Indicated prevention in psychosis risk—psychological approaches

The main focus of psychological treatment for youth at clinical high risk of psychosis has been to prevent transition to full-blown psychosis. However, there are other targets that have been considered less often such as attenuated psychotic symptoms (APS), negative symptoms, social functioning, depression, anxiety, and cognition. This chapter reviews all psychological treatment studies to date including cognitive behavioral therapy (CBT), family intervention, cognitive remediation, and integrated psychological therapy. There are some positive results in support of CBT in preventing transition to psychosis and reducing APS. None of the treatments reviewed appear to have an impact on negative symptoms or social functioning, which is of concern as many of these young people continue to have poorer social functioning even when they do not make the transition to psychosis and APS have remitted.