Cortical thickness alterations in Parkinson's disease related anxiety: A cross-sectional 7 T MRI study.

Almost half of people with early psychosis have lifetime problematic substance use, especially alcohol and cannabis (; ). Substance use poses challenges to treatment engagement and worsens symptoms and quality of life (; ; ). Existing early psychosis treatments have limited impact on substance use (e.g., ; ; ; ). However, involving family and natural supports in treatment could help address substance use in early psychosis care, aligning with treatment guidelines for clients with early psychosis (; ; ) and substance use (; ). Working with families may also help address family conflict and caregiver burden that are common in families of young adults with problematic substance use and psychosis (; ; ) and are associated with poorer outcomes (; ). Involving family in the treatment of people with early psychosis and substance use is growing in importance, and people with early psychosis are often open to family involvement (). However, families are often not engaged (; ; ) or retained in psychosis treatment (). Understanding the family’s perspective on substance use and early psychosis treatment may aid in better implementing family components of care. The current study was aimed at characterizing the impact of substance use and early psychosis on the family and family experiences with their client relative’s treatment through secondary analysis of a pilot trial of telehealth Community Reinforcement Approach and Family Training (CRAFT; ). We adapted CRAFT for family members of clients with early psychosis and substance use (CRAFT-EP; ). Examining these family perspectives has the potential to improve treatment engagement strategies and outcomes for individuals with co-occurring early psychosis and substance use. We conducted a mixed methods secondary analysis of data from the completed single-group feasibility pilot of CRAFT-EP. We used quantitative survey data from baseline assessments and qualitative data from open-ended baseline survey responses and session 1 transcripts to assess family views on 1) the impact of the client’s substance use on the family, and 2) the client’s treatment engagement and level of family involvement.