December 2022

Updates from the EPINET-TX State Hub

Lessons from EPINET-TX

The research article highlighted this month focuses on understanding psychosis symptomatology in children and adolescents. Currently, almost 24% of the individuals in EPINET-TX are under the age of 18. What are we beginning to learn from the differences between the adolescents and young adults in Texas CSC programs?

Adolescents in EPINET-TX, on average, report more frequent psychosis symptoms than either 18 to 24-year-olds or those young adults over 25. Average scores on psychosis-related items on the Colorado Symptom Index (self-report) are presented in the figure below. Higher levels of symptomatology are not seen on most other items of the CSI, such as feeling depressed or anxious. However, children are more likely to report problems with concentration and thoughts of harming others than young adults.

Research Highlights

Hallucinations in Children and Adolescents: An Updated Review and Practical Recommendations for Clinicians 

Maijer, K., Hayward, M., Fernyhough, C., Calkins, M. E., Debbané, M., Jardri, R., Kelleher, I., Raballo, A., Rammou, A., Scott, J. G., Shinn, A. K., Steenhuis, L. A., Wolf, D. H., & Bartels-Velthuis, A. A. (2019). Hallucinations in Children and Adolescents: An Updated Review and Practical Recommendations for Clinicians. Schizophrenia bulletin45(45 Suppl 1), S5–S23. the article.

Untitled Design

Background: Hallucinations in children and adolescents are conceptualized to occur on a continuum from healthy to psychopathology-related phenomena. Childhood hallucinations are reported as mostly transient and become increasingly associated with psychopathology during later adolescence. Hallucinations in children and adolescents has had limited impact on clinical practice, primarily due to the lack of consistent definitions, differences in assessment methods, and phenomenological complexity.

Methods: This systematic review identified 57-peer reviewed articles published since 2014 that evaluated the presence of hallucinations in youth.

Findings:  Research since 2014 has not significantly advanced our understanding of the etiology of hallucinations in youth. Reasons include a lack of studies evaluating the etiology and course of hallucinations in youth, lack of a concise definition of hallucinations and the relation of hallucinations with other psychiatric comorbidities. Hallucinations both in children and adults represent a broad phenotype. Although hallucinations in children are often transient and benign, children and adolescents seeking help for hallucinations may experience difficulty receiving appropriate care.

Implications for Practice

  • Providers should be aware of potential barriers to disclosure when screening for hallucinations, as parents may not always be aware of the significance of children's hallucinations.
  • Clinicians should use a holistic and destigmatizing approach when addressing hallucinations with children and families.
  • A "curious-but-cautious" attitude can help clinicians learn more about the hallucinatory experience.
  • Children at young ages have capacity to report on their hallucinatory experiences and age-appropriate questionnaires can facilitate these conversations in both community and clinical settings.

Spotlight on Bluebonnet Trails!

Mara Jabsen Maintains Strong Connections to Facilitate Engagement!

Despite our best outreach efforts, some young people and families may not be ready to engage in Coordinated Specialty Care when they are referred. Or they may initially agree but fail to follow through and connect with services. Mara, who serves as both the Outreach Coordinator and Family Partner at ClearPath, knows how easy it is for a young person to fall through the gaps. She takes outreach a step further by getting permission to check back in with the individual to see how they are. She sees these regular "check-ins" as an opportunity to continue to build a relationship, let the individual and their family know that the program cares about them and their success, and identify opportunities when the individual may be more motivated to participate in treatment. She has found that if a young person experiences a barrier to achieving their goals, such as a hospitalization or losing a job, they are sometimes more open to exploring if ClearPath can help them overcome barriers. And, even if the individual never joins the team, they know that they have Mara rooting for them!

Upcoming Events and Training Opportunities

Case Conceptualization for First Episode Psychosis Series 2: Session 1: 

Attendees will learn how case conceptualization can inform team-based, recovery-oriented care and the foundations of three different approaches: Next up is a 3-part focus on Culturally Informed Therapy for Schizophrenia.

January 12 at 10:00 - 11:00 AM CST | Zoom Registration

First Episode Psychosis (FEP) Provider Well-Being Community Calls

The purpose of the virtual FEP Provider Well-Being Community Calls is for FEP providers to provide

mutual aid to one another by discussing shared experiences, offering empathy, and facilitating change. Community calls will be structured to include one skill-based practice (e.g. mindfulness, compassion), discussion about relevant topics, and resource sharing.

February 16 at 10:00 - 11:00 AM CST | Zoom Registration

FEP Monthly Peer and Family Partner Networking Meeting: January

January 9 at 9:00-10:00 AM CST | Zoom Registration

Improve Vocational Outcomes among Adolescent and Young Adults in CSC: Integrate Evidence-based Engagement and Support Strategies

This webinar provides a strong philosophical and practice foundation for integrating developmentally-attuned evidence-based vocational service strategies to promote work and school engagement among young people with serious mental health needs.

January 19 at 12:00 - 1:00 pm CST | Register

2023 Texas Mental Health Creative Arts Contest

The contest aims to raise awareness of mental health experiences, challenge stigma, and provide an opportunity to express complex emotions through creative outlets. Participants may enter by submitting original, creative works in one of three categories (original artwork, writing, or photography), that draws on the contest theme “Why Does Mental Health Matter to You?” The contest is open to Texans of all ages and is judged in four age groups—elementary school, middle school, high school, and adult—across each of the three categories.

Deadline March 10th, 2023. | Enter Here