title: Psychotherapy for adolescents and young adults at high risk for psychosis: a systematic review.
abstract: OBJECTIVE
  Unlike medication treatment, which may confer an unfavourable risk-benefit ratio, psychosocial intervention has been an emerging target of recent randomized controlled trials (RCTs) assessing its efficacy in delaying or preventing the onset of psychosis in individuals identified at 'clinical high risk'. Literature comparing qualitative differences in these psychotherapeutic interventions is scarce. The aim of the current study was to conduct a PRISMA systematic review evaluating the efficacy of psychotherapeutic interventions in reducing the rates of conversion to psychosis in clinical high-risk individuals.
  
  
  METHODS
  RCTs were identified in PubMed, Medline and PsycINFO databases up to 30 November 2013. Six studies (comprising 800 participants) met review inclusion criteria. Three investigators performed data extraction independently by using a pre-structured selection form, and conducted risk of bias assessment employing the Cochrane approach.
  
  
  RESULTS
  All six studies employed cognitive behaviour therapy as a core element. Three trials achieved a significant effect. The two trials that employed cognitive behaviour therapy enhanced for the specialized needs of clinical high-risk patients maintained significant effects at post-treatment follow up.
  
  
  CONCLUSIONS
  Evidence from recent trials suggest that cognitive behaviour therapy may be beneficial in delaying or preventing onset of psychosis in clinical high-risk individuals, although effect sizes to date appear small. Further research is needed in larger samples to establish whether cognitive behaviour therapy is efficacious, and if additional intervention components can enhance established psychotherapies.
authors.affiliation: Department of Psychiatry, University of Maryland, Baltimore, Maryland, USA.
authors.forename: Nana
authors.initials: N
authors.lastname: Okuzawa
authors.forename: Emily
authors.initials: E
authors.lastname: Kline
authors.forename: Janine
authors.initials: J
authors.lastname: Fuertes
authors.forename: Shobhit
authors.initials: S
authors.lastname: Negi
authors.forename: Gloria
authors.initials: G
authors.lastname: Reeves
authors.forename: Seth
authors.initials: S
authors.lastname: Himelhoch
authors.forename: Jason
authors.initials: J
authors.lastname: Schiffman
mesh_terms: D000293:Adolescent; D015928:Cognitive Behavioral Therapy; D061345:Early Medical Intervention; D006801:Humans; D011618:Psychotic Disorders / Q000517:prevention & control* / Q000628:therapy*; D055815:Young Adult
keywords: adolescent; adult; psychotherapy; psychotic disorder; review