Adaptation of a Psychosocial Intervention for Canadian Youth at Clinical High Risk for Psychosis: Adaptation d'une intervention psychosociale pour les jeunes à haut risque clinique de psychose au Canada.

Aim: This paper provides a detailed account of the process and outcomes involved in adapting a psychosocial intervention - the Optimal Health Program (OHP) - for young individuals who are at clinical high risk (CHR) for psychosis. This adaptation process included the active participation of youth with lived experience of psychosis spectrum disorder (CHR and first episode psychosis). Methods: A six-member advisory group consisting of youth with lived experience was established. The group convened weekly to review the OHP workbook in detail. This initiative was supported by a dedicated research assistant. Adherence to established guidelines for engaging with youth was maintained throughout. Following the completion of the adaptation, a review session was conducted to gather feedback. Results: The primary adaptations made to the intervention can be categorized as follows: 1) modification of language; 2) tailoring to the CHR population; 3) incorporation of personal stories; 4) emphasis on personalized recovery; 5) inclusion of 'guiding and supportive activities'; 6) enhancement of graphic design. Suggestions for a digital application were not integrated due to their scope extending beyond the aims of the current project. An assessment of the engagement process revealed that the involvement of youth was meaningful and impactful. Conclusions: Through sustained and meaningful engagement with youth with lived experience, the present project adapted OHP for CHR individuals. The resulting intervention materials are anticipated to be closely aligned with the distinct needs and priorities of young CHR individuals. Subsequent endeavours in developing appropriate interventions that aim to improve outcomes for this population should involve engaging and collaborating with individuals with lived experience. We are currently in the process of evaluating the feasibility, acceptability, and preliminary efficacy of delivering OHP to individuals with CHR in a clinical trial.