A Treatment Engagement Protocol to Improve Follow-Up Care for Psychiatrically Hospitalized Adolescents at Clinical High Risk for Psychosis

项目摘要/摘要（30行）： 许多患有精神障碍的个体报告经历了阈下临床高血压， 青春期的危险症状。青年在早期阶段的识别和参与 精神病可以促进症状监测，早期治疗可以最大限度地恢复。的 本研究的目的是确定精神科住院的青少年谁目前与 新出现的过敏症状，并将他们和他们的照顾者纳入简短的治疗 参与干预。具体目标是：1）制定一项简短的以家庭为基础的干预措施 并在随机对照试验（RCT）中进行干预试验; 2）评估 治疗机制假定为干预的基础;和3）评估关系 建议的机制和服务使用之间的关系。拟议的干预措施包括三个 循证模块：评估、心理教育和激励增强。三 所谓的潜在机制将是有针对性的：心理健康素养，对 治疗和家庭伙伴关系。内容将在出院后使用现有的 设计用于扩大干预范围和范围的移动的平台（例如，轨道 转介，监测症状，并提供持续的材料）。以制订和 使干预措施适应住院环境，将试用循证内容， 确定青少年和家长，定性访谈将进行探讨意见 关于干预内容和交付。这项试验将与家长和青少年进行 （n = 16-30对）使用迭代方法最终确定内容。接下来，将进行RCT 采用较大样本（n = 80对）进行，并在1个月和3个月时测量结局 随访，将与常规治疗组进行比较。主要结果将是 参与所谓的治疗机制（即心理健康素养，态度 治疗，家庭伙伴关系）。次要结局包括门诊服务使用和 完成转诊到国家的协调专科护理（CSC）诊所，早期精神病 提供门诊病例管理的计划，以支持服务过渡和持续 监测.本研究的主要目标是评估 简要干预，并探讨干预的介入机制和影响 服务使用结果。拟议的研究是创新的，因为它提供了专门的 从青少年住院部开始并在出院后继续进行的干预， 症状监测家庭支持计划新的干预计划可能会提高 与正在进行的精神卫生保健联系起来，这是改善精神卫生保健结果的关键一步。

Project Summary/Abstract (30 lines): Many individuals with psychotic disorders report having experienced subthreshold clinical high risk (CHR) symptoms in adolescence. Identification and engagement of youth in early stages of psychosis can facilitate symptom monitoring, and early treatment maximizes recovery. The purpose of this study is to identify psychiatrically hospitalized adolescents who present with new-onset CHR symptoms and enroll them and their caregivers in a brief treatment engagement intervention. The specific aims are to: 1) develop a brief family-based intervention and pilot the intervention in a randomized control trial (RCT); 2) evaluate the engagement of therapeutic mechanisms presumed to underlie the intervention; and 3) evaluate the relations between the proposed mechanisms and service use. The proposed intervention includes three evidence-based modules: assessment, psychoeducation, and motivational enhancement. Three purported underlying mechanisms will be targeted: mental health literacy, attitudes toward treatment, and family partnership. Content will be reinforced after discharge using an existing mobile platform designed to enhance the scope and reach of the intervention (e.g., track referrals, monitor symptoms, and provide ongoing access to materials). In order to develop and adapt the intervention to the inpatient setting, evidence-based content will be piloted with identified teens and parents, and qualitative interviews will be conducted to explore opinions regarding intervention content and delivery. This pilot will be conducted with parents and teens (n = 16-30 dyads) using an iterative approach to finalize content. Next, an RCT will be conducted with a larger sample (n = 80 dyads), and outcomes, measured at 1- and 3-month follow-ups, will be compared to a treatment-as-usual group. Primary outcomes will be engagement of the purported therapeutic mechanisms (i.e. mental health literacy, attitudes toward treatment, family partnership). Secondary outcomes include outpatient service use and completion of referral to the state’s coordinated specialty care (CSC) clinic, an early psychosis program offering outpatient case management to support service transitions and ongoing monitoring. The broad goals of this study are to evaluate the feasibility and acceptability of the brief intervention, and to explore the intervention’s engagement of mechanisms and influence on service use outcomes. The proposed study is innovative because it offers specialized intervention for CHR starting on an adolescent inpatient unit and continuing after discharge with a symptom monitoring family support program. The novel intervention program may enhance linkage to ongoing mental health care, a step that is crucial for improving CHR outcomes.