Feasibility and Effectiveness of a Psychosis-Specific Intensive Outpatient Program

Intensive outpatient programs (IOPs) are rarely designed specifically to treat psychosis. In 2016 UCLA established the Thought Disorders Intensive Outpatient Program (TD IOP), combining a time-limited, group-based intervention called cognitive behavioral social skills training (CBSST) and medication management to treat individuals with psychosis. The purpose of this study is to assess the feasibility of developing an IOP for individuals with psychosis and the effectiveness of the program in improving psychotic symptom severity.

Adults were referred to the TD IOP from inpatient and outpatient settings. Programming included 3 hours of CBSST and 6 hours of additional groups weekly as well as individual psychiatry and social work services. Primary outcomes were symptom changes as measured at intake and discharge by the Clinician-Rated Dimensions of Psychosis Symptom Severity scale. Program feedback was solicited from a small subset of patients.

Of the 92 enrolled subjects, 71 completed the program (77.2%). Average length of stay was 52 ± 30 days across all enrolled. Participants showed significant (p < 0.05) improvement with small-moderate effect sizes across five of eight psychosis symptom domains (hallucinations, delusions, disorganized speech, depression, and mania). Patient-reported program satisfaction was high (86.6 ± 12.7 score, range 0-100).

The current study indicates that targeted treatment for psychosis is successful within an IOP framework, with minimal additional training required for Master's level clinicians. Participants demonstrated significant symptomatic relief from group-based, time-limited treatment. Further work is needed to determine the full range of program benefits on patient well-being and illness morbidity.