Researchers at the University of North Carolina (UNC) are exploring how MOST can be integrated with clinical care and help to maintain the treatment benefits young people gain from attending Coordinated Speciality Care (CSC) services. Common measures of recovery from psychosis include functional outcomes, such as employment, and the remission of symptoms.
UNC are interested in social functioning outcomes such as reducing loneliness, and how MOST can build community, promote inclusivity, social connection, and a sense of safety by offering non-judgemental support that differs from conventional social contact and social networking.;
This research is the first online, strengths-based social networking intervention to be successfully implemented in first episode psychosis services in the United States.
Project: Horyzons, US Open Trial
Between 2016 and 2018 the feasibility and acceptability of Horyzons was evaluated by UNC researchers. Twenty-six participants aged between 18 and 35 diagnosed with a schizophrenia spectrum disorder were given access to Horyzons for 12 weeks. Researchers assessed the relationship between engagement with Horyzons and loneliness, perceived social support, relationship quality, negative emotions, positive emotions, self-esteem, and psychological wellbeing.
Early findings indicate that Horyzons is both feasible, and safe. It was positively received by young people that participated. Those who actively engaged showed improvements in psychosis-related and depressive symptoms, and negative emotions. Self-reported loneliness showed the biggest, upward shift from baseline measures to mid-treatment.
Study outcomes were limited by small participant numbers, the lack of a control condition, a short duration, and a brief follow up period.
Horyzons US Open Trial was a three-month intervention and finished in 2018.
Project: Horyzons: Implementation in Clinical Practice
In 2021, UNC researchers began investigating the feasibility and acceptability of Horyzons as a part of routine face-to-face care at first episode psychosis clinics in North Carolina. Young people, clinicians and peer support specialists are involved in this research.
Research into the efficacy of Coordinated Speciality Care (CSC) services shows they are reducing psychosis symptoms, improving social functioning, and helping young people get their lives back on track.
While young people benefit from CSC, the gains are often not maintained for more than two years after discharge. Coupled with a limited range of supportive online social communities for young people experiencing psychosis, UNC identified a need to understand the benefits of offering Horyzons alongside clinical care and how it might help to maintain therapy gains after discharge.
UNC researchers are also listening to feedback from young people, peer workers, clinicians, and a range of project staff about how Horyzons ought to look, feel, and operate to achieve the best health outcomes.
Horyzons: Implementation in Clinical Practice is actively recruiting.
Project: Horyzons 2.0
UNC researchers are collaborating with Orygen Digital and Australian Catholic University (ACU) to design, develop, and test MOST for caregivers of young people receiving face-to-face support from CSC-First Episode Psychosis (FEP) services in North Carolina.
The trial will build upon two important research studies conducted by Orygen Digital (Horyzons) and ACU (Altitudes). Altitudes used a now retired version of MOST to support caregivers to understand psychosis and its treatment, problem solve, and manage stress and communication with their young person. Horyzons 2.0 will feature updated clinical content for caregivers.
Horyzons 2.0 expands the work of Horyzons: a five-year randomised controlled trial (RCT) that sought to maintain the treatment benefits of specialist treatment services, reduce social isolation, and improve social functioning in young people with a first episode of psychosis.
Horyzons 2.0 is due to start recruiting in 2023 and will investigate the effectiveness of two distinct versions of MOST to young people and their caregivers.