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5 - Training US Community Mental Health Centers in Evidence-Based Coordinated Specialty Care for First Episode Psychosis

Observations from the NAVIGATE Program Trainers

from Part II - The Present

Published online by Cambridge University Press:  03 March 2022

By
Shirley M. Glynn ,
Susan Gingerich ,
Piper Meyer-Kalos  and
Delbert G. Robinson
Edited by
Meaghan Stacy  and
Charlie A. Davidson
Meaghan Stacy
Affiliation:
Yale University, Connecticut
Charlie A. Davidson
Affiliation:
Emory University, Atlanta
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Summary

Building on positive research findings in Europe, Canada, and Australia over the past 30 years, the US National Institute of Mental Health (NIMH) funded two large trials of Coordinated Specialty Care (CSC) for first episode psychosis approximately 10 years ago. These studies found that participation in CSC, which includes both pharmacological and manualized psychosocial treatments, resulted in greater treatment retention, improved quality of life and work/school rates and reduced psychopathology among participants (Dixon et al., 2015; Kane et al., 2016). The authors of this chapter were intervention co-developers and trainers in the NIMH funded Recovery After an Initial Schizophrenia Episode (RAISE) national randomized controlled trial comparing CSC to customary care in 34 non-academic “real-world” community mental health clinics. The psychosocial components of the RAISE CSC intervention, entitled NAVIGATE, are manualized and available at navigateconsultants.org. The authors have now provided intensive onsite training and consultation in NAVIGATE in over 20 US states, typically to a combination of state and local community mental health agencies. In this chapter, they will present an overview of NAVIGATE and the national training effort, and then highlight both success and challenges in working to improve evidence-based first episode psychosis mental health treatment in the USA on a national and local level.

Keywords

First episodecoordinated specialty caretrainingRAISEimplementationfidelityconsultationorganizational change
Type
Chapter
Information
Recovering the US Mental Healthcare System
The Past, Present, and Future of Psychosocial Interventions for Psychosis
 , pp. 103 - 127
Publisher: Cambridge University Press
Print publication year: 2022

