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)： 许多精神障碍患者报告称经历了阈值下的临床高峰期 青春期的风险(CHR)症状。在#年的早期阶段识别和参与青年 精神病可以促进症状监测，早期治疗可以最大限度地恢复。这个 这项研究的目的是确定在精神科住院的青少年 新出现的慢性阻塞性肺疾病症状，并为他们和他们的照顾者登记一个简短的治疗 参与干预。具体目标是：1)发展简短的以家庭为基础的干预 并在随机对照试验(RCT)中引导干预；2)评估 治疗机制被认为是干预的基础；以及3)评估这些关系 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项 循证单元：评估、心理教育和动机增强。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。内容将在使用现有的 旨在增强干预范围和覆盖范围的移动平台(例如，跟踪 转诊，监测症状，并提供持续的材料访问)。为了发展和发展 使干预措施适应住院环境，将试行循证内容 确定青少年和父母，并进行定性访谈，以探索意见 关于干预内容和交付。这项试点将在家长和青少年中进行 (n=16-30个二元组)使用迭代方法来最终确定内容。接下来，RCT将是 通过更大的样本(n=80个二元组)进行，以及在1个月和3个月时测量的结果 随访，将与照常治疗组进行比较。主要结果将是 参与所谓的治疗机制(即心理健康知识、态度 走向治疗、家庭伙伴关系)。次要结果包括门诊服务使用情况和 完成到州协调专科护理(CSC)诊所的转诊，这是一种早期精神病 提供门诊病例管理的计划，以支持服务过渡和持续 监控。这项研究的主要目标是评估该方案的可行性和可接受性 简要干预，并探讨干预的介入机制和影响 关于服务使用结果。这项拟议的研究具有创新性，因为它提供了专门的 从青少年住院病房开始到出院后继续进行慢性阻塞性肺疾病的干预 症状监测家庭支持计划。新型干预计划可以增强 与正在进行的精神卫生保健相联系，这是改善慢性精神分裂症结果的关键一步。

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.