Manualized group cognitive-behavioral therapy for social anxiety in first episode psychosis

Group computer assisted cognitive remediation therapy

Social Phobia

Psychosis

All CBT sessions will be conducted in English or French by trained clinicians with the aid of a group CBT script that we have developed over the last two years. The script will provide a general outline for each session, remind the therapist about relevant CBT principles, and provide examples of topics and homework that may be useful in each session. This intervention will include: i) Psychoeducation on social anxiety disorder; ii) Cognitive Restructuring; iii) Exposure component; iv) Use of Thought Records to identify, explore and dispute negative thoughts about dysfunctional self-identity and core beliefs related to the onset and presence of diagnosis of schizophrenia. The latter module specifically examines stigmatization and self-stigmatization that are contributing factors to social anxiety. Each of the 13 group sessions consisting of 6-8 participants on average, will last for 1.5 hour each. One session per week will be provided for the 13-week period.

Manualized group Cognitive-behavioral therapy (CBT) for social anxiety in first episode psychosis

This group intervention has been developed by Dr. Bowie a co-applicant on the current proposal. This intervention involves completing cognitive training activities on a computer, documenting and attempting new strategies for solving problems, and doing 'bridging activities'. The target domains of cognition to be trained are processing speed, attention, memory and executive functions. The investigators will perform 13 weekly sessions of 1.5 hours. The software Brain Training Pro (http://www.scientificbraintrainingpro.fr), which has been used extensively in the field of schizophrenia, will be used. Each 1.5 hour session will be conducted with groups of 6-8 participants. The therapist's interventions, while minimal, are meant to emphasize the link between activities in the CACRT sessions and day-to-day activities that people do.

Group Computer assisted cognitive remediation therapy

Douglas Mental Health University Institute

Manualized Group Cognitive-behavioral Therapy for Social Anxiety in First Episode Psychosis

Manualized Group Cognitive-behavioral Therapy for Social Anxiety in First Episode Psychosis: A Randomized Controlled Trial

Participants:
120 participants receiving treatment for a FEP with social anxiety symptoms aged 18-35 will be recruited in Montreal from five FEP clinics affiliated with McGill University or Université de Montréal. Half of these participants will receive CBT, the other half CACRT.
Assessment:
As part of a thorough clinical assessment, symptoms of social anxiety will be assessed for each participant at intake, at the end of the therapy, and 3 and 6 months after the therapy. Change in symptom severity will be evaluated over time. Assessment will be conducted by a by a trained bilingual rater who will be blind to treatment.
Unit of measure:
The unit of measure used is the Social Interaction Anxiety Scale (SIAS). The SIAS is a 20-item scale which measures anxiety in interpersonal encounters.

Participants:
120 participants receiving treatment for a FEP with social anxiety symptoms aged 18-35 will be recruited in Montreal from five FEP clinics affiliated with McGill University or Université de Montréal. Half of these participants will receive CBT, the other half CACRT.
Assessment:
As part of a thorough clinical assessment, symptoms of social anxiety will be assessed for each participant at intake, at the end of the therapy, and 3 and 6 months after the therapy. Change in symptom severity will be evaluated over time. Assessment will be conducted by a by a trained bilingual rater who will be blind to treatment.
The unit of measure used is the Social Phobia Inventory (SPIN). The SPIN is a 17-item scale assessing multiple dimensions of social anxiety including fear, avoidance and physiological discomfort.

Participants:
120 participants receiving treatment for a FEP with social anxiety symptoms aged 18-35 will be recruited in Montreal from five FEP clinics affiliated with McGill University or Université de Montréal. Half of these participants will receive CBT, the other half CACRT.
Assessment:
As part of a thorough clinical assessment, symptoms of social anxiety will be assessed for each participant at intake, at the end of the therapy, and 3 and 6 months after the therapy. Change in symptom severity will be evaluated over time. Assessment will be conducted by a by a trained bilingual rater who will be blind to treatment.
Unit of measure:
The unit of measure used is the Brief Social Phobia Scale (BSPS). The BSPS is an 11-item clinician-rated assessment scale developed by Davidson which specifically measures fear, avoidance and autonomic physiological responses that are usually associated with most common social situations.

Participants:
120 participants receiving treatment for a FEP with social anxiety symptoms aged 18-35 will be recruited in Montreal from five FEP clinics affiliated with McGill University or Université de Montréal. Half of these participants will receive CBT, the other half CACRT.
Assessment:
As part of a thorough clinical assessment, symptoms of social anxiety will be assessed for each participant at intake, at the end of the therapy, and 3 and 6 months after the therapy. Psychosis symptom remission will be evaluated over time. Assessment will be conducted by a by a trained bilingual rater who will be blind to treatment.
Unit of measure:
The unit of measure used is the Scale for Assessment of Positive Symptoms (SAPS) and Negative Symptoms (SANS). The SAPS and SANS is a 59-item scale assessing multiple categories of positive and negative symptoms.

Participants:
120 participants receiving treatment for a FEP with social anxiety symptoms aged 18-35 will be recruited in Montreal from five FEP clinics affiliated with McGill University or Université de Montréal. Half of these participants will receive CBT, the other half CACRT.
Assessment:
As part of a thorough clinical assessment, symptoms of social anxiety will be assessed for each participant at intake, at the end of the therapy, and 3 and 6 months after the therapy. Functional recovery will be evaluated over time. Assessment will be conducted by a by a trained bilingual rater who will be blind to treatment.
Unit of measure:
The unit of measure used is the Recovery Assessment Scale (RAS). The RAS is a 41-item self-report measure examining multiple dimensions of functional recovery as perceived by the patient him/herself.

Participants:
120 participants receiving treatment for a FEP with social anxiety symptoms aged 18-35 will be recruited in Montreal from five FEP clinics affiliated with McGill University or Université de Montréal. Half of these participants will receive CBT, the other half CACRT.
Assessment:
As part of a thorough clinical assessment, symptoms of social anxiety will be assessed for each participant at intake, at the end of the therapy, and 3 and 6 months after the therapy. Functional recovery will be evaluated over time. Assessment will be conducted by a by a trained bilingual rater who will be blind to treatment.
Unit of measure:
The unit of measure used is the the Social and Occupational Functioning Scale (SOFAS). The SOFAS is used to evaluate the individual's level of social and occupational functioning independent of the overall severity of psychiatric symptoms.

Martin Lepage

James McGill Professor of Psychiatry, Researcher & Clinical Psychologist

McGill University

Canadian Institutes of Health Research (CIHR)

Two arms are for intervention and two are for control or placebo

Diarrhea

It is a dietary supplement ,65 ml containing 15 billion lactobacillus

polyalthia simiarum/antimikotik

Manualized Group Cognitive-behavioral Therapy for Social Anxiety in First Episode Psychosis

Randomized Controlled Field Trial of a Probiotics to Assess Its Role in Preventig Diarrhoea

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