Book contents
- An Ounce of Prevention
- An Ounce of Prevention
- Copyright page
- Dedication
- Contents
- Figures
- Contributors
- Acknowledgments
- Part One A Foundation in Prevention
- Part Two Prevention with Children and Youth
- Part Three Prevention with Emerging Adults
- Part Four Across the Lifespan: Adults and Families
- 12 Empowering Mothers and Promoting Resilience in Children Exposed to Intimate Partner Violence
- 13 Culturally Sensitive Health Promotion and Health Care to Prevent Chronic Diseases in Black Communities
- 14 PIER: A Clinical/Epidemiologic System for Prevention of Psychosis
- 15 Retirement Transition as a Preventive Intervention Target
- Part Five Closing
- Index
- References
14 - PIER: A Clinical/Epidemiologic System for Prevention of Psychosis
from Part Four - Across the Lifespan: Adults and Families
Published online by Cambridge University Press: 14 November 2024
Book contents
- An Ounce of Prevention
- An Ounce of Prevention
- Copyright page
- Dedication
- Contents
- Figures
- Contributors
- Acknowledgments
- Part One A Foundation in Prevention
- Part Two Prevention with Children and Youth
- Part Three Prevention with Emerging Adults
- Part Four Across the Lifespan: Adults and Families
- 12 Empowering Mothers and Promoting Resilience in Children Exposed to Intimate Partner Violence
- 13 Culturally Sensitive Health Promotion and Health Care to Prevent Chronic Diseases in Black Communities
- 14 PIER: A Clinical/Epidemiologic System for Prevention of Psychosis
- 15 Retirement Transition as a Preventive Intervention Target
- Part Five Closing
- Index
- References
Summary
This chapter describes Psychosis Identification and Early Referral (PIER), a clinical and public health system for identifying, treating, and rehabilitating young people at risk for major psychosis and psychotic disorders. A specialized clinical team educates key sectors of the community in identifying very early signs and symptoms of a likely psychosis in youth ages 10–25. The team then rigorously assesses those referred and found at risk and provides family-aided assertive community treatment. This model was originally developed for schizophrenia in young adults, and it has been adapted for the much younger and less seriously symptomatic and disabled at-risk population. The model includes flexible, in-vivo clinical treatment, family psychoeducation, cognitive-behavioral therapy, occupational therapy, supported education and supported employment, and psychiatric and nursing care. PIER has been tested across six population-representative sites in the United States; within testing periods, very few participating youths have experienced psychosis and about 90 percent are in school or working. It has been replicated widely enough that it is available to over 15 percent of the US population.
- Type
- Chapter
- Information
- An Ounce of PreventionEvidence-Based Prevention for Counseling and Psychology, pp. 280 - 312Publisher: Cambridge University PressPrint publication year: 2024
References
Baksheev, G. N., Allott, K., Jackson, H. J., McGorry, P. D., & Killackey, E. (2012). Predictors of vocational recovery among young people with first-episode psychosis: Findings from a randomized controlled trial. Psychiatric Rehabilitation Journal, 35(6), 421–427. doi.org/10.1037/h0094574CrossRefGoogle ScholarPubMed
