Gender-affirming care in the assessment and treatment of psychosis risk: Considering minority stress in current practice and future research.

Introduction: Although research has documented the marked disparities in rates of psychosis-spectrum diagnoses in various socially marginalized populations, there is limited research addressing the needs of gender expansive individuals in the context of psychosis-spectrum illnesses using a minority stress lens. As clinical high-risk for psychosis (CHR-p) assessment and treatment becomes accessible to increasingly diverse populations, there is a need for clinicians to demonstrate greater clinical competency working with individuals across diverse social backgrounds and identities.

Methods: We examined rates of gender expansive (GE) patients seeking evaluation at an urban-based CHR-p clinic and compared the diagnostic profile of GE individuals to cisgender patients.

Family-focused therapy for individuals at high clinical risk for psychosis: A confirmatory efficacy trial.

Aims: Young people with attenuated psychotic symptoms (APS), brief intermittent psychosis, and/or genetic risk and functional deterioration are at high risk for developing psychotic disorders. In a prior trial, family-focused therapy for clinical high risk youth (FFT-CHR) was more effective than brief psychoeducation in reducing APS severity over 6 months. This 7-site trial will compare the efficacy of FFT-CHR to a psychoeducational and supportive intervention (enhanced care) on APS and social functioning in CHR individuals over 18 months.

Neurocognitive and social cognitive training for youth at clinical high risk (CHR) for psychosis: A randomized controlled feasibility trial.

Background: Cognitive deficits are present in individuals at clinical high risk for psychosis (CHRP). We developed Cognition for Learning and for Understanding Everyday Social Situations (CLUES), an integrated social- and neurocognitive remediation intervention for CHRP, and examined its feasibility and efficacy compared to an active control intervention in a pilot randomized controlled trial.

Method: Thirty-eight individuals at CHR-P were randomized to CLUES or Enriched Acceptance and Commitment Therapy (EnACT).

Development of a Boston Treatment Program for Youth at Clinical High Risk for Psychosis: Center for Early Detection, Assessment, and Response to Risk (CEDAR).

Over the past two decades, increasing attention has been given to the importance of early intervention for psychosis. This article describes the development of the Center for Early Detection, Assessment and Response to Risk (CEDAR), which focuses on early identification and treatment of youth at clinical high risk for psychosis. There are relatively few models in the United States for such programs, and we present our developmental story, focusing mainly on the CEDAR Clinic, as a case study of how such a program can develop.

Predictors of distress and hope in relatives of individuals with schizophrenia.

Background: The present study was conducted to examine factors that may be targeted by psychoeducation programs in order to reduce distress and increase hope in family members of individuals with schizophrenia.

Method: Using separate stepwise multiple regressions, we examined the relationships among 51 family members' reactions to a loved one's illness (adaptive and maladaptive coping strategies, criticism, overinvolvement, and blaming attributions) and distress and hope.

Results: Maladaptive coping strategies significantly predicted more distress and less hope in participants.

Family-directed cognitive adaptation for schizophrenia.

Cognitive impairment is pervasive in schizophrenia and is a major cause of poor functioning and caregiver burden. However, there are few treatments specifically aimed at helping families cope with a relative's cognitive difficulties and reducing the effects of cognitive impairments on the client's daily functioning. Family-directed cognitive adaptation (FCA) is a 16-session treatment developed to address this need.