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References

Addis, M. E., Wade, W. A., & Hatgis, C. (2006). Barriers to dissemination of evidence-based practices: Addressing practitioners’ concerns about manual-based psychotherapies. Clinical Psychology: Science and Practice, 6(4), 430–441. https://doi.org/10.1093/clipsy.6.4.430Google Scholar
Ayllon, T., & Azrin, N. (1968). The token economy: A motivational system for therapy and rehabilitation. Appleton Century Crofts. Behaviour Research and Therapy, 7(3), 348. https://doi.org/10.1016/0005-7967(69)90022-9Google Scholar
Azrin, S. T., Goldstein, A. B., & Heinssen, R. K. (2015). Early intervention for psychosis: The recovery after an initial schizophrenia episode project. Psychiatric Annals, 45(11), 548–553. https://doi.org/10.3928/00485713-20151103-05Google Scholar
Balas, E. A., & Boren, S. A. (2000). Managing clinical knowledge for health care improvement. Yearbook of Medical Informatics, 09(01), 65–70. https://doi.org/10.1055/s-0038-1637943Google Scholar
Beck, A. T. (1952). Successful outpatient psychotherapy of a chronic schizophrenic with a delusion based on borrowed guilt. Psychiatry, 15(3), 305–312. https://doi.org/10.1080/00332747.1952.11022883CrossRefGoogle ScholarPubMed
Becker, D. R., & Drake, R. E. (2003). A Working Life for People with Severe Mental Illness. Oxford University Press.Google Scholar
Beidas, R. S., & Kendall, P. C. (2010). Training therapists in evidence-based practice: A critical review of studies from a systems-contextual perspective. Clinical Psychology: Science and Practice, 17(1), 1–30. https://doi.org/10.1111/j.1468-2850.2009.01187.xGoogle Scholar
Bellack, A. S., Hersen, M., & Turner, S. M. (1976). Generalization effects of social skills training in chronic schizophrenics: An experimental analysis. Behaviour Research and Therapy, 14(6), 391–398. https://doi.org/10.1016/0005-7967(76)90085-1Google Scholar
Bowtell, M., Eaton, S., Thien, K., Bardell-Williams, M., Downey, L., Ratheesh, A., Killackey, E., McGorry, P., & O’Donoghue, B. (2018). Rates and predictors of relapse following discontinuation of antipsychotic medication after a first episode of psychosis. Schizophrenia Research, 195, 231–236. https://doi.org/10.1016/j.schres.2017.10.030Google Scholar
Breitborde, N. J., Guirgis, H., Stearns, W., Carpenter, K. M., Lteif, G., Pine, J. G., … Moe, A. M. (2020). The Ohio State University Early Psychosis Intervention Center (EPICENTER) step-based care programme for individuals at clinical high risk for psychosis: Study protocol for an observational study. British Medical Journal Open, 10(1), 1–8.Google Scholar
Chinman, M., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Swift, A., & Delphin-Rittmon, M. E. (2014). Peer support services for individuals with serious mental illnesses: Assessing the evidence. Psychiatric Services, 65(4), 429–441. https://doi.org/10.1176/appi.ps.201300244Google Scholar
Correll, C. U., Galling, B., Pawar, A., Krivko, A., Bonetto, C., Ruggeri, M., … Kane, J. M. (2018). Comparison of early intervention services vs treatment as usual for early-phase psychosis: A systematic review, meta-analysis, and meta-regression. The Journal of the American Medical Association Psychiatry, 75(6), 555–565. https:/10.1001/jamapsychiatry.2018.0623Google ScholarPubMed
Dobson, K. S. (1989). A meta-analysis of the efficacy of cognitive therapy for depression. Journal of Consulting and Clinical Psychology, 57(3), 414–419. https://doi.org/10.1037/0022-006x.57.3.414Google Scholar
Doyle, R., Turner, N., Fanning, F., Brennan, D., Renwick, L., Lawlor, E., & Clarke, M. (2014). First-episode psychosis and disengagement from treatment: A systematic review. Psychiatric Services, 65(5), 603–611. https://doi.org/10.1176/appi.ps.201200570Google Scholar
Falloon, I. R. H., Boyd, J. L., McGill, C. W., Razani, J., Moss, H. B., & Gilderman, A. M. (1982). Family management in the prevention of exacerbations of schizophrenia. New England Journal of Medicine, 306(24), 1437–1440. https://doi.org/10.1056/nejm19820617306240Google Scholar
