Perceived Autonomy Support in the NIMH RAISE Early Treatment Program

Psychiatr Serv. 2017 Sep 1;68(9):916-922. doi: 10.1176/ Epub 2017 Jun 1.


Objective: This study examined perceived support for autonomy-the extent to which individuals feel empowered and supported to make informed choices-among participants in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). The aims of this study were to evaluate whether NAVIGATE, the active treatment studied in RAISE ETP, was associated with greater improvements in perceived autonomy support over the two-year intervention, compared with community care, and to examine associations between perceived autonomy support and quality of life and symptoms over time and across treatment groups.

Methods: This study examined perceived autonomy support among the 404 individuals with first-episode psychosis who participated in the RAISE ETP trial (NAVIGATE, N=223; community care, N=181). Three-level conditional linear growth modeling was used given the nested data structure.

Results: The results indicated that perceived autonomy support increased significantly over time for those in NAVIGATE but not in community care. Once treatment began, higher perceived autonomy support was related to higher quality of life at six, 12, and 18 months in NAVIGATE and at 12, 18, and 24 months in community care. Higher perceived autonomy support was related to improved scores on total symptoms and on excited symptoms regardless of treatment group and time.

Conclusions: Overall, perceived autonomy support increased in NAVIGATE but not for those in community care and was related to improved quality of life and symptoms across both treatment groups. Future research should examine the impact of perceived autonomy support on a wider array of outcomes, including engagement, medication adherence, and functioning.

Keywords: Psychoses; Psychotherapy; Recovery; Schizophrenia.

MeSH terms

  • Adult
  • Community Health Services / methods*
  • Early Medical Intervention / methods*
  • Female
  • Humans
  • Male
  • National Institute of Mental Health (U.S.)*
  • Outcome and Process Assessment, Health Care*
  • Personal Autonomy*
  • Psychotic Disorders / therapy*
  • Schizophrenia / therapy*
  • Social Support*
  • United States
  • Young Adult