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Casey A. Cragin, Psy.D., is a 2017 graduate of the Psy.D. Program in Clinical Psychology at Antioch University, New England

Dissertation Committee:

  • Martha Straus, Ph.D., Committee Chair
  • William Slammon, Ph.D., Committee Member
  • Tara Niendam, Ph.D., Committee Member

Keywords

early psychosis, trauma, posttraumatic stress disorder, clinical practice guidelines, expert consensus

Document Type

Dissertation

Publication Date

2017

Abstract

Despite very high rates of trauma-related disorders among individuals with early psychosis, no clinical practice guidelines for the treatment of comorbid early psychosis and trauma-related disorders exist to date. Indeed, the routine exclusion of individuals with past and current psychosis from participation in trauma research and practice has limited the accumulation of research evidence that could inform such clinical practice guidelines. While preliminary research evidence suggests that traditional, empirically supported treatments for trauma-related disorders can be safely and effectively employed to reduce symptoms of posttraumatic stress and chronic psychosis, it remains unclear whether such treatments are appropriate for individuals in the early stages of psychotic illness. Clinical experts (N = 118) representing 121 early psychosis programs across 28 states were surveyed using the expert consensus method. Forty-nine clinical experts responded, and reached consensus on 46 of 49 expert consensus items related to the treatment of comorbid early psychosis and trauma-related disorders. Conjoint or family therapy and individual therapy were rated as treatment approaches of choice. Anxiety or stress management and psychoeducation were rated as interventions of choice for addressing both trauma symptoms and psychotic symptoms. In addition, case management was rated as an intervention of choice for addressing psychotic symptoms. No consensus was reached on expert consensus items regarding the appropriateness of a parallel treatment approach for the treatment of comorbid early psychosis and trauma-related disorders, sensorimotor or movement interventions for addressing trauma symptoms, or exposure interventions for addressing psychotic symptoms. In areas where expert consensus exists, clinical practice guidelines for the treatment of comorbid early psychosis and trauma-related disorders are offered in accordance with the expert consensus method. In areas where expert consensus does not exist, recommendations for future research are proposed. The results of this study are intended to serve as a launching point for scientists and practitioners interested in advancing appropriate treatment for high-risk and underserved individuals with comorbid early psychosis and trauma-related disorders.

Comments

Casey A. Cragin

ORCID Scholar ID# 0000-0002-6012-1387

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