Foa, E. B., McLean, C. P., Brown, L. A., Zang, Y., Rosenfield, D., Zandberg, L. J., … Peterson, A. L. (2020). The effects of a prolonged exposure workshop with and without consultation on provider and patient outcomes: A randomized implementation trial. Implementation Science, 15(1), 59. https://doi.org/10.1186/s13012–020-01014-xCrossRefGoogle ScholarPubMed
Garety, P. A., Kuipers, L., Fowler, D., Chamberlain, F., & Dunn, G. (1994). Cognitive behavioural therapy for drug‐resistant psychosis. British Journal of Medical Psychology, 67(3), 259–271. https://doi.org/10.1111/j.2044-8341.1994.tb01795.xGoogle Scholar
Gleeson, J. F. M., Cotton, S. M., Alvarez-Jimenez, M., Wade, D., Gee, D., Crisp, K., … McGorry, P. D. (2009). A randomized controlled trial of relapse prevention therapy for first-episode psychosis patients. The Journal of Clinical Psychiatry, 70(4), 477–486. https://doi.org/10.4088/jcp.08m04407Google Scholar
Grant, J., Green, L., & Mason, B. (2003). Basic research and health: A reassessment of the scientific basis for the support of biomedical science. Research Evaluation, 12(3), 217–224. https://doi.org/10.3152/147154403781776618Google Scholar
Grawe, R. W., Falloon, I. R. H., Widen, J. H., & Skogvoll, E. (2006). Two years of continued early treatment for recent-onset schizophrenia: A randomised controlled study. Acta Psychiatrica Scandinavica, 114(5), 328–336. https://doi.org/10.1111/j.1600-0447.2006.00799.xGoogle Scholar
Heinssen, R. K., Goldstein, A. B., & Azrin, S. T. (April 14, 2014). Evidence-based treatments for first episode psychosis: Components of coordinated specialty care. Https://Www.Nimh.Nih.Gov/Health/Topics/Schizophrenia/Raise/Nimh-White-Paper-Csc-for-Fep_147096.Pdf. https://www.nasmhpd.org/sites/default/files/Summary%20of%20Evidence-BasedTreament%20Components%20for%20FEP_14APR_2014_Final.pdfGoogle Scholar
Herschell, A. D., Kolko, D. J., Baumann, B. L., & Davis, A. C. (2010). The role of therapist training in the implementation of psychosocial treatments: A review and critique with recommendations. Clinical Psychology Review, 30(4), 448–466. https://doi.org/10.1016/j.cpr.2010.02.005Google Scholar
Hogarty, G. E. (1986). Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia. Archives of General Psychiatry, 43(7), 633. https://doi.org/10.1001/archpsyc.1986.01800070019003Google Scholar
Hogarty, G. E. (1991). Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia. Archives of General Psychiatry, 48(4), 340. https://doi.org/10.1001/archpsyc.1991.01810280056008Google Scholar
Humensky, J. L., Dixon, L. B., & Essock, S. M. (2013). State mental health policy: An interactive tool to estimate costs and resources for a first-episode psychosis initiative in New York State. Psychiatric Services, 64(9), 832–834. https://doi.org/10.1176/appi.ps.201300186CrossRefGoogle ScholarPubMed
Kane, J. M., Robinson, D. G., Schooler, N. R., Mueser, K. T., Penn, D. L., Rosenheck, R. A., … Heinssen, R. K. (2016). Comprehensive versus usual community care for first-episode psychosis: 2-Year outcomes from the NIMH RAISE early treatment program. American Journal of Psychiatry, 173(4), 362–372. https://doi.org/10.1176/appi.ajp.2015.15050632Google Scholar
Kendler, K. S. (2020). Eugen Bleuler’s views on the genetics of schizophrenia in 1917. Schizophrenia Bulletin, 46(4), 758–764. https://doi.org/10.1093/schbul/sbz131Google Scholar
Kingdon, D., Turkington, D., & John, C. (1994). Cognitive behaviour therapy of schizophrenia: The amenability of delusions and hallucinations to reasoning. The British Journal of Psychiatry, 164(5), 581–587. https://doi.org/10.1192/bjp.164.5.581Google Scholar
Miltenberger, R. G. (2011). Behavior Modification: Principles and Procedures. Cengage Learning.Google Scholar
Moe, A. M., Rubinstein, E. B., Gallagher, C. J., Weiss, D. M., Stewart, A., & Breitborde, N. J. K. (2018b). Improving access to specialized care for first-episode psychosis: An ecological model. Risk Management and Healthcare Policy, Volume 11, 127–138. https://doi.org/10.2147/rmhp.s131833Google Scholar
Morris, Z. S., Wooding, S., & Grant, J. (2011). The answer is 17 years, what is the question: Understanding time lags in translational research. Journal of the Royal Society of Medicine, 104(12), 510–520. https://doi.org/10.1258/jrsm.2011.110180CrossRefGoogle ScholarPubMed
