Accepted for/Published in: JMIR Formative Research
Date Submitted: Dec 16, 2020
Date Accepted: Feb 25, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
E-mental health interventions for young adults with early psychosis and cannabis use disorder: a qualitative study of patient and clinician perspectives
ABSTRACT
Background:
Persistence of cannabis use disorder (CUD) in young adults with first episode psychosis is associated with poor clinical and functional outcomes. Face-to-face psychological interventions are effective in treating CUD. However, their use in early intervention services (EIS) for psychosis is inconsistent due to barriers including high workload and heterogeneity in training of clinicians and lack of motivation for treatment among patients. Tailoring new technology-based psychological interventions (TBPIs) to overcome these barriers is necessary to ensure their optimal acceptability.
Objective:
The purpose of this study was two-fold: 1) to explore psychological intervention practices and intervention targets that are relevant for treating CUD in individuals with early psychosis, and 2) to explore factors related to the development and implementation of a technology-assisted psychological intervention.
Methods:
Ten patients undergoing treatment for first episode psychosis (FEP) and CUD in EIS participated in a focus group in June 2019. Semi-structured individual interviews were conducted with ten clinicians working in first episode clinics in the province of Québec, Canada. A hybrid inductive-deductive approach was used to analyse data. For deductive analysis, we used categories of promoting strategies found in the literature shown to increase adherence to online interventions for substance use (i.e., tailoring, reminders, delivery strategies, social support and incentives). For inductive analysis, we identified new themes through an iterative process of reviewing the data multiple times by two independent reviewers.
Results:
Data was synthesized in five categories of factors that emerged from data collection, and a narrative synthesis of commonalities and differences of patient and clinician perspectives was produced. The categories included: attitudes and beliefs related to psychological intervention (e.g., behavioral stage of change), strategies for psychological interventions (e.g., motivational interviewing), incentives (e.g., financial), general interest in TBPIs (e.g., facilitators and barriers), and tailoring of TBPIs (e.g., outcome measures of interest for clinicians).
Conclusions:
This study provides a comprehensive portrait of the multi-faceted needs and preferences of patients and clinicians related to TBPIs. Our results can inform the development of smartphone- or web-based psychological interventions for CUD in young adults with early psychosis. Clinical Trial: N/A
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