Treatment approach Robin: Clinical applicability of a standardised manual and smartphone app for adolescents at clinical high risk for psychosis

Although the clinical high risk (CHR) for psychosis seems to be frequent in adolescents and associated with a marked reduction in functioning in this age group, there is a lack of evidence-based treatment strategies and research within this population. To address these gaps, a standardised manual and supporting smartphone app was developed for adolescents at CHR for psychosis. This study evaluates the feasibility and acceptability of implementing this combined approach in a naturalistic clinical trial. A total of 40 help-seeking adolescents (67% female) meeting the CHR for psychosis aged 13-18 years (mean age 15.86) were recruited. The treatment programme was completed by 85% (n = 34) of the patients. Patients showed high satisfaction with the overall intervention (mean 62.3 out of 76) and all participants stated that they would recommend the app to peers. There were significant changes (p < .001) in the anticipated direction in attenuated positive symptoms (F(1, 33) = 181.42, p < .001), comorbidities (F(2,66) = 38.93, p < .001), global functionality (F(2,66) = 65.05, p < .001), self-efficacy (F(1,29.8) = 7.93, p = .005) and quality of life (F(1,27) = 25.69, p < .001) comparing pre- and post-intervention. To the best of the authors knowledge, this is one of the first studies for adolescents at CHR for psychosis using a standardised treatment manual in combination with a smartphone app, both developed particularly for these patients by experienced clinicians. Future testing of the efficacy seems feasible and the findings could be an important contribution to the field of early interventions for psychosis as well as eMental health.