T18. PSYCHOTHERAPY READINESS AMONG PSYCHIATRICALLY HOSPITALIZED ADOLESCENTS WITH PSYCHOSIS-SPECTRUM DISORDERS

Abstract

Background: Psychosis often emerges in late adolescence, and many individuals report a period of months to years during which psychotic-spectrum experiences increase in frequency, intensity, and interference before receiving appropriate care. For a host of reasons, including stigma and embarrassment, psychosis-spectrum symptoms often progress, untreated, until acute level care is warranted. With growing attention to the clinical high risk (CHR) phase, early intervention initiatives are becoming increasingly available to address early signs of illness and mitigate risk. Psychosocial interventions employed during the prodromal "pre-psychotic" phase have been consistently linked to positive outcomes. Despite the field's growing understanding of this population and their needs, and the promising outcomes linked to early care, many youth with emerging symptoms do not receive appropriate treatment for these experiences. One important factor associated with treatment use and engagement is an individual's attitude toward treatment. Little is known about how adolescents at CHR view mental health treatment in their early contacts with mental health professionals. Method(s): This study sought to explore psychotherapy readiness in relation to psychosis-spectrum experiences among adolescents admitted to a psychiatric inpatient unit for acute safety concerns, often linked to suicidality. Participants included 389 adolescents admitted to a psychiatric inpatient unit in the Northeast United States, all of whom completed a brief diagnostic interview and the Readiness for Psychotherapy Index (RPI) upon intake. Result(s): A total of 74 participants were determined to meet criteria for a psychosis-spectrum disorder (PSD). The remaining 315 adolescents demonstrated a similar level of acuity and presented with a variety of mental health concerns, not including psychosis. Scores on the RPI were compared across adolescents with PSDs and those without. Two of the RPI subscales differed significantly across groups, the Perseverance and Distress scales. There were no significant differences in scores on the other two subscales, Disinterest and Openness, and on the Overall Readiness scale. The PSD group endorsed significantly lower scores on the Perseverance subscale, indicating a lower willingness to work in therapy (less readiness for psychotherapy) than the comparison group. On the Distress subscale, PSD adolescents endorsed greater concern for their mental health problems. These findings indicate that adolescents with PSD are reporting greater distress related to their mental health, however, they may also be less willing to work in therapy. Discussion(s): These observations warrant further research, as the attitudes and beliefs behind these findings may have significant implications for treatment engagement strategies and interventions. To further explore these results, a subsample of first-time admission youth with PSDs completed a brief qualitative interview exploring the nature of their mental health distress, as well as their attitudes toward therapists and treatment. Information from the interviews was extracted and summarized into a thematic matrix. Qualitative themes, identified through preliminary matrix analyses, will be presented in addition to quantitative results. Implications of these findings for treatment engagement and future research directions will also be discussed.