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OBJECTIVE. The purpose of this systematic review was to describe the evidence for the effectiveness of early intervention to improve and maintain performance in occupations for youths with or at risk for serious mental illness (SMI).
METHOD. Titles and abstracts of 670 articles were reviewed, 234 were retrieved for full review, and 30 met inclusion criteria.
RESULTS. Moderate to strong evidence supports cognitive remediation (CR) and mixed evidence supports cognitive-behavioral therapy (CBT) as an adjunct modality to improve general functioning. Moderate to strong evidence supports use of supported employment and supported education (SE/E) to improve social and occupational outcomes in employment and academics. Strong evidence supports family psychoeducation (FPE) to prevent relapse and rehospitalization and improve problem-solving skills and general functioning.
CONCLUSION. Occupational therapy practitioners should integrate CR, SE/E, and FPE into early intervention with youth with or at risk for SMI. In addition, CBT is an effective modality for use with this population.
The transition from adolescence to young adulthood (12-35 yr old) is a period of increased risk for onset of serious mental illness (SMI; McGorry, 2011). Early detection and rapid intervention may reduce the impact of mental illness and may even delay or prevent transition to SMI. Early intervention may also reduce the risk of death by suicide or a lifetime of disability characterized by unemployment, incomplete education, social isolation, and significant symptoms that interfere with daily living (Gonzalez et al., 2015; McGorry, 2011).
SMI, such as schizophrenia, bipolar disorder, and major depression, costs the U.S. government substantial amounts of money for Medicaid subsidies and other benefits (Gonzalez et al., 2015). Early intervention services (EIS), especially for people experiencing the early signs or first episode of psychosis, have been shown to be effective in reducing the impact of SMI through early detection, targeted interventions, and easy access to care (Bird et al., 2010; Gonzalez et al., 2015).
We were unable to find a systematic review that specifically focused on the role of occupational therapy in EIS for people with SMI or specifically on interventions to improve occupational performance in this population. This review aimed to identify the evidence related to specific interventions within the scope of occupational therapy practice for people in the early stages of onset of SMI. This review...