Adaptation of Cognitive Enhancement Therapy for persons at Psychosis High Risk

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 DESCRIPTION (provided by applicant): Persons at clinical high risk (CHR) state for psychosis are characterized by attenuated or transient psychotic episodes, trait vulnerability and functional deficits. If untreated, a significant proportion of CHR individuals have adverse outcomes, including conversion to psychosis, other psychopathology and functional deterioration. Despite enhanced CHR research focus over the past decade there are few established prevention approaches. This proposal seeks to develop, evaluate feasibility, acceptability and obtain preliminary data on efficacy of a novel manualized approach for cognitive enhancement, the Cognition for Learning and for Understanding Everyday Social Situations (CLUES) in individuals at clinical high risk (CHR) for psychosis. This approach is based on the principles and approaches of cognitive enhancement therapy (CET), shown by this research group to have efficacy, generalizability to functional outcome, durability and possible neuroprotective effects. In Phase 1 (0-6 months) we will adapt CET techniques to the symptomatic, functional, and developmental features of CHR, train staff and develop assessment procedures and a manual for the CLUES intervention with the help of a focus group and input from an advisory group of experts. In phase 2, using a feasibility trial (n=8) we will assess acceptability, tolerability, treatment adherence, treatment fidelity, and obtain preliminary evidence of target engagement (i.e. change in cognition and social cognition). .In Phase 3 (19-36 months) we will conduct a randomized control trial to generate pilot efficacy, generalization to functional outcome, durability and tolerability data on CLUES in CHR individuals (n=30). These data will serve as a prerequisite to a later, larger-scale intervention study of CLUES in the CHR population.