Bond, G. R., Drake, R. E., & Luciano, A. (2015). Employment and educational outcomes in early intervention programmes for early psychosis: A systematic review. Epidemiologia e Psichiatria Sociale, 24(5), 446–457. doi.org/10.1017/S2045796014000419CrossRefGoogle ScholarPubMed
Brown, C., & Dunn, W. (2002). Adolescent/adult sensory profile: User’s manual. The Psychological Corporation.Google Scholar
Carswell, A., McColl, M. A., Baptiste, M. L., Polatajko, H., & Pollock, N. (2004). The Canadian occupational performance measure: A research and clinical literature review. Canadian Journal of Occupational Therapy, 71(4), 210–222. doi.org/10.1177/000841740407100406.CrossRefGoogle Scholar
Catalan, A., Salazar de Pablo, G., Vaquerizo Serrano, J., Mosillo, P., Baldwin, H., Fernandez-Rivas, A., Moreno, C., Arango, C., Correll, C. U., Bonoldi, I., & Fusar-Poli, P. (2021). Annual Research Review: Prevention of psychosis in adolescents – Systematic review and meta-analysis of advances in detection, prognosis and intervention. Journal of Child Psychology and Psychiatry and Allied Disciplines, 62(5), 657–673. doi.org/10.1111/jcpp.13322CrossRefGoogle ScholarPubMed
Dyck, D. G., Short, R. A., Hendryx, M. S., Norell, D., Myers, M., Patterson, T., McDonell, M. G., Voss, W. D., & McFarlane, W. R. (2000). Management of negative symptoms among patients with schizophrenia attending multiple-family groups. Psychiatric Services, 51(4), 513–519. doi.org/10.1176/appi.ps.51.4.513CrossRefGoogle ScholarPubMed
Eaton, W. W. (1999). Evidence for universality and uniformity of schizophrenia around the world: Assessment and implications. In Gattaz, W. F. & Hafner, H. (Eds.), Search for the causes of schizophrenia (Vol. IV, pp. 21–33). Steinkopf.CrossRefGoogle Scholar
U.K. Essays. (2013). Ensuring effective assessment in psychiatry and mental health nursing essay. UKEssays, November.Google Scholar
Falloon, I. R. (1992). Early intervention for first episodes of schizophrenia: A preliminary exploration. Psychiatry, 55(1), 4–15. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1557469CrossRefGoogle ScholarPubMed
Fisher, A. G., & Jones, K. B. (2010). Assessment of motor and process skills, Vol. 1: Development, standardization, and administration manual (7th ed.). Fort Collins, CO: Three Star Press.Google Scholar
Fjell, A., Thorsen, G. R. B., Friis, S., Johannessen, J. O., Larsen, T. K., Lie, K., Lyse, H., Melle, I., Simonsen, E., Smeby, N. A., Oxnevad, A. L., McFarlane, W. R., Vaglum, P., & McGlashan, T. (2007). Multifamily group treatment in a program for patients with first-episode psychosis: Experiences from the TIPS Project. Psychiatric Services, 58(2), 171–173. doi.org/10.1176/ps.2007.58.2.171CrossRefGoogle Scholar
Fusar-Poli, P., Borgwardt, S., Bechdolf, A., Addington, J., Riecher-Rossler, A., Schultze-Lutter, F., Keshavan, M. S., Wood, S., Ruhrmann, S., Seidman, L., Valmaggia, L., Cannon, T., Velthorst, E., DeHaan, L., Cornblatt, B., Bonoldi, I., Birchwood, M., McGlashan, T., Carpenter, W., McGorry, P., Klosterkotter, J., McGuire, P., & Yung, A. R. (2013). The psychosis high-risk state: A comprehensive state-of-the-art review. JAMA Psychiatry, 70(1), 107–120. doi.org/10.1001/jamapsychiatry.2013.269CrossRefGoogle Scholar
Fusar-Poli, P., McGorry, P., & Kane, J. (2017). Improving outcomes of first-episode psychosis: An overview. World Psychiatry, 16(3), 251–265. doi.org/28941089CrossRefGoogle ScholarPubMed
