High levels of optimism in persons with first-episode psychosis: Clinical implications

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Introduction: Philosophically, early intervention for psychosis has its roots in rejecting a nihilistic view of the prognosis of psychosis in favour of one that emphasizes therapeutic optimism and hope for functional recovery. In actual clinical practice, however, there is often still an emphasis on symptom resolution and functional impairments. Little is known about how young persons with psychosis themselves view the rest of their lives and its possibilities.

Objective: This research seeks to determine the levels of optimism in youth, upon entry into treatment for a first episode of psychosis, regarding reaching goals and living the quality of life they imagine for themselves in the future.

Methods: The data was collected as part of a larger project at the Prevention and Early Intervention Program for Psychoses (PEPP) in Montreal. The data is based on questions from two self-report questionnaires administered upon entry into treatment; the Birchwood Social Functioning Scale and adapted items from the hope subsection of Arnett’s Emerging Adulthood Questionnaire. Through these questions, youth with psychosis indicated how hopeful they were regarding both their capacity for work/school and the attainment of their desired quality of life, financial well-being, career/educational goals and personal relationships in the future.

Results: Across all questions, young persons with psychosis (N = 60) entering treatment displayed moderate to high levels of optimism/hope. Moreover, none of the patients for any question felt there to be no hope. Of those clients who were not working or in school at baseline, 75% felt they were ‘definitely’ capable of employment or returning to school. When asked about how hopeful they were that they would have the quality of life they desire, the highest proportion of patients felt moderately to very hopeful (85%). Similar results were found when asked about financial wellbeing (84% moderately to very hopeful), career and educational goals (76% moderately to very hopeful) and hopefulness for quality of personal relationships ( 87% moderately to very hopeful) in the future.

Clinical implications: Our findings show that young persons recently diagnosed with psychosis report high levels of optimism and hope for their future. Using simple tools to ask patients about hope and optimism early on could provide clinicians with concrete tools to shift the focus of treatment early on towards hope, therapeutic optimism and functional recovery. Assessing hope and optimism and basing treatment on this could likely create improved alliance between patients and clinicians and better engagement in treatment/services.

Poster First Author: 
Emily Schorr
Conference Presented At: 
IAYMH 2015
Poster Date: 
October, 2015
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