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Berk brings to the program extensive research and clinical expertise in dialectical behavioral therapy, a specialized intervention for individuals with suicidal or self-harming behaviors, or both.
The STEP Program is a trial of a specialized intervention service for patients early in the course of psychotic illness, to provide a variety of coordinated treatments (including cognitive behavioral therapy, cognitive remediation, case management, psychopharmacologic treatment) and learn about early psychosis, through neuroimaging, cognitive assessments, and genetics.
The age criterion was imposed for the following reasons: it is more difficult for men <18 years old to cross the border; the proportion of men in pilot work who reported having had sex with an FSW before they were 18 was low (7%); and a specialized intervention that takes into account the needs of younger men would be needed.
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All patients were part of a longitudinal naturalistic outcome study of first-episode psychosis and were recruited and treated through the Prevention and Early Intervention Program for Psychoses (PEPP-Montreal), a specialized early intervention service with integrated clinical, research, and teaching modules, at the Douglas Mental Health University Institute in Montreal, Canada.
Studies included exclusively women and evaluated more generic multidisciplinary interventions (e.g. group counseling, support groups, combined psychosocial and economic interventions, medical care and psychological support), as well as a specialized psychotherapeutic intervention (i.e. cognitive behavioral therapy).
In the control group, patients receive care as usual which most often is a single interview or referral to specialized intervention.
Firstly, it can demonstrate the effectiveness of specialized intervention for patients suffering from treatment resistant disorders.
Second, the highly specialized intervention strategy was no more effective than usual care, which could indicate that usual care represents a well functioning welfare system.
Our data emphasize the importance of providing early, specialized intervention to prevent organ dysfunction and to reduce risk factors leading to mortality.
The results indicated that obese adolescents would benefit from more specialized interventions; a need for an online public health intervention addressing the non-obese adolescent population was also identified.
We believe the mechanisms underlying ID-images are of high priority with regard to both further investigation and the development of interventions for suicidality – both diagnostically, in terms of suicidal risk (and depression severity, in general), and as a crucial target of specialized interventions.
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