Granö, N., Karjalainen, M., Edlund, V., Saari, E., Itkonen, A., Anto, J., & Roine, M. (2014). Changes in depression, anxiety and hopelessness symptoms during family- and community-oriented intervention for help-seeking adolescents and adolescents at risk of psychosis. Nordic Journal of Psychiatry, 68(2), 93–99. doi.org/10.3109/08039488.2013.768294CrossRefGoogle ScholarPubMed
Haas, A. P., & Drescher, J. (2014). Impact of sexual orientation and gender identity on suicide risk: Implications for assessment and treatment. Psychiatric Times, 31(12). www.psychiatrictimes.com/view/impact-sexual-orientation-and-gender-identity-suicide-risk-implications-assessment-and-treatmentGoogle Scholar
Hall, R. C. (1995). Global assessment of functioning. A modified scale. Psychosomatics, 36(3), 267–275. doi.org/10.1016/S0033-3182(95)71666-8CrossRefGoogle ScholarPubMed
Hinojosa‐Marqués, L., Tecelli, D. M., & Neus, B. V. (2022). Family environmental factors in at‐risk mental states for psychosis. Clinical Psychology & Psychotherapy, 29(2), 424–454. doi.org/10.1002/cpp.2651CrossRefGoogle ScholarPubMed
Hjorthøj, C., Stürup, A. E., McGrath, J. J., & Nordentoft, M. (2017). Years of potential life lost and life expectancy in schizophrenia: A systematic review and meta-analysis. The Lancet Psychiatry, 4(4), 295–301. doi.org/10.1016/S2215-0366(17)30078-0CrossRefGoogle ScholarPubMed
Humensky, J. L., Essock, S. M., & Dixon, L. B. (2017). Characteristics associated with the pursuit of work and school among participants in a treatment program for first episode of psychosis. Psychiatric Rehabilitation Journal, 40(1), 108–112. doi.org/10.1037/prj0000256CrossRefGoogle Scholar
Joa, I., Johannessen, J. O., Auestad, B., Friis, S., McGlashan, T., Melle, I., Opjordsmoen, S., Simonsen, E., Vaglum, P., & Larsen, T. K. (2008). The key to reducing duration of untreated first psychosis: Information campaigns. Schizophrenia Bulletin, 34(3), 466–472. doi.org/sbm09510.1093.CrossRefGoogle ScholarPubMed
Joly, B. M., Pukstas, B. K., Elbaum, W. M., & Mittal, P. (2012). Promoting early detection of psychosis: The role of community outreach. Journal of Public Mental Health, 11(4), 195–208.CrossRefGoogle Scholar
Judd, C., & Park, B. (1996). Definition and assessment of accuracy in stereotypes. Psychological Review, 100, 109–128.CrossRefGoogle Scholar
Kessler, R. C., Birnbaum, H., Demler, O., Falloon, I. R., Gagnon, E., Guyer, M., Gagnon, E., Howes, M. J., Kendler, K. S., Shi, L., Walters, E., & Wu, E. Q. (2005). The prevalence and correlates of nonaffective psychosis in the National Comorbidity Survey Replication (NCS-R). Biological Psychiatry, 58(8), 668–676. doi.org/S0006-3223(05)00495-610.1016CrossRefGoogle ScholarPubMed
Killackey, E., Kelly, A., Jackson, H. J., Scutella, R., Tseng, Y.-P., & Cotton, S. (2019). Individual placement and support for vocational recovery in first-episode psychosis: Randomised controlled trial. The British Journal of Psychiatry, 214(2), 76–82. doi.org/10.1192/bjp.2018.191CrossRefGoogle ScholarPubMed
Krstev, H., Carbone, S., Harrigan, S. M., Curry, C., Elkins, K., & McGorry, P. D. (2004). Early intervention in first-episode psychosis – The impact of a community development campaign. Social Psychiatry and Psychiatric Epidemiology, 39(9), 711–719. doi.org/10.1007/s00127-004-0798-5CrossRefGoogle ScholarPubMed
