Early Psychosis Intervention

Despite years of research, debate and changes in mental health policy, there is still a lack of consensus as to what recovery from psychosis actually means, how it should be measured and how it may ultimately be achieved. In Recovering from a First Episode of Psychosis: An Integrated Approach to Early Intervention, it is argued that recovery from a first episode of psychosis (FEP) is comprised of three core elements: symptomatic, social and personal. Moreover, all three types of recovery need to be the target of early intervention for psychosis programmes (EIP) which provide evidence-based, integrated, bio-psychosocial interventions delivered in the context of a value base offering hope, empowerment and a youth-focused approach. Over the 12 chapters in the book, the authors, all experienced clinicians and researchers from multi-professional backgrounds, demonstrate that long-term recovery needs to replace short term remission as the key target of early psychosis services and that, to achieve this, we need a change in the way we deliver EIP: one that takes account of the different stages of psychosis and the ‘bespoke’ targeting of integrated medical, psychological and social treatments during the ‘critical period’. Illustrated with a wealth of clinical examples, this book will be of great interest to clinical psychologists, psychiatrists, psychiatric nurses and other associated mental health professionals.

Proceedings of the NATO Advanced Research Workshop on Early Intervention in Psychiatric Disorders, Prague, Czech Republic, October 22-27, 1998

With expert guidance on developing specialty care service models for young people experiencing first-episode psychosis, the book offers a multimodal approach that aims for recovery and remission.

Taking into account cultural differences between Asian and Western patients, this book focuses on delivery of effective treatment at an early stage in psychosis, especially for young people. It pays particular attention to early intervention programmes established in Hong Kong and Singapore, and assesses recent developments in Korea, Japan and other countries. The volume covers approaches in the management of psychosis, including pathway to care, stigma and interventions. With reference to the experiences of frontline practitioners, research findings and theories, it highlights the practical needs in non-Western healthcare settings. Culturally relevant discussions on recovery, relapse, self-harm and comorbid substance abuse are discussed. It also covers case studies to illustrate challenges and strategies in managing early psychosis.

The treatment of early psychosis has been bedevilled by an entrenched pessimism, stemming from the asylum era and the Kraepelinian model of schizophrenia. More recently, however, there has been a surge of interest in preventively oriented treatment of patients showing the first signs of psychotic illness, with the realization that these illnesses are frequently highly responsive to early treatment. This is the first text to focus on the potential of early detection of psychosis, and the practicalities of treatment. Based on the pioneering experience and research of a now well-established prevention and intervention centre, and with contributions from international authorities, the book outlines a framework for intervention, reviews the evidence available to guide clinical practice, and describes models of treatment. Incorporating many personal narratives and case histories, it is strong on theory, sensitive on practical issues, and will challenge, inform and guide clinicians.

The new edition of this popular handbook has been thoroughly updated to include the latest data concerning treatment of first-episode patients. Drawing from their experience, the authors discuss the presentation and assessment of the first psychotic episode and review the appropriate use of antipsychotic agents and psychosocial approaches in effective management. This is an authoritative text written by a team of highly respected authors for psychiatrists, neurologists, primary care practitioners and health care professional working in psychiatry. Drawing from their experience, the presentation and assessment of the first psychotic episode are discussed, details regarding antipsychotic drugs and their appropriate use are reviewed and psychosocial approaches are examined. The resulting book offers a concise and valuable guide to those wishing to review the latest proposals for the treatment of first-episode psychosis supported by up-to-date references, in a single publication.

Psychological Interventions in Early Psychosis provides a comprehensive overview of the emerging research and clinical evidence base for psychological treatments across the phases of early psychosis. Beginning with identified at-risk young people, the text continues through to those in acute and recovery phases, to the needs of patients with persistent symptoms. This practical treatment handbook: draws upon the expertise of several internationally recognised clinical and research programs integrates reviews of the relevant research literature with illustrative case examples covers critical issues for the clinician in focal chapters on suicide prevention, comorbid cannabis abuse, and family work describes several modalities of treatment, such as multi-family psychoeducation, group work, psychodynamic and cognitive behavioural approaches. Specialist early psychosis services are developing rapidly worldwide. Psychological Interventions in Early Psychosis will be an essential resource for clinicians and service leaders alike.

The First Episode Psychosis Services Fidelity Scale (FEPS-FS 1.0) is a highly reliable scale that assesses the degree to which mental health teams deliver specialized evidence-based care to people experiencing a first episode psychosis. The scale comprises 35 components each rated on a 1 to 5 scale. It has been used in the United States, Canada and Europe. It can be used for on site fidelity reviews, remote fidelity assessment or self-report. Published papers document its psychometric features and allow comparisons with a representative sample of US programs. It is suitable for research, quality improvement and accreditation. The Manual provides a practical guide for scoring a FEPS program against the criteria set out in the fidelity scale. It is designed to increase the reliability and consistency of ratings across different sites and assessors. It includes a definition and rationale for each component, data sources, decision rules and a structured interview guide. There are also modules to support training the key informant and data abstractor. Templates support structured feedback to programs for quality improvement. The scale can be adjusted to rate care for different diagnostic groups including the schizophrenia spectrum disorders, bipolar disorder and those with an attenuated psychosis syndrome.