Enhanced Coordinated Specialty Care for Early Psychosis

NCT ID: NCT06071858

Last Updated: 2025-02-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

350 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-01

Study Completion Date

2028-10-31

Brief Summary

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The goal of this clinical trial is to compare engagement in treatment in coordinated specialty care (CSC) to five extra care elements (CSC 2.0) in first-episode psychosis. The main question it aims to answer is:

• Does the addition of certain elements of care increase the number of visits in treatment for first-episode psychosis?

Participants will either:

* Receive care as usual (CSC) or
* Receive care as usual (CSC) plus five additional care elements (CSC 2.0):

1. Individual peer support
2. Digital outreach
3. Care coordination
4. Multi-family group therapy
5. Cognitive remediation

Researchers will compare the standard of care (CSC) to CSC 2.0 to see if participants receiving CSC 2.0 have more visits to their clinic in their first year.

Detailed Description

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Conditions

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Psychosis Schizophrenia Schizoaffective Disorder Psychosis Nos/Other Bipolar Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Coordinated Specialty Care (CSC; standard of care)

Care as usual; no intervention.

Group Type NO_INTERVENTION

No interventions assigned to this group

Enhanced Coordinated Speciality Care (CSC 2.0)

CSC 2.0 arm will be offered 1:1 peer support, digital outreach, care coordination, multi-family group therapy, and cognitive remediation (if applicable).

Group Type EXPERIMENTAL

Care Coordination

Intervention Type BEHAVIORAL

* The study staff clinician will review all medical issues for each patient and reach out to primary care providers (PCP), dieticians, and other medical providers as needed.
* The study staff clinician will serve as point person for communication with emergency departments and inpatient providers if the patient requires those levels of care.
* The clinician will communicate with outside providers to provide background and ensure health decision making by those providers, visit and support patients as appropriate, access outside records and share with rest of the care team, and most critically ensure that a proper discharge plan has been made for the patient including care appointments, access to prescriptions and any new referrals made during hospitalization.

Individual Peer Support

Intervention Type BEHAVIORAL

• Patients will be offered weekly 1:1 sessions with a Peer Provider as part of routine care in a mixture of in-person and virtual formats as appropriate to support patients around treatment decisions, and recovery.

Digital Outreach

Intervention Type BEHAVIORAL

• mindLAMP smartphone application for various kinds of outreach including but not limited to medication and/or appointment reminders, resources, and activities such as breathing and meditation exercises.

Cognitive Remediation

Intervention Type BEHAVIORAL

* For participants identified as needing and/or wanting support around cognition.
* The cognitive remediation program is available online or in-app and offers memory, attention, processing speed, executive functioning, and social cognition training activities.

Multi-Family Group Therapy

Intervention Type BEHAVIORAL

* Families whose loved ones are in CSC clinic will be offered weekly group sessions with a study staff clinician.
* Each group may include 5-8 families and include a mixture of in-person and virtual formats.
* These groups will be open-ended, including psychoeducation, and practical problem-solving discussions around care and other topics.

Interventions

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Care Coordination

* The study staff clinician will review all medical issues for each patient and reach out to primary care providers (PCP), dieticians, and other medical providers as needed.
* The study staff clinician will serve as point person for communication with emergency departments and inpatient providers if the patient requires those levels of care.
* The clinician will communicate with outside providers to provide background and ensure health decision making by those providers, visit and support patients as appropriate, access outside records and share with rest of the care team, and most critically ensure that a proper discharge plan has been made for the patient including care appointments, access to prescriptions and any new referrals made during hospitalization.

Intervention Type BEHAVIORAL

Individual Peer Support

• Patients will be offered weekly 1:1 sessions with a Peer Provider as part of routine care in a mixture of in-person and virtual formats as appropriate to support patients around treatment decisions, and recovery.

Intervention Type BEHAVIORAL

Digital Outreach

• mindLAMP smartphone application for various kinds of outreach including but not limited to medication and/or appointment reminders, resources, and activities such as breathing and meditation exercises.

Intervention Type BEHAVIORAL

Cognitive Remediation

* For participants identified as needing and/or wanting support around cognition.
* The cognitive remediation program is available online or in-app and offers memory, attention, processing speed, executive functioning, and social cognition training activities.

Intervention Type BEHAVIORAL

Multi-Family Group Therapy

* Families whose loved ones are in CSC clinic will be offered weekly group sessions with a study staff clinician.
* Each group may include 5-8 families and include a mixture of in-person and virtual formats.
* These groups will be open-ended, including psychoeducation, and practical problem-solving discussions around care and other topics.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* People undergoing an intake evaluation to CSC for first-episode psychosis in one of the following outpatient clinics:
* McLean Hospital OnTrack (OnTrack Clinic)
* Massachusetts General Hospital (FEPP Clinic)
* Boston Medical Center (WRAP Clinic)
* Cambridge Health Alliance (RISE Clinic)
* UMass Memorial Health Care (STEP Clinic)
* ServiceNet (PREP West)

Exclusion Criteria

* None
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mclean Hospital

OTHER

Sponsor Role lead

Massachusetts General Hospital

OTHER

Sponsor Role collaborator

Boston Medical Center

OTHER

Sponsor Role collaborator

Cambridge Health Alliance

OTHER

Sponsor Role collaborator

University of Massachusetts, Worcester

OTHER

Sponsor Role collaborator

National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

Responsible Party

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Dost Ongur

Director, LEAP Center

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Dost Ongur, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Mclean Hospital

Locations

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McLean Hospital OnTrack Clinic

Belmont, Massachusetts, United States

Site Status RECRUITING

Massachusetts General Hospital FEPP Clinic

Boston, Massachusetts, United States

Site Status RECRUITING

Boston Medical Center WRAP

Boston, Massachusetts, United States

Site Status RECRUITING

Cambridge Health Alliance RISE Clinic

Cambridge, Massachusetts, United States

Site Status RECRUITING

UMass Memorial Community Healthlink STEP Clinic

Worcester, Massachusetts, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Dost Ongur, MD, PhD

Role: CONTACT

617-855-3922

Jacqueline Dow, MPH

Role: CONTACT

617-855-3321

Facility Contacts

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Dost Ongur, MD, PhD

Role: primary

Dost Ongur, MD, PhD

Role: primary

Dost Ongur, MD, PhD

Role: primary

Dost Ongur, MD, PhD

Role: primary

Dost Ongur, MD, PhD

Role: primary

Other Identifiers

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2P50MH115846-05

Identifier Type: NIH

Identifier Source: secondary_id

View Link

2023P002612

Identifier Type: -

Identifier Source: org_study_id

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