Lucksted, A., McFarlane, W., Downing, D., & Dixon, L. (2012). Recent developments in family psychoeducation as an evidence-based practice. Journal of Marital and Family Therapy, 38(1), 101–121. doi.org/10.1111/j.1752-0606.2011.00256.xCrossRefGoogle ScholarPubMed
Luepker, R. V., Murray, D. M., Jacobs, D. R., Mittelmark, , , M. B., Bracht, N., & Carlaw, R. (1994). Community education for cardiovascular disease prevention: Risk factor changes in the Minnesota Heart Health Program. American Journal of Public Health, 84(9), 1383–1393. doi.org/10.2105/ajph.84.9.1383CrossRefGoogle ScholarPubMed
Lynch, S., McFarlane, W. R., Joly, B., Adelsheim, S., Auther, A., Cornblatt, B. A., Migliorati, M., Ragland, J. D., Sale, T., Spring, E., Calkins, R., Carter, C. S., Jaynes, R., Taylor, S. F., & Downing, D. (2016). Early detection, intervention and prevention of psychosis program: Community outreach and early identification at six U.S. sites. Psychiatric Services, 67(5), 510–516. doi.org/10.1176/appi.ps.201300236CrossRefGoogle ScholarPubMed
McFarlane, W. R. (2002). Multifamily groups in the treatment of severe psychiatric disorders. Guilford Press.Google Scholar
McFarlane, W. R. (2010). Integrating the family in the treatment of psychotic disorders. In Hagen, R., Turkington, D., Berge, T., & Grawe, R. W. (Eds.), CBT for psychosis: A symptom-based approach. Routledge.Google Scholar
McFarlane, W. R., & Cook, W. L. (2007). Family expressed emotion prior to onset of psychosis. Family Process, 46(2), 185–197. doi.org/10.1111/j.1545-5300.2007.00203.xCrossRefGoogle ScholarPubMed
McFarlane, W. R., Cook, W. L., Downing, D., Verdi, M. B., Woodberry, K. A., & Ruff, A. (2010). Portland identification and early referral: A community-based system for identifying and treating youths at high risk of psychosis. Psychiatric Services, 61(5), 512–515. doi.org/61/5/51210.1176/appi.ps.61.5.512CrossRefGoogle ScholarPubMed
McFarlane, W. R., Dushay, R. A., Deakins, S. M., Stastny, P., Lukens, E. P., Toran, J., & Link, B. (2000). Employment outcomes in family-aided assertive community treatment. American Journal of Orthopsychiatry, 70(2), 203–214. doi.org/10.1037/h0087819CrossRefGoogle ScholarPubMed
McFarlane, W. R., Dushay, R., Lukens, E., Stastny, P., Deakins, S., & Link, B. (1999). Work outcomes in family-aided assertive community treatment: Vocational rehabilitation for persons with psychotic disorders. Epidemiologia e Psichiatria Sociale, 8(3), 174–182. doi.org/10.1017/s1121189x00008046CrossRefGoogle ScholarPubMed
McFarlane, W. R., Dushay, R. A., Stastny, P., Deakins, S. M., & Link, B. (1996). A comparison of two levels of family-aided assertive community treatment. Psychiatric Services, 47(7), 744–750. doi.org/10.1176/ps.47.7.744Google ScholarPubMed
McFarlane, W. R., Levin, B., Travis, L., Lucas, F. L., Lynch, S., Verdi, M., Williams, D., Adelsheim, S., Calkins, R., Carter, C. S., Cornblatt, B., Taylor, S. F., Auther, A. M., McFarland, B., Melton, R., Migliorati, M., Niendam, T., Ragland, J. D., Sale, T., Salvador, M., & Spring, E. (2015). Clinical and functional outcomes after 2 years in the early detection and intervention for the prevention of psychosis multisite effectiveness trial. Schizophrenia Bulletin, 41(1), 30–43. doi.org/10.1093/schbul/sbu108CrossRefGoogle ScholarPubMed
McFarlane, W. R., Link, B., Dushay, R., Marchal, J., & Crilly, J. (1995). Psychoeducational multiple family groups: Four-year relapse outcome in schizophrenia. Family Process, 34(2), 127–144. doi.org/10.1111/j.1545-5300.1995.00127.xCrossRefGoogle ScholarPubMed
McFarlane, W. R., Lukens, E., Link, B., Dushay, R., Deakins, S. A., Newmark, M., Dunne, E. J., Horen, B., & Toran, J. (1995). Multiple-family groups and psychoeducation in the treatment of schizophrenia. Archives of General Psychiatry, 52(8), 679–687. doi.org/10.1001/archpsyc.1995.03950200069016CrossRefGoogle ScholarPubMed
McFarlane, W. R., Stastny, P., & Deakins, S. (1992). Family-aided assertive community treatment: A comprehensive rehabilitation and intensive case management approach for persons with schizophrenic disorders. New Directions for Mental Health Services (53), 43–54. doi.org/10.1002/yd.23319925306CrossRefGoogle Scholar
McFarlane, W. R., Susser, E., McCleary, R., Verdi, M., Lynch, S., Williams, D., & McKeague, I. W. (2014). Reduction in incidence of hospitalizations for psychotic episodes through early identification and intervention. Psychiatric Services, 65(10), 1194–1200. doi.org/10.1176/appi.ps.201300336CrossRefGoogle ScholarPubMed
McGlashan, T. H., Walsh, B., & Woods, S. W. (2010). The psychosis risk syndrome. Oxford University Press.Google Scholar
Melle, I., Johannesen, J. O., Friis, S., Haahr, U., Joa, I., Larsen, T. K., Opjordsmoen, S., Rund, B. R., Simonsen, E., Vaglum, P., & McGlashan, T. (2006). Early detection of the first episode of schizophrenia and suicidal behavior. American Journal of Psychiatry, 163(5), 800–804. doi.org/10.1176/ajp.2006.163.5.800CrossRefGoogle ScholarPubMed
Miklowitz, D. J., O’Brien, M. P., Schlosser, D. A., Addington, J., Candan, K. A., Marshall, C., Addington, J., Candan, K. A., Marshall, C., Domingues, I., Walsh, B. C., Zinberg, J. L., De Silva, S. D., Friedman-Yakoobian, M., & Cannon, T. D. (2014). Family-focused treatment for adolescents and young adults at high risk for psychosis: Results of a randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry, 53(8), 848–858. doi.org/http://dx.doi.org/10.1016/j.jaac.2014.04.020CrossRefGoogle Scholar
Murphy, T., Krasa, H., Lavigne, G., Frangiosa, T., Palsgrove, A., & Stalters, L. (2021). Societal costs of schizophrenia and related disorders. S. a. P. A. Alliance. https://sczaction.org/wp-content/uploads/2021/11/571-012_WhitePaper_Report_FINAL_updated_11.09.21.pdfGoogle Scholar
Nordentoft, M., Thorup, A., Petersen, L., Ohlenschlaeger, J., Melau, M., Christensen, T. O., Krarup, G., Jorgensen, P., & Jeppesen, P. (2006). Transition rates from schizotypal disorder to psychotic disorder for first-contact patients included in the OPUS trial. A randomized clinical trial of integrated treatment and standard treatment. Schizophrenia Research, 83(1), 29–40. doi.org/10.1016/j.schres.2006.01.002CrossRefGoogle Scholar
Parks, J., Svendsen, D., Singer, P., & Foti, M. E. (2006). Morbidity and mortality in people with serious mental illness.Google Scholar
Petersen, L., Nordentoft, M., Jeppesen, P., Ohlenschaeger, J., Thorup, A., Christensen, T. O., Krarup, G., Jorgensen, P., Nordentoft, M., & Jorgensen, P. (2005). Improving 1-year outcome in first-episode psychosis: OPUS trial. British Journal of Psychiatry. Supplement, 48, s98–103. doi.org/10.1192/bjp.187.48.s98Google ScholarPubMed
Robertson, I., Ward, T., Ridgeway, V., & Nimmo-Smith, I. (1994). The test of everyday attention. Pearson.Google Scholar
Rosenheck, R., Mueser, K. T., Sint, K., Lin, H., Lynde, D. W., Glynn, S. M., Robinson, D. G., Schooler, N. R., Marcy, P., Mohamed, S., & Kane, J. M. (2017). Supported employment and education in comprehensive, integrated care for first episode psychosis: Effects on work, school, and disability income. Schizophrenia Research, 182, 120–128. doi.org/10.1016/j.schres.2016.09.024CrossRefGoogle ScholarPubMed
Ruff, A., McFarlane, W. R., Downing, D., Cook, W. L., & Woodberry, K. A. (2012). A community outreach and education model for early identification of mental illness in young people. Adolescent Psychiatry, 2(2), 140–145.CrossRefGoogle Scholar
Rupp, A., & Keith, S. J. (1993). The costs of schizophrenia. Psychiatric Clinics of North America, 16(2), 413–423.CrossRefGoogle ScholarPubMed
Stein, L. I., & Test, M. A. (1980). Alternative to mental hospital treatment. I. Conceptual model, treatment program, and clinical evaluation. Archives of General Psychiatry, 37(4), 392–397. doi.org/10.1001/archpsyc.1980.01780170034003CrossRefGoogle ScholarPubMed
Substance Abuse and Mental Health Services Administration. (2011). Supported Education: Building Your Program. HHS Pub. No. SMA-11-4654, Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services.Google Scholar
Thompson, E., Rakhshan, P., Pitts, S. C., Demro, C., Millman, Z. B., Bussell, K., DeVylder, J., Kline, E., Reeves, G. M., & Schiffman, J. (2019). Family functioning moderates the impact of psychosis-risk symptoms on social and role functioning. Schizophrenia Research, 204 (February), 337–342. doi.org/10.1016/j.schres.2018.08.035CrossRefGoogle ScholarPubMed
van der Gaag, M., Nieman, H., Rietdijk, J., Dragt, S., Ising, H. K., Klaassen, R. M., Smit, F., Bechdolf, A., French, P., Linszen, D. H., Yung, A. R., McGorry, P., & Cuijpers, P. (2013). Preventing a first episode of psychosis: Meta-analysis of randomized controlled prevention trials of 12 month and longer-term follow-ups. Schizophrenia Research, 149(1–3), 56–62. doi.org/http://dx.doi.org/10.1016/j.schres.2013.07.004CrossRefGoogle ScholarPubMed
Wehman, P., & Moon, M. S. (1988). Vocational rehabilitation and supported employment. Paul H. Brookes.Google ScholarPubMed
World Health Organization (2004). Evidence for action: Effectiveness of community-based outreach in preventing HIV/AIDS in injecting drug users. Geneva: World Health Organization.Google Scholar
Woodberry, K. A., McFarlane, W. R., Giuliano, A. J., Verdi, M. B., Cook, W. L., Faraone, S. V., & Seidman, L. J. (2013). Change in neuropsychological functioning over one year in youth at clinical high risk for psychosis. Schizophrenia Research, 146(1–3), 87–94. doi.org/10.1016/j.schres.2013.01.017CrossRefGoogle ScholarPubMed
Wu, E. Q., Birnbaum, H. G., Shi, L., Ball, D. E., Kessler, R. C., Moulis, M., & Aggarwal, J. (2005). The economic burden of schizophrenia in the United States in 2002. Journal of Clinical Psychiatry, 66(9), 1122–1129. doi.org/10.4088/jcp.v66n0906CrossRefGoogle ScholarPubMed
Yung, A. R., McGorry, P. D., McFarlane, C. A., Jackson, H. J., Patton, G. C., & Rakkar, A. (1996). Monitoring and care of young people at incipient risk of psychosis. Schizophrenia Bulletin, 22(2), 283–303. doi.org/10.1093/schbul/22.2.283CrossRefGoogle ScholarPubMed