This project will recruit clients of a local early psychosis clinic who are currently using cannabis. Case managers will refer interested clients to the study, which will explore the effectiveness of a computer-delivered psychological treatment for cannabis use (and related problems; the SHADE intervention).
Dr Daniel Pellen (Early Psychosis Treatment Centre, Bondi Junction)
Professor Vaughan Carr (School of Psychiatry, UNSW)
Cannabis use is associated with an increased risk of psychosis, is highly prevalent in people presenting for treatment of first episode psychosis (FEP), and is associated with increased risk of relapse. Therefore, it is vital that Early Psychosis Treatment Centers (EPTC) address cannabis use. Evidence suggests that the treatment of choice for problematic cannabis useis psychological intervention, most commonly provided by a clinical psychologist. Unfortunately, Early Psychosis Treatment Centers rarely have the resources to provide sufficient psychological services, particularly for cannabis use. In addition, the option of referring to alcohol and other drug treatment services is often hampered by a lack of co-ordination with mental health services. An emerging option to address these problems is the use of computer-based interventions. This project will use an evidence-based computerized treatment for problematic cannabis use (SHADE)within an EPTC to determine its effectiveness in reducing cannabis use problems.
To explore the effectiveness of a computer-based treatment for cannabis use problems in an early psychosis population.
Thirty-two people presenting for treatment for FEP will be recruited into the study. Consenting participants will complete a baseline assessment, with randomization to SHADE or wait-list occurring at the conclusion of the baseline assessment. Participants allocated to the SHADE condition will watch an introductory session on computer (approximately 15 minutes’ duration) to orient them to the SHADE treatment program, under the supervision of the project worker. They will then have an appointment made for as soon as possible to commence the first of 10 SHADE computer sessions. Participants will come into the EPTC to complete their SHADE sessions over the ensuing 10 weeks, meeting on each occasion with the project worker for a 10-minute debriefing/compliance check regarding their SHADE-related activities.
Participants assigned to the wait-list condition will be informed of the outcome, and advised that they will be contacted in 15 weeks’ time to arrange a follow-up assessment and the first SHADE computer session. During this time, participants on the wait-list will be instructed to attend their usual appointments with their case worker. After 15-weeks, wait-list participants will complete their 15-week assessment, and complete the SHADE computer intervention as above.
Follow-up assessments will be conducted by the project worker at the EPTC for all participants, regardless of allocation at 15- and 30-weeks post-baseline.
Participant recruitment to the trial has ceased, and data analysis has commenced.
The possibility of providing a CBI for cannabis use in FEP is a logical next step and an exciting option as it potentially addresses all of the problems currently faced by EPTCs in addressing comorbid cannabis use in FEP. Additionally, the target population of young people are the most likely to be comfortable with technology and accustomed to accessing computers for health related support.