Adaptation of a Psychosocial Intervention for Canadian Youth at Clinical High Risk for Psychosis: Adaptation d'une intervention psychosociale pour les jeunes à haut risque clinique de psychose au Canada

Abstract

Aim: This paper provides a detailed account of the process and outcomes involved in adapting a psychosocial intervention – the Optimal Health Program (OHP) – for young individuals who are at clinical high risk (CHR) for psychosis. This adaptation process included the active participation of youth with lived experience of psychosis spectrum disorder (CHR and first episode psychosis). Methods: A six-member advisory group consisting of youth with lived experience was established. The group convened weekly to review the OHP workbook in detail. This initiative was supported by a dedicated research assistant. Adherence to established guidelines for engaging with youth was maintained throughout. Following the completion of the adaptation, a review session was conducted to gather feedback. Results: The primary adaptations made to the intervention can be categorized as follows: 1) modification of language; 2) tailoring to the CHR population; 3) incorporation of personal stories; 4) emphasis on personalized recovery; 5) inclusion of ‘guiding and supportive activities’; 6) enhancement of graphic design. Suggestions for a digital application were not integrated due to their scope extending beyond the aims of the current project. An assessment of the engagement process revealed that the involvement of youth was meaningful and impactful. Conclusions: Through sustained and meaningful engagement with youth with lived experience, the present project adapted OHP for CHR individuals. The resulting intervention materials are anticipated to be closely aligned with the distinct needs and priorities of young CHR individuals. Subsequent endeavours in developing appropriate interventions that aim to improve outcomes for this population should involve engaging and collaborating with individuals with lived experience. We are currently in the process of evaluating the feasibility, acceptability, and preliminary efficacy of delivering OHP to individuals with CHR in a clinical trial.

Plain Language Summary Title:

Adapting a Psychosocial Program for Canadian Youth at Clinical High Risk for Psychosis

Plain Language Summary This paper details how the Optimal Health Program (OHP), a psychosocial intervention, was adapted for young people at clinical high risk (CHR) for psychosis. The process involved a six-member advisory group of youth with lived experience of CHR and first episode psychosis, who met weekly to review the OHP workbook. A research assistant supported the effort, ensuring guidelines for working with youth were followed. Key adaptations included modifying language, tailoring content to the CHR population, adding personal stories, focusing on personalized recovery, incorporating supportive activities, and improving graphic design. A digital app suggestion was not pursued due to scope limitations. Feedback from the youth highlighted their meaningful and impactful involvement in the process. The adapted OHP materials are now more aligned with the needs of CHR youth. Future interventions should continue involving youth with lived experience. A clinical trial is underway to assess the feasibility, acceptability, and preliminary effectiveness of the adapted OHP program.