Abstracts Category : Other

Early Psychosis and Trauma-Related Disorders: ClinicalPractice Guidelines and Future Directions

by Casey A Cragin

Despite very high rates of trauma-related disordersamong individuals with early psychosis, no clinical practiceguidelines for the treatment of comorbid early psychosis andtrauma-related disorders exist to date. Indeed, the routineexclusion of individuals with past and current psychosis fromparticipation in trauma research and practice has limited theaccumulation of research evidence that could inform such clinicalpractice guidelines. While preliminary research evidence suggeststhat traditional, empirically supported treatments fortrauma-related disorders can be safely and effectively employed toreduce symptoms of posttraumatic stress and chronic psychosis, itremains unclear whether such treatments are appropriate forindividuals in the early stages of psychotic illness. Clinicalexperts (N = 118) representing 121 early psychosis programs across28 states were surveyed using the expert consensus method.Forty-nine clinical experts responded, and reached consensus on 46of 49 expert consensus items related to the treatment of comorbidearly psychosis and trauma-related disorders. Conjoint or familytherapy and individual therapy were rated as treatment approachesof choice. Anxiety or stress management and psychoeducation wererated as interventions of choice for addressing both traumasymptoms and psychotic symptoms. In addition, case management wasrated as an intervention of choice for addressing psychoticsymptoms. No consensus was reached on expert consensus itemsregarding the appropriateness of a parallel treatment approach forthe treatment of comorbid early psychosis and trauma-relateddisorders, sensorimotor or movement interventions for addressingtrauma symptoms, or exposure interventions for addressing psychoticsymptoms. In areas where expert consensus exists, clinical practiceguidelines for the treatment of comorbid early psychosis andtrauma-related disorders are offered in accordance with the expertconsensus method. In areas where expert consensus does not exist,recommendations for future research are proposed. The results ofthis study are intended to serve as a launching point forscientists and practitioners interested in advancing appropriatetreatment for high-risk and underserved individuals with comorbidearly psychosis and trauma-related disorders.Advisors/Committee Members: Straus, Martha (Committee Chair).