Sacramento Clinical High Risk for Psychosis Stepped-Care Program

Conditions

• Clinical High Risk for Psychosis
• Ultra High Risk for Psychosis

Eligibility Criteria

Sex

ALL

Age

12 Years - 25 Years

Healthy Volunteers

Not accepted

Interventions

• Stepped-Care including Cognitive Behavioral Case Management — BEHAVIORAL
  Step 1:assessment and feedback, general engagement strategies, assessment of needs and social determinants of health, begin case management, goal setting. Step 2: TAU. Initiation of team-based care at community clinics and 'enhanced monitoring'. Step 3: atheoretically-based stress management skills (stress thermometer, coping skills and coping plans), problem solving strategies. Step 4: targeted intervention for CHRp. Initiation of formulation-based CBT modules, therapy consultation groups with the UC Davis team (UCD), regular meetings between clinic leadership and UCD. Participants may switch providers to increase level of early psychosis specialization. Step 5: add prescriber consultation groups with UCD. Step 6: assessment of trauma and family conflict then Family-Focused Therapy, Trauma-Focused Cognitive Behavioral Therapy, or CBT for CHR at UCD. Termination: At 24 months, referral to UCD coordinated specialty care clinic or other appropriate service for those still CHRp+.

Study Details

This is a dissemination and implementation study that is evaluating a stepped-care intervention for identifying and treating youths at clinical high-risk for psychosis within multiple community mental health centers.

Key Dates

Start date

Mar 20, 2023

Status verified

Dec 2025

Primary completion

Oct 1, 2026

Completion

Oct 1, 2026

Study Design

Enrollment

223 participants (estimated)

Allocation

NA

Intervention model

SINGLE_GROUP

Primary purpose

TREATMENT

Arms

• Experimental: Cognitive Behavioral Case Management
  Once youths are identified with a clinical high risk for psychosis (CHRp) syndrome they will begin a 2-year, 6 step intervention. They will be assessed every 6 months. If youths continue to meet CHRp criteria they will move into the next step. If they no longer meet criteria they exit the study and resume standard care. If they develop psychosis or reach the end of the 2-year intervention they can move to EDAPT, a psychosis specialty clinic or work with personnel to find a more appropriate clinical service.

Primary Outcome Measure

Feasibility: The number of youth at clinical high risk for psychosis enrolled in stepped care over the course of the intervention. [ Time Frame: 2, 3, or 4 years depending on site ]

Central Contacts

• Daniel I Shapiro, PhD
  916-734-7875
  [email protected]
• Maria Pagador
  916-799-4932
  [email protected]

Locations (6)

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