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. 2025 Apr 13:7067437251328357.
doi: 10.1177/07067437251328357. Online ahead of print.

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

Yun Lu  1 , Thea L Hedemann  1   2 , Lisa D Hawke  1   2 , Augustina Ampofo  1 , Riley Goldsmith  1 , Nicole Kozloff  1   2 , Gillian Strudwick  2   3 , Michael Kiang  1   2 , David Castle  4   5 , George Foussias  1   2 , Muhammad Omair Husain  1   2
Affiliations

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

Yun Lu et al. Can J Psychiatry. .

Abstract
in English, French

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.

Objectif: Cet article donne un compte rendu détaillé du processus et des résultats de l’adaptation d’une intervention psychosociale – programme pour une santé optimale (PSO) – chez les jeunes à haut risque clinique (HRC) de psychose. Ce processus d’adaptation impliquait la participation de jeunes ayant vécu une expérience de trouble du spectre psychotique (HRC et premier épisode de psychose). Méthodologie: Un groupe consultatif de six membres, composé de jeunes ayant une expérience vécue a été formé. Le groupe s’est réuni une fois par semaine pour étudier en détail le manuel du PSO, initiative soutenue par un assistant de recherche spécialisé. L’adhésion aux lignes directrices établies relatives à l’engagement des jeunes a été maintenue en tout temps. Au terme du processus, une séance d’examen a été organisée pour recueillir les commentaires. Résultats: Les principaux changements apportés à l’intervention peuvent être divisés en catégories : 1) modification du langage; 2) adaptation pour la population HRC; 3) incorporation d’histoires personnelles; 4) accent sur la récupération personnalisée; 5) inclusion d’activités de guidance et de soutien; 6) rehaussement de l’infographie. Les suggestions pour une application numérique n’ont pas été intégrées car leur portée dépassait les objectifs visés par le présent projet. Une évaluation du processus d’engagement a révélé que la participation des jeunes a été significative et constructive. Conclusions: Grâce à un réel engagement soutenu auprès de jeunes ayant une expérience vécue, le présent projet a abouti à l’adaptation du PSO dans le contexte de HRC. On pense que le matériel d’intervention en résultant sera en étroite harmonie avec les besoins et les priorités des jeunes HRC. Les tentatives ultérieures de mise au point d’interventions appropriées visant à améliorer les résultats auprès de cette population devraient passer par l’engagement et la collaboration de personnes ayant une expérience vécue. Nous sommes présentement à évaluer la faisibilité, l’acceptabilité et l’efficacité préliminaire de l’administration du PSO aux personnes HRC dans le cadre d’un essai clinique.

Keywords: clinical high risk; intervention adaptation; psychosis; youth engagement.

Plain language summary

Adapting a Psychosocial Program for Canadian Youth at Clinical High Risk for PsychosisPlain 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.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: David Castle is one of the founders of the Optimal Health Program (OHP) and holds 50% of the IP for OHP; however, he has never gained financially from OHP and any future use of OHP will be under free license to Center for Addiction and Mental Health (CAMH), as per usual such arrangements.

Figures

Figure 1.
Figure 1.
Process from recruitment to follow-up of youth engagement adaptation.
See this image and copyright information in PMC

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