Graduated Recovery Intervention Program for Enhancing Treatment for First-Episode Psychosis

University of North Carolina (UNC)

Status: Completed

Conditions: Psychotic Disorders; Schizophrenia

Treatments: Behavioral: Graduated Recovery Intervention Program (GRIP); Behavioral: Treatment as usual (TAU)

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT00307216

R34MH071252 (U.S. NIH Grant/Contract)

DATR A2-AISZ

Details and patient eligibility

About

This study will determine the effectiveness of the Graduated Recovery Intervention Program, a manual-based individual therapy program, in enhancing the clinical benefit of routine treatment for individuals recovering from their first episodes of psychosis.

Full description

Several mental disorders can be classified as psychotic disorders, such as schizophrenia and manic depression. Psychosis is a defining feature of psychotic disorders, and is characterized by delusions and hallucinations that result in extreme impairment of a person's ability to think clearly. First-episode psychosis refers to the first time someone experiences psychotic symptoms or a psychotic episode. The symptoms can be disturbing and unfamiliar to those who have not previously experienced them. The person experiencing first-episode psychosis may not understand what is happening, and may become confused and distressed. Psychosis is treatable, however, and most people recover. Standard treatment for psychosis entails a combination of behavioral therapy and drug therapy. GRIP is a comprehensive psychosocial intervention for people recovering from an initial episode of non-affective psychosis. The purpose of GRIP is to improve occupational functioning after first-episode psychosis and promote goal pursuit and effective illness self-management. This study will determine the effectiveness of GRIP in enhancing the clinical benefit of routine treatment for individuals recovering from their first episodes of psychosis.

Participants in this study will be randomly assigned to receive either treatment as usual (TAU) or TAU plus GRIP. Participants receiving TAU will meet with their case-manager and health care providers on an as-needed basis. Participants assigned to receive TAU plus GRIP will attend therapy sessions weekly for up to 36 weeks, in addition to routine appointments. GRIP includes four phases, each of which focuses on one of the following topics: engagement and wellness management; substance use; persistent symptoms; and functional recovery. Assessments of social functioning, psychotic symptoms, attitudes toward treatment, substance use, and hospital readmission rate will be assessed at baseline, mid-treatment, post-treatment, and at the follow-up visit 3 months post-treatment.

Enrollment: 46 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Meets DSM-IV criteria for schizophrenia, schizophreniform disorder, or schizoaffective disorder
• Has been in treatment for psychosis for less than 3 years
• Clinically stable (based on clinician judgement)
• IQ score greater than 70
• Currently receiving keyworker services at UNC Hospital's OASIS program

Exclusion criteria

• Organic brain disorder
• Substance-induced psychotic disorder
• Mental retardation

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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46 participants in 2 patient groups

1

Experimental group

Description:

Participants will receive Graduated Recovery Intervention Program plus treatment as usual

Treatment:

Behavioral: Treatment as usual (TAU)

Behavioral: Graduated Recovery Intervention Program (GRIP)

2

Active Comparator group

Description:

Participants will receive treatment as usual

Treatment:

Behavioral: Treatment as usual (TAU)