(PS7-94) Qualitative Evaluation of Acceptability and Feasibility of a Behavioral Intervention to Reduce Violence Among Young Adults with Early Psychosis

For young adults with schizophrenia-spectrum disorders, the early psychosis period presents a higher risk of violent behavior compared to later in the course of illness. This timeframe offers a unique opportunity for intervention through specialized early intervention services (EIS), but there are currently no studies exploring the use of CBT-based interventions to reduce violence for young adults with early psychosis. This formative research explored the perspectives of EIS participants and staff toward the Psychological Intervention for Complex PTSD and Schizophrenia-Spectrum disorder (PICASSO), a CBT method that specifically addresses violence, anger, and psychosis. Semi-structured qualitative interviews were conducted within the OnTrackNY network of EIS programs, whose 28 locations provide coordinated specialty care services to young adults in New York State.  Research participants included three groups: EIS clinicians (n = 7); EIS peer specialists (n = 5); and EIS participants (n = 6). Interviews explored the acceptability and feasibility of PICASSO. In addition, interviews with EIS participants used the Theory of Planned Behavior to investigate how EIS participants felt about reducing violence. Interview transcripts were analyzed in Dedoose using thematic content analysis. Overall, EIS participants, peer specialists, and clinicians found that PICCASO had potential acceptability and feasibility in an EIS setting. Themes regarding acceptability included negative experiences of violence and the desire to control and minimize violence. Themes regarding feasibility raised concerns about time constraints, consistency of patient participation in the intervention, and implementation issues in the context of stigma related to both psychosis and perpetration of violence. Findings from this study suggest young adults with a history of violence are highly motivated to reduce violent behavior, in part because of the significant disruptions this behavior may cause in their lives. The collected recommendations indicate that if adequate resources are devoted to addressing time and training constraints and implementation issues, a CBT intervention for violence like PICASSO appears both acceptable and feasible for EIS participants and staff.