Table 3.

Recommendations and Reviews Related to CHR Psychoeducation

Authors & Year; Country	Aims/purpose	Type of Review / Recommendation	Key conclusion(s)
(Cadenhead and Mirzakhanian, 2016); USA	Describe early intervention in the psychosis risk syndrome and illustrate a case vignette	Narrative review & case vignette	Recommendation: Recommended Content: Emphasis of initial education should be on health promotion and early treatment rather than risk for psychosis.
(Early Psychosis Guidelines Writing Group and EPPIC National Support Program); Australia	Develop Australian Clinical Guidelines for Early Psychosis	Clinical guidelines	Recommendation: Recommended Content: Explanation of the illness and recovery, treatment options, agency in treatment, and prospects for the future and how these can be influenced. Material: should be appropriate for young people and for early psychosis, and be available to people from diverse backgrounds. Provider responsibility: providers are responsible for ensuring access to psychoed.
(Elauser and Juckel, 2012); Germany	Critically review the current state of CHR psychoed	Narrative review	Recommendation: Promising but “no definite recommendation” Content: diagnostic uncertainty, managing stigma, developmental significance, treatment. Provider responsibility: Providers need to update their knowledge, adapt psychoed with new updates in the field. More explicit provision is needed. Evidence/research: More research is needed to understand the needs of CHR regarding psychoed and evaluate CHR psychoed.
(Headspace National Youth Mental Health Foundation, 2015); Australia	Summary of evidence for different treatment options available to young people at UHR	Clinical guidelines	Recommendation: Recommended. Should be provided as part of CBT/supportive therapy for UHR. Content: begin with psychoeducation about psychosis and risk, describe as occurring on a continuum, provide prevalence rates, normalize, and use up-to-date evidence. Strengthen coping resources and reduce impact of stressors.
(Hetrick et al., 2018); Australia	Develop an implementation guide for scaling up an early intervention in psychosis services model (EPPIC) informed by analyzing barriers and enablers, behavior change theory, and effects of implementation	Implementation guide	Recommendation: Recommended. Psychoed is provided to patients and families on initial and as needed basis via individual, group, or family work. Family work consists of, at a minimum, psychoed relevant to the phase of illness. Provider responsibility: Case manager provides access to evidence-based treatment. Barriers to implementation include inexperience in CHR population, lack of skills/knowledge, and confidence in providing psychoeducation.
(International Early Psychosis Association Writing Group, 2005); International	Develop international clinical practice guidelines for early psychosis	Clinical guidelines	Recommendation: Recommended. Help-seeking ARMS patients need to be provided psychoed. Content: ARMS patients should be encouraged to develop coping skills for attenuated psychosis.
(McFarlane et al., 2012b); USA	Review family psychoeducation in CHR and FEP	Narrative review	Recommendation: Not specified. Content: emphasis on stress sensitivity, information sharing among family, early warning signs, indications for crisis Evidence/research: PMFGs and FACT show promising outcomes in early phases of psychosis. Family psychoed is acceptable to families and meets many of their needs. The multifamily group format adds an element of social support, network expansion.
Müller and Bechdolf, 2016); Germany	Discuss psychological interventions for CHR individuals	Narrative review	Recommendation: Evidence is encouraging but not sufficient. Content: Goals of CHR psychoed should convey realistic assessment of risk for psychosis, achieve a better understanding of risk symptoms, and improve skills for managing risk symptoms. Evidence/research: There have not been any RCTs for CHR psychoeducation.
(Stain et al., 2010); Australia	Review evidence for ARMS concept and effectiveness of early intervention to provide recommendations for community mental health services	Narrative review and clinical guidelines	Recommendation: Recommended. Core treatment approaches for help seeking UHR youth should include psychoed. Content: Understanding symptoms and treatments for those symptoms. Evidence/research: More research needed to provide clear evidence on efficacy.
(Thompson et al., 2015); USA	Describe psychosocial interventions that have demonstrated efficacy in treating CHR individuals	Narrative review	Recommendation: Promising. Psychoed is a core treatment element for CHR. Provider responsibility: Psychoed is a necessary process in a decision-making model that may guide clinicians in the selection of treatment components for CHR.
(van der Gaag et al., 2019); Netherlands	Review and propose next steps for CBT in the prevention of psychosis	Treatment protocol	Recommendation: Not specified. ARMS patients, compared to those with psychosis, are more receptive to psychoed and eager for therapy, as they maintain insight.

ARMS = At risk mental state, CHR= clinical high risk for psychosis, UHR = ultra high risk for psychosis, FEP = first episode psychosis, psychoed = psychoeducation, USA = United States of America