Table 2.
Protocol Adaptations for CLASP-S
|
Primary Factors for Adaptation: Consideration of those with active psychosis, co-occurring problems (e.g., substance use, depression), lower levels of education, current cognitive deficits, medication side effects, significant positive/negative symptoms of psychosis, and functional impairment | ||
| CLASP | CLASP-S Additions | |
|---|---|---|
| Structure | 3 initial sessions (40 – 50 minutes) beginning during hospitalization, completed ≤ 2 weeks post discharge; 1 in-person meeting with both the patient and SO post discharge; 11 follow-up phone contacts (15–30 minutes) held separately with patient and SO for up to a 6-month period | Flexibility for sessions to be held in person or remotely via phone or secure videoconference; Option for sessions to be shorter in duration based on patient presentation and needs |
| Process | Rapport building, history taking, psychoeducation about suicide risk, suicide risk assessment, completion/review of safety plan, values clarification/goal setting | Rapport building and support across sessions; Emphasis on structure; Use of handouts written at an appropriate reading level; Motivational enhancements to promote medication adherence; Ongoing assessment of psychotic and other symptoms that may interfere with treatment; Modeling and behavioral skill rehearsal by the therapist; Linkage with community resources to promote out-of-session practice; Discussion of relapse prevention between the patient and SO |
| Content | The Life Plan (dedicated space to record the patient’s values and accompanying goals) | Psychoeducation about the symptoms, course, and treatment of psychosis; Stigma and other illness-related treatment barriers; The role of expressed emotion; Cognitive tailoring of content based on individual need (e.g., Communication skills training; Problem solving strategies; Stress management techniques); Attention to treatment adherence; Reminders and self-monitoring strategies to support learning; Personalizing of treatment goals based on individual needs and abilities |
Note. SO = Significant Other.