Feasibility of a Stepped‐Care Intervention for Those at Clinical High Risk for Psychosis in the United States

This small preliminary study supports larger scale trials of stepped-care interventions for CHRp in the US, but also illuminates key features of the US healthcare system that must shape implementation. The stepped-care intervention appeared tolerable and feasible in those who were eligible and engaged; clinical outcomes were promising. Comorbid treatment needs in this heterogenous population, including medication needs/preferences, and disengagement during referral to psychosis specialty care precluded participation for many. Future studies should evaluate larger samples, account for needs and preferences for medication, and place screening and early steps in general outpatient mental health services to evaluate real-world effectiveness.