Feasibility Trial of a Parent Peer-Co-Led Caregiver Group for Pediatric Early Onset Schizophrenia Spectrum Disorders

NCT07867964 — Not applicable, Not yet recruiting, 20 participants, Boston Children's Hospital

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Wait-List Controlled Feasibility Trial of a Parent Peer-Co-Led Caregiver Group for Pediatric Early Onset Schizophrenia Spectrum Disorders

RegistryNCT07867964
StatusNot yet recruiting
PhaseNot applicable
Study typeInterventional; non randomized, parallel, masking: single, treatment
Enrollment20 (Estimated)
SponsorBoston Children's Hospital (Other)
ConditionsSchizophrenia; Psychosis
InterventionsGroup Therapy, Treatment as Usual (TAU) (Behavioral, other)
Datesstart 2027-05-01 (estimated), primary completion 2027-08-01 (estimated), completion 2027-12-01 (estimated), first posted 2026-10-09, last updated 2026-10-09
Locations1 site in United States

Related Papers Related Patents Related Grants Related Experts
All trials for Schizophrenia; Psychosis All trials of Group Therapy All trials of Treatment as Usual (TAU)

-Summary

While early onset schizophrenia spectrum disorders are among the most debilitating psychiatric illnesses, evidence-based treatment for this population is limited. This study evaluates the feasibility and acceptability of a parent peer co-led group intervention for caregivers of youth with Early Onset Schizophrenia Spectrum Disorder to support further refinement.

Caregivers of youth with Early Onset Schizophrenia Spectrum Disorder will be invited to participate. Participants will be assigned to either the treatment group or the wait-list control group. Those in the treatment group will receive the group intervention immediately at study start and wait-list participants will be invited to participate following completion of the study. The group intervention consists of 10 group therapy intervention sessions covering psychosis psychoeducation (e.g. symptoms monitoring, stress \& stress management, family communication skills, and coping skills).

Feasibility will be assessed through recruitment and retention, acceptability through the Client Satisfaction Questionnaire. Secondary aims include effectiveness using Goal Attainment Scaling (GAS), Perceived Stress Scale (PSS), and qualitative feedback from participants.

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+Detailed description

Schizophrenia spectrum disorders (SSD) are a group of disorders defined by the presence of delusions, hallucinations, disorganized thinking, grossly disorganized or abnormal motor behavior, and/or negative symptoms, and typically present between late teens and mid-30s. While treatment approaches for adults with SSD are well-established, evidence-based psychosocial interventions for pediatric early-onset SSD (EOSSD; onset <18 years) remain limited. Current recommendations emphasize psychotropic interventions, with little empirical support for psychosocial treatments, underscoring the urgent need for clinical research in this population.

Although extensive research supports psychosocial interventions for first episode psychosis (FEP), studies specific to pediatric EOSSD are scarce. Existing research has evaluated cognitive remediation, cognitive behavioral therapy (CBT), and family interventions \[5\] for EOSSD. In one study comparing CBT to treatment-as-usual (TAU), no significant differences emerged on PANSS scores; follow-up completion was low, and only 3 of 11 participants achieved a good response (>50% reduction in PANSS total score) \[6\]. A recent review by Kelleher et al. \[2\] concluded that such poor outcomes suggest there is limited effectiveness of CBT for EOSSD in real-world care, highlighting the need for alternative treatment approaches.

In addition to the limited evidence on individual psychosocial approaches, even though including caregivers/families in treatment is an integral component in gold-standard care in FEP treatment, to our knowledge only one other study has explored the effects of a caregiver/family-focused intervention for pediatric EOSSD. In this one study, participants who were in the structured family intervention had significantly fewer visits to the emergency department (13% vs 50%) and saw greater symptom improvement.

The use of parent peers (also termed parent partners or parent-to-parent programs) is an emerging strategy for delivering psychoeducation and support to parents of youth with behavioral health challenges (e.g. autism, inpatient hospitalization) with promising evidence. A review of 25 parent-to-parent interventions for caregivers of youth with autism found that parents were effective in delivering the intervention and reported benefits to include developing a sense of belonging and alleviating social isolation, which are frequently reported as areas of need by our caregivers of youth with EOSSD.

In sum, while psychosocial interventions are well-studied in adult SSDs, pediatric EOSSD remains an under-researched area with poor treatment outcomes. The few existing studies show that caregiver and peer involvement may be particularly impactful. To address these gaps, the current study will evaluate the feasibility and acceptability of a psychoeducation group for caregivers of youth ≤18 years with EOSSD (schizophrenia, schizoaffective disorder), co-led, and co-designed by a licensed psychologist and a caregiver with lived experience.

+Arms and interventions

ArmTypeInterventionsDescription
Treatment GroupExperimentalBehavioral: Group TherapyParticipants in the Treatment Group will attend 10 group therapy sessions.
Wait List Control GroupActive comparatorOther: Treatment as Usual (TAU)Participants in the wait-list control arm will serve as a comparison group for the duration of the primary intervention period. Upon completion of the primary study endpoints and post-tests, the wait-list control group will be offered the opportunity to receive the identical intervention.
  • Group Therapy (Behavioral): The intervention consists of 10 sessions. Intervention sessions are held over a secure zoom platform, for 1-1.5 hrs, with up to 10 participants, once/week. The group will be facilitated by licensed psychologist. The group sessions will include, 1) Introductions, Goal Setting, Group Norms, Overview of Group, 2) Psychosis Psychoeducation, 3) Developmental Considerations, 4) Mental Health Systems \& Collaborating with Schools, 5) Role of Stress and Decreasing Stress in the Home, 6) Communication Skills, 7) Health Behaviors, 8) Coping Skills \& The Science of Psychosis, 9) Medications \& Prevention Planning, 10) Goal Setting \& Wrap-Up.
  • Treatment as Usual (TAU) (Other): Participants in the Waitlist group will receive treatment as usual (parent support and guidance from child's clinician, individual therapy for child, and psychopharmacological medication management for their child).

+Outcome measures

Primary outcomes

  • Feasibility measured as attendance to the group sessions [Immediately following the last intervention session]: The average number of total group sessions attended
  • Acceptability as measured on the Client Satisfaction Questionnaire-Participant Versions (CSQ) [Within two weeks following group intervention completion]: Client Satisfaction Questionnaire-Participant (CSQ) - used to assess acceptability of intervention, as defined by participant ratings on quality of service, fits of the intervention to meet need to support satisfaction, and overall satisfaction.

Secondary outcomes

  • Effectiveness of the intervention as measured on progress on the Goal Attainment Scale (GAS) [Within two weeks following group intervention completion]: Effectiveness is defined as progress made towards individualized patient's goals, we will assess the difference in progress made towards goals between those in the wait-list control and treatment group. Progress towards caregiver goals will be measured using Goal Attainment Scale (GAS).
  • Social Validity [Post-Intervention]: Social validity as assessed via the Semi-structured Interview for Social Validation

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Individuals who are 18 years old or older.
* Individuals who are primary caregivers
* Individuals are caregivers of a young person who meets criteria for EOSSD per clinician report.
* Individuals who are fluent in English.

Exclusion Criteria:

* Non-fluency in English.
* Impaired decision making capacity per PI review.

+Locations (1)

FacilityCityCountryStatus
Boston Children's HospitalBrookline, MassachusettsUnited States

+Publications

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  • Lammers EJ, Zickafoose JS, Peterson GG, Blue L, Stewart KA, Kranker K. Parent Partners: Evaluation of a Novel Peer-Support Intervention for the Caregivers of Children Hospitalized for Behavioral Health Conditions. Acad Pediatr. 2019 Nov-Dec;19(8):908-916. doi: 10.1016/j.acap.2019.06.001. Epub 2019 Jun 6. PMID 31176786
  • Day C, Michelson D, Thomson S, Penney C, Draper L. Evaluation of a peer led parenting intervention for disruptive behaviour problems in children: community based randomised controlled trial. BMJ. 2012 Mar 13;344:e1107. doi: 10.1136/bmj.e1107. PMID 22416059
  • Chien WT, Ho LK, Gray R, Bressington D. A randomized controlled trial of a peer-facilitated self-management program for people with recent-onset psychosis. Schizophr Res. 2022 Dec;250:22-30. doi: 10.1016/j.schres.2022.09.028. Epub 2022 Oct 13. PMID 36242787
  • Castelein S, Bruggeman R, van Busschbach JT, van der Gaag M, Stant AD, Knegtering H, Wiersma D. The effectiveness of peer support groups in psychosis: a randomized controlled trial. Acta Psychiatr Scand. 2008 Jul;118(1):64-72. doi: 10.1111/j.1600-0447.2008.01216.x. PMID 18595176
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  • Calvo A, Moreno M, Ruiz-Sancho A, Rapado-Castro M, Moreno C, Sanchez-Gutierrez T, Arango C, Mayoral M. Psychoeducational Group Intervention for Adolescents With Psychosis and Their Families: A Two-Year Follow-Up. J Am Acad Child Adolesc Psychiatry. 2015 Dec;54(12):984-90. doi: 10.1016/j.jaac.2015.09.018. Epub 2015 Oct 13. PMID 26598473
  • Fusar-Poli P, McGorry PD, Kane JM. Improving outcomes of first-episode psychosis: an overview. World Psychiatry. 2017 Oct;16(3):251-265. doi: 10.1002/wps.20446. PMID 28941089
  • Morrison AP, Pyle M, Maughan D, Johns L, Freeman D, Broome MR, Husain N, Fowler D, Hudson J, MacLennan G, Norrie J, Shiers D, Hollis C, James A; MAPS group. Antipsychotic medication versus psychological intervention versus a combination of both in adolescents with first-episode psychosis (MAPS): a multicentre, three-arm, randomised controlled pilot and feasibility study. Lancet Psychiatry. 2020 Sep;7(9):788-800. doi: 10.1016/S2215-0366(20)30248-0. Epub 2020 Jul 7. PMID 32649925
  • Anagnostopoulou N, Kyriakopoulos M, Alba A. Psychological interventions in psychosis in children and adolescents: a systematic review. Eur Child Adolesc Psychiatry. 2019 Jun;28(6):735-746. doi: 10.1007/s00787-018-1159-3. Epub 2018 May 4. PMID 29728871
  • McDonagh MS, Dana T, Selph S, Devine EB, Cantor A, Bougatsos C, Blazina I, Grusing S, Fu R, Kopelovich SL, Monroe-DeVita M, Haupt DW. Treatments for Schizophrenia in Adults: A Systematic Review [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2017 Oct. Report No.: 17(18)-EHC031-EF. Available from http://www.ncbi.nlm.nih.gov/books/NBK487628/ PMID 29537779
  • Correll CU, Galling B, Pawar A, Krivko A, Bonetto C, Ruggeri M, Craig TJ, Nordentoft M, Srihari VH, Guloksuz S, Hui CLM, Chen EYH, Valencia M, Juarez F, Robinson DG, Schooler NR, Brunette MF, Mueser KT, Rosenheck RA, Marcy P, Addington J, Estroff SE, Robinson J, Penn D, Severe JB, Kane JM. Comparison of Early Intervention Services vs Treatment as Usual for Early-Phase Psychosis: A Systematic Review, Meta-analysis, and Meta-regression. JAMA Psychiatry. 2018 Jun 1;75(6):555-565. doi: 10.1001/jamapsychiatry.2018.0623. PMID 29800949
  • Kelleher I. Annual Research Review: Psychosis in children and adolescents: key updates from the past 2 decades on psychotic disorders, psychotic experiences, and psychosis risk. J Child Psychol Psychiatry. 2025 Apr;66(4):460-476. doi: 10.1111/jcpp.14088. Epub 2025 Jan 3. PMID 39754377

+Investigators