Individualized vocational and educational support and training for youth at clinical high risk for psychosis

Abstract

Aim: Early intervention for psychosis has been of high interest in the past two decades. Research demonstrates that clinical high risk for psychosis (CHR-p) populations experience impairments in role functioning. Although several vocational and cognitive interventions exist for people living with psychosis, there are no known evidence-based treatments for role functioning difficulties during the CHR-p stage. There is clear evidence for a need for interventions that directly target role functioning.

Methods: This paper describes the theoretical development and implementation of a novel intervention targeting role functioning impairments: Individualized Vocational and Educational Support and Training (InVEST). The CEDAR Clinic, a specialized CHR-p coordinated specialty care (CSC) team, has worked to develop InVEST to target core aspects of role functioning, namely executive functioning, stress sensitivity, and task initiation. The intervention is cost-efficient, as bachelor level clinicians provide the service under supervision of licensed clinicians. This summary describes InVEST, provides a disguised case example, and presents initial exploratory data (N = 135) focused on the intervention's feasibility in this CSC program.

Results: Although these preliminary data are limited, available information suggests that InVEST may provide a core treatment modality within CHR-p treatment programs.

Conclusions: More research formally investigating InVEST with a larger sample would provide further evidence of the intervention's efficacy.

Keywords: CHR; clinical high risk; coordinated specialty care; psychosis; role functioning.