Early Psychosis and Trauma-Related Disorders: Clinical Practice Guidelines and Future Directions
Open accessAbstract
Despite 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 that could support such clinical practice guidelines. While preliminary research evidence suggests that traditional, evidence-based 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 treatment interventions of choice for addressing both trauma symptoms and psychotic symptoms. In addition, case management was rated as a treatment intervention of choice for addressing psychotic symptoms. No consensus was reached on expert consensus items regarding the appropriateness of a parallel treatment approach exposure interventions for addressing psychotic symptoms, or sensorimotor or movement interventions for addressing trauma symptoms. In areas where expert consensus exists and is supported by current research, preliminary clinical practice guidelines for the treatment of comorbid early psychosis and trauma-related disorders are offered. In areas where expert consensus does not exist, recommendations for future research are offered. 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.
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Current clinical guidelines suggest integrated treatment with one clinician addressing psychosis and adversity sequelae simultaneously.
“Current clinical guidelines for addressing AEs with people with psychotic disorders [14] suggest integrated treatment with one clinician addressing psychosis and AEs sequelae simultaneously.”
From Outcomes of an adapted prolonged exposure psychotherapy for people with early phase psychosis, substance misuse, and a history of adversity: the PE + trial (2024) · cites this paper as [14]
The Results (Treatment Approaches) define integrated treatment as the same provider treating early psychosis and a trauma-related disorder at the same time, and rate it first-line for clients aged 18–25 with both conditions. The paper calls its recommendations preliminary and does not establish this approach for all adverse-experience sequelae or all psychotic disorders, as the citing sentence implies. (LLM, conf=0.86)
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- Authors
- Cragin, C. A., Straus, M. B., Blacker, D., Tully, L. M., & Niendam, T. A.
- Affiliations
- Antioch University New England (US)
- University of California, Davis (US)
- Corresponding author
- Cragin, Casey A.
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2017-03-06
- Volume
- 8
- Pages
- 33-33
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC5337515
- OpenAlex
- W2594665183
- Cited by
- 23
- References
- 49
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 1 · 2020: 3 · 2019: 3 · 2018: 2 · 2017: 1
- FWCI
- 3.05
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- OhioLink ETD Center (Ohio Library and Information Network) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Funders
- Health Resources and Services Administration (D40HP26868)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- early psychosis, trauma-related disorders, comorbidities, expert consensus, post-traumatic stress disorder, trauma-informed care, individual psychotherapy, psychoeducation, case management, exposure therapy, movement-based interventions, treatment appropriateness
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