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Deploying a Texting Intervention for Early Psychosis; From Research to Real-World Practice

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The vast majority of young adults with early psychosis own mobile phones, identify texting as their preferred communication modality, and report an interest in messaging-based treatments. Researchers in the BRiTE Center developed a texting intervention for people with psychosis called the Mobile Interventionist. Treatment is conducted via daily recovery-oriented text conversations between patients and a trained messaging practitioner. This novel form of engagement produces an asynchronous but continuous form of treatment and combines the advantages of digital health (i.e., accessibility, reach beyond the brick-and-mortar clinic, low intensity), with the flexibility, personal tone and sensitivity of a clinician. Several studies have demonstrated that our texting intervention approach is feasible, acceptable, engaging and effective. This initiative will help translate this promising research into real-world clinical practice by implementing the Mobile Interventionist texting model at the University of Washington’s Specialized Treatment Program for Early Psychosis (STEP).

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Clinically, the intervention may improve the illness management of young adults with early psychosis participating in the pilot, improving their long-term trajectories. Programmatically, the pilot bridges the research/practice gap by providing training and guided clinical experience to a real-world clinical team.

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Funded by the Garvey Institute for Brain Health Solutions

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Bolster: Developing a caregiver-facing mHealth intervention to reduce duration of untreated psychosis

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Caregivers often play a pivotal role in treatment-seeking, making first contact with providers, persuading the affected relative to make such contacts, or ensuring that the affected individual remains engaged in care. However, caregivers often lack accurate information about psychosis, treatments and recovery, or feel overwhelmed and unable to help or communicate with their affected relative. Caregivers report that they are frequently use digital resources to support caregiving and treatment facilitation, but few report satisfaction with resources available to them. Early work examining web-based platforms has demonstrated that digital health technologies are feasible, acceptable, and have potential to improve caregivers’ psychosis-related knowledge and appraisals. Mobile health interventions are particularly well-suited to this task, as they can provide individualized, real-time, real- place support. It remains unclear at present, however, whether and how remotely delivered mHealth can be leveraged to increase engagement in treatment for young adults with EP.

The proposed research project aims to develop and test an mHealth intervention designed to improve caregivers’ illness knowledge and caregiving skills through interactive cognitive-behavioral modules, and through these improvements, reduce distress, improve coping, improve family communication, increase caregiver treatment facilitation and reduce duration of untreated psychosis. This proposal will involve (1) needs assessment and user co-design sessions with EP caregivers to understand their needs, interests and preferences in a caregiver-facing mHealth intervention, (2) a one-week usability field trial of this new intervention to determine feasibility and functionality, and (3) a remote pilot randomized controlled trial comparing this new intervention to existing online caregiving support resources.

Funded by the National Institute of Mental Health (R34MH124878)

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