Integrating Psychosis Recovery by Enabling Adult Carers at Home in an Early Psychosis Clinic (p-REACH)

Research has shown that psychosis is not only detrimental to the individual, but it is also highly disruptive to the family system. Early comprehensive and evidence-based interventions for psychosis, that target both the individual and their support system, increase the likelihood of long-term positive outcomes.

Psychosis REACH (p-REACH) is a training model that has been demonstrated to positively impact caregiver self-reported depression, anxiety and negative aspects of caregiver experience, less pejorative views toward psychosis and reduced tension in the home environment. Participants are trained by both experts and family peers in key Cognitive Behavioral Therapy for Psychosis skills to support their loved one who has a diagnosis of psychotic disorder.

Funding from an MRI grant is supporting Dr. Kate Hardy, Clinical Professor in the Stanford University Department of Psychiatry and Behavioral Sciences, to develop a pilot study fully integrating Psychosis REACH training within an early psychosis service. Drawing upon work conducted in collaboration with the University of Washington she will collect data on the following:

 1) the feasibility and acceptability of this intervention delivered within an early psychosis service,

2) the effectiveness of the p-REACH intervention on caregiver outcomes (depression and anxiety, expressed emotion, perceptions of caregiver burden, and attitudes toward psychosis) and patient treatment engagement (attendance, missed sessions, and drop out) and patient hospitalizations,

3) the qualitative experience of families participating in p-REACH training and ongoing group coaching.

Results from this pilot study will support further research efforts to explore the effectiveness of integrating CBTp informed skills for families within early psychosis care with the overarching aim of maintaining effective and supportive familial relationships that can otherwise become so easily disrupted due to psychosis.

Sophie Suberville