IEPA 11

Childhood adversities are associated with psychosis, and empirical evidence investigating the causal mechanisms underlying this association is accruing (Bentall et al, 2014; Gibson et al, 2016; Hardy, 2017; Varese et al, 2012). People with psychosis are at an increased risk of revictimisation and are more likely to experience a range of post-traumatic stress difficulties, which negatively influences functional and clