T230. IDENTITY IN THE EARLY STAGES OF PSYCHOSIS: PERSPECTIVES OF CANADIAN EARLY PSYCHOSIS CLINICIANS
Notice bibliographique
Résumé
Abstract Background A recent narrative review of the research literature (Ben-David & Kealy, 2019) found that identity-related concerns were an important aspect of young people’s experiences in the early stages of psychosis. Themes across articles suggested that the emergence of psychosis leads to identity disruption, which in turn may contribute to additional mental health risks. Moreover, studies indicated the salience to young people of addressing personal identity during the recovery process. Understanding clinicians’ perspectives on issues related to identity in early psychosis is an important next step, particularly to determine needs for knowledge development, clinician support, and intervention practices. The current literature on clinician’s perspective on early psychosis and identity is limited, with more attention placed on clinician’s perspectives on the use of medication, and psychosocial interventions (e.g. cognitive behavioral therapy (CBT)). The purpose of the present study was to understand the perspectives of early psychosis intervention (EPI) clinicians on identity related concerns among young people in the early stages of psychosis. Methods An online questionnaire was distributed to 331 EPI clinicians in the province of British Columbia, Canada. Participants were asked about their opinions on identity in the early stages of psychosis using fixed and open response questions. The open-ended response question “what kinds of interventions do you think would strengthen clients’ personal identity in the early stages of psychosis?” was coded by two investigators, using content analysis methodology. Results The response rate was 30%. Of the participants, 98% agreed that personal identity is an important issue for clinical attention among young people in the early stages of psychosis, and 99% agreed that schizophrenia spectrum disorders can have a negative impact on a young person’s identity. Despite near-unanimous acknowledgement of identity as a critical issue in early psychosis, only 53% of clinicians endorsed a high level of confidence in their ability to address issues related to identity in treatment, and only 28% agreed that current intervention practices adequately address personal identity. Seventy-four percent of the participants provided qualitative responses regarding intervention approaches that they believed would strengthen clients’ personal identity in the early stages of psychosis. Common themes included social connection and peer support, therapeutic interventions (e.g. CBT, mindfulness, narrative therapy, psychoeducation), focusing on the youths strengths, involving family in the work, connecting youth to personal identity (e.g. exploring culture, values, interests and sources of meaning, storytelling), and enhancing relationships between service providers and youth. Discussion EPI clinicians in British Columbia agree that personal identity in the early stages of psychosis is an important issue. However, they indicated feeling markedly less confident in their ability to address issues related to identity in treatment. Findings suggest that EPI programs should invest in identity- related training for clinicians. Future research can focus on the impact of identity-related interventions with regard to treatment engagement and client recovery outcomes.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,011 | 0,020 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,002 | 0,004 |
| Études des sciences et des technologies | 0,033 | 0,009 |
| Communication savante | 0,009 | 0,003 |
| Science ouverte | 0,002 | 0,007 |
| Intégrité de la recherche | 0,004 | 0,006 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».