Altitudes USA: a moderated online social therapy intervention for first episode psychosis caregivers

BACKGROUND: Caregiving in first-episode psychosis (FEP) is challenging. Although family interventions in FEP are effective, relatively few caregivers access them, and most do not directly address caregivers' own mental health needs. Digital interventions present a novel opportunity to support individual caregiver well-being. AIMS: This study evaluated the feasibility, acceptability, and preliminary benefits of Altitudes, a blended digital health intervention for FEP caregivers. METHODS: Participants engaged in a 6-month trial of the Altitudes platform, which features psychoeducation, therapy content, and social networking. Caregivers completed assessments at baseline, mid-treatment (3 months), and post-treatment (6 months). Feasibility was measured by engagement and retention rates; acceptability was evaluated through user experience questionnaires. Exploratory outcomes included distress, self-compassion, loneliness, experiences of caregiving, and expressed emotion. RESULTS: Caregivers found the intervention highly acceptable, with high retention and sustained engagement in the platform's human support elements. At follow-up, caregivers reported lower distress, increased compassionate self-responding, increased positive caregiving experiences, and reduced loneliness. All effects had wide confidence intervals, warranting cautious interpretation. CONCLUSIONS: Altitudes is a feasible and acceptable digital intervention for FEP caregivers and may benefit multiple domains of caregiver mental health. Future research is needed to support its effectiveness and strengthen long-term engagement.