Patterns and perceptions of face-to-face and digital communication in the clinical high risk and early stages of psychosis

Relationship Quality and Mental Health Implications for Adolescents during the COVID-19 Pandemic: a Longitudinal Study

Although parent-adolescent and peer-adolescent relationship quality are critical for adolescent wellbeing during typical stressful life events, the unique features of the COVID-19 pandemic put into question whether strong parent-adolescent and peer-adolescent relationship quality functioned as protective factors of adolescent mental health in this context. The current longitudinal study examined a community sample of adolescents across 3 time points, each 6 months apart (Time 1: Fall, 2019; n = 163, 50.9% male; mean age = 15.75 years, SD = 1.02). Results showed that increases in depression symptoms, perceived stress, and emotion dysregulation from Fall 2019 to Fall 2020 were predicted by changes in parent, but not peer relationship quality. The current study demonstrates that adolescent-parent relationship quality may be protective against mental health difficulties during the COVID-19 pandemic, while adolescent-peer relationship quality may not. Identifying protective factors that may play a role in mitigating the impact of the pandemic, and other such widespread health crises, on youth mental health is critical in reducing the long-term psychological harm of the viral outbreak, as well as promoting adolescent wellbeing and resilience.

Telepsychotherapy with Youth at Clinical High Risk for Psychosis: Clinical Issues and Best Practices during the COVID-19 Pandemic

Early detection and prevention of psychosis has become an international priority. Much of this work has focused on youth presenting with attenuated symptoms of psychosis-those at Clinical High Risk for psychosis (CHR)-given their elevated probability of developing the full disorder in subsequent years. Individuals at CHR may be prone to exacerbated psychological distress during the COVID-19 pandemic and its subsequent physical isolation measures, due to heightened stress sensitivity and comorbid mental health problems. Telepsychotherapy holds promise for reaching this population, especially during the current COVID-19 outbreak. However, there are limited evidence-based guidelines or interventions for use of telepsychotherapy with this population. In this paper, we review common clinical issues for individuals at CHR and how they might be exacerbated by the COVID-19 pandemic; best practices for treatment and adaptations for telepsychotherapy for individuals at CHR; and highlight real clinical issues that we are currently experiencing in a United States-based specialized CHR clinic as we conduct telepsychotherapy via videoconferencing. We conclude with questions for those in the field to contemplate, as well as potential challenges and benefits in using telepsychotherapy with individuals at CHR and their families.