Culturally Informed Therapy for Families in an Early Psychosis Clinic

Psychosis extends beyond the individual experiencing symptoms. It often reshapes family systems, influencing communication patterns, caregiving roles, cultural expectations, and the emotional tone of daily life. For many families, supporting a loved one during early psychosis involves navigating uncertainty, shifting responsibilities, and unfamiliar treatment systems, all within a developmentally sensitive period.

In the MRI-funded project Culturally Informed Therapy (CIT) for Families in an Early Psychosis Clinic, Dr. Olivia Altamirano (Stanford University, Department of Psychiatry and Behavioral Sciences) examined how a culturally responsive, family-centered intervention could be adapted for use in an early psychosis care setting. The project was implemented within Stanford’s INSPIRE Clinic, with the aim of supporting both individual recovery and family relational functioning during early stages of illness.

Culturally Informed Therapy is a family-based cognitive-behavioral intervention that integrates psychoeducation, communication training, problem-solving, and attention to collectivism and spirituality. Rather than treating culture as a contextual variable, CIT positions families’ values, belief systems, and meaning-making processes as central components of the therapeutic framework. This orientation reflects the understanding that families often draw on cultural and spiritual resources to interpret illness, manage distress, and sustain connection.

For this study, the CIT model was adapted to the context of early psychosis care. The intervention consisted of 15 sessions organized across five modules: family collectivism, psychoeducation, spirituality, communication, and problem-solving. Group-based delivery emphasized shared learning and cohesion, while also supporting participants in applying skills to ongoing caregiving and relational challenges.

The project reflects MRI’s longstanding focus on systemic and interactional processes. Early psychosis frequently emerges during late adolescence and early adulthood—a period marked by shifts in autonomy, identity, and family roles. By engaging families directly, the study examined how strengthening the relational environment may support adjustment during this transition.

As the project moved into implementation, several practical challenges emerged. Recruitment and retention were affected by factors common to clinical settings, including difficulties contacting families, changes in care arrangements, hospitalizations, and the logistical demands of coordinating group-based treatment. Eleven participants enrolled in the intervention, the majority of whom were caregivers, and three completed the full course of treatment.

Although analyses are ongoing, preliminary findings were presented at the 2025 Annual Association for Behavioral and Cognitive Therapies conference, with MRI acknowledged as the funding source. Early patterns suggested that caregivers who enrolled in CIT were more likely to report adaptive forms of religious coping at baseline. Other findings related to religious orientation and acculturation were limited by sample size, highlighting both the potential relevance of culturally informed frameworks and the challenges of conducting family-based intervention research in applied settings.

The project also contributed to training and dissemination. Graduate students co-facilitated intervention groups and received ongoing supervision, while research assistants supported recruitment and coordination. MRI funding supported trainee involvement in conference presentations, extending the project’s impact to clinician and researcher development.

This work offers a practice-informed view of the opportunities and constraints involved in implementing culturally responsive, family-centered interventions in early psychosis care. It underscores the importance of engaging families not only through clinical symptoms, but through the relational, cultural, and meaning-making systems that shape how they experience and respond to illness. In doing so, the project contributes to a growing emphasis on treatment models that are both relationally grounded and contextually responsive.