Enhancing Role Functioning in Clinical High Risk for Psychosis: An Open Trial of "InVEST" (Individualised Vocational...

School and vocational ("role") functioning is an important treatment target for young people exhibiting signs of clinical high risk for psychosis (CHR-P). However, there are currently no evidence-based approaches to help people at CHR-P with role functioning difficulties.

This manuscript describes the development and pilot open trial evaluation of "InVEST" (Individualised Vocational and Educational Support and Training). InVEST is a coaching program designed to enhance role functioning in youth at CHR-P. InVEST is designed to be flexible, low-intensity, and easy-to-train, and it is carried out by bachelor's and undergraduate-level "coaches" who work with clients individually for 4 months. The intervention specifically targets three mechanisms believed to relate to role functioning in this clinical population: (1) organisation, (2) task initiation, and (3) distress resilience. This manuscript describes a small open trial and the iterative development of a manual based on participant feedback about this intervention in preparation for a randomised controlled trial.

All participants (N = 5) completed the baseline assessment, 16 weeks of coaching, and follow-up, with no dropouts. Participants reported high satisfaction with the program, and participant feedback was used to iterate and develop the InVEST manual. Additionally, most participants showed improvement in role functioning (4/5), organisation and planning (4/5), and task initiation (3/5) following InVEST participation.

This small pilot study provides initial support for the feasibility and acceptability of InVEST and suggests that further study in comparison to a control condition is warranted.