title: A randomized trial of family focused therapy with populations at clinical high risk for psychosis: effects on interactional behavior.
abstract: OBJECTIVE
  This study investigated whether family focused therapy (FFT-CHR), an 18-session intervention that consisted of psychoeducation and training in communication and problem solving, brought about greater improvements in family communication than enhanced care (EC), a 3-session psychoeducational intervention, among individuals at clinical high risk for developing psychosis.
  
  
  METHODS
  This study was conducted within a randomized controlled trial across 8 sites. We examined 10-min problem-solving discussions at baseline and 6-month reassessment among 66 adolescents and young adults and their parents. Trained coders who were blind to treatment and time of assessment achieved high levels of interrater reliability when evaluating family discussions on categories of calm-constructive and critical-conflictual behavior.
  
  
  RESULTS
  Individuals at high risk and their family members who participated in FFT-CHR demonstrated greater improvement from baseline to 6-month reassessment in constructive communication and decreases in conflictual behaviors during family interactions than those in EC. Participants in FFT-CHR showed greater increases from baseline to 6 months in active listening and calm communication and greater decreases in irritability and anger, complaints and criticism, and off-task comments compared to participants in EC. These changes occurred equally in high-risk participants and their family members.
  
  
  CONCLUSIONS
  A 6-month family skills training treatment can bring about significant improvement in family communication among individuals at high risk for psychosis and their parents. Future studies should examine the association between enhancements in family communication and reduced risk for the onset of psychosis among individuals at high risk.
authors.affiliation: Department of Psychiatry, University of California, Los Angeles, School of Medicine.
authors.forename: Mary P
authors.initials: MP
authors.lastname: O'Brien
authors.affiliation: Department of Psychiatry, University of California, Los Angeles, School of Medicine.
authors.forename: David J
authors.initials: DJ
authors.lastname: Miklowitz
authors.affiliation: Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System.
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Candan
authors.affiliation: Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary.
authors.forename: Catherine
authors.initials: C
authors.lastname: Marshall
authors.affiliation: Department of Psychiatry, University of California, San Diego.
authors.forename: Isabel
authors.initials: I
authors.lastname: Domingues
authors.affiliation: Department of Psychiatry, Yale University School of Medicine.
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Walsh
authors.affiliation: Department of Psychology, University of California, Los Angeles.
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Zinberg
authors.affiliation: Center for the Assessment and Prevention of Prodromal States, University of California, Los Angeles.
authors.forename: Sandra D
authors.initials: SD
authors.lastname: De Silva
authors.affiliation: Beth Israel Deaconess Medical Center, Harvard Medical School.
authors.forename: Kristen A
authors.initials: KA
authors.lastname: Woodberry
authors.affiliation: Department of Psychiatry and Department of Psychology, University of California, Los Angeles.
authors.forename: Tyrone D
authors.initials: TD
authors.lastname: Cannon
mesh_terms: D000293:Adolescent; D003142:Communication; D005190:Family / Q000523:psychology*; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011340:Problem Solving; D011618:Psychotic Disorders / Q000523:psychology*; D016896:Treatment Outcome; D055815:Young Adult