Mueser, K. T., Penn, D. L., Addington, J., Brunette, M. F., Gingerich, S., Glynn, S. M., … Kane, J. M. (2015). The NAVIGATE program for first-episode psychosis: Rationale, overview, and description of psychosocial components. Psychiatric Services, 66(7), 680–690. https://doi.org/10.1176/appi.ps.201400413Google Scholar
Neimeyer, G. J., Taylor, J. M., Rozensky, R. H., & Cox, D. R. (2014). The diminishing durability of knowledge in professional psychology: A second look at specializations. Professional Psychology: Research and Practice, 45(2), 92–98. https://doi.org/10.1037/a0036176Google Scholar
Ojeda, V. D., Munson, M. R., Jones, N., Berliant, E., & Gilmer, T. P. (2020). The availability of peer support and disparities in outpatient mental health service use among minority youth with serious mental illness. Administration and Policy in Mental Health and Mental Health Services Research, 1–9. https://doi.org/10.1007/s10488–020-01073-8CrossRefGoogle Scholar
Oliver, J. A., & Lang, J. M. (2018). Barriers and consultation needs regarding implementation of evidence-based treatment in community agencies. Children and Youth Services Review, 94, 368–377. https://doi.org/10.1016/j.childyouth.2018.10.004Google Scholar
Osterberg, L., & Blaschke, T. (2005). Adherence to medication. New England Journal of Medicine, 353(5), 487–497. https://doi.org/10.1056/nejmra050100CrossRefGoogle ScholarPubMed
Paul, G. L., & Lentz, R. J. (1977). Psychosocial Treatment of Chronic Mental Patients: Milieu Versus Social-Learning Programs. Harvard University Press.Google Scholar
Petersen, L., Jeppesen, P., Thorup, A., Abel, M.-B., Øhlenschlæger, J., Christensen, T. Ø., … Nordentoft, M. (2005). A randomised multicentre trial of integrated versus standard treatment for patients with a first episode of psychotic illness. British Medical Journal, 331(7517), 602. https://doi.org/10.1136/bmj.38565.415000.e01Google Scholar
Peterson, C., & Seligman, M. (2004). Character strengths and virtues: A handbook and classification (1st ed.). American Psychological Association/Oxford University Press.Google Scholar
Robinson, D. G., Schooler, N. R., Correll, C. U., John, M., Kurian, B. T., Marcy, P., … Kane, J. M. (2018). Psychopharmacological treatment in the RAISE-ETP study: Outcomes of a manual and computer decision support system based intervention. American Journal of Psychiatry, 175(2), 169–179. https://doi.org/10.1176/appi.ajp.2017.16080919Google Scholar
Ruggeri, M., Bonetto, C., Lasalvia, A., Fioritti, A., de Girolamo, G., Santonastaso, P., … Meneghelli, A. (2015). Feasibility and effectiveness of a multi-element psychosocial intervention for first-episode psychosis: Results from the cluster-randomized controlled get up piano trial in a catchment area of 10 million inhabitants. Schizophrenia Bulletin, 41(5), 1192–1203. https://doi.org/10.1093/schbul/sbv058CrossRefGoogle Scholar
Schoeler, T., Petros, N., Di Forti, M., Klamerus, E., Foglia, E., Murray, R., & Bhattacharyya, S. (2017). Poor medication adherence and risk of relapse associated with continued cannabis use in patients with first-episode psychosis: A prospective analysis. The Lancet Psychiatry, 4(8), 627–633. https://doi.org/10.1016/s2215–0366(17)30233-xGoogle Scholar
Schoenbaum, M., Sutherland, J. M., Chappel, A., Azrin, S., Goldstein, A. B., Rupp, A., & Heinssen, R. K. (2017). Twelve-month health care use and mortality in commercially insured young people with incident psychosis in the United States. Schizophrenia Bulletin, 43(6), 1262–1272. https://doi.org/10.1093/schbul/sbx009Google Scholar
Srihari, V. H., Tek, C., Kucukgoncu, S., Phutane, V. H., Breitborde, N. J. K., Pollard, J., … Woods, S. W. (2015). First-episode services for psychotic disorders in the U.S. Public Sector: A pragmatic randomized controlled trial. Psychiatric Services, 66(7), 705–712. https://doi.org/10.1176/appi.ps.201400236Google Scholar
Test, M. A., & Stein, L. I. (1976). Practical guidelines for the community treatment of markedly impaired patients. Community Mental Health Journal, 12(1), 72–82. https://doi.org/10.1007/bf01435740Google Scholar
Zubin, J., & Spring, B. (1977). Vulnerability: A new view of schizophrenia. Journal of Abnormal Psychology, 86(2), 103–126. https://doi.org/10.1037/0021-843x.86.2.103Google Scholar

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