate" or "high" risk range for any substance (excluding tobacco products) on the WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)

• Speaks and understands English

Exclusion Criteria:

• Aged 36 and older

• Aged 18 and younger

• Primary diagnosis of cocaine or methamphetamine addiction

• Participant does not speak or understand English

• Current involuntary inpatient admission in a hospital or under a Community Treatment Order

• Diagnosed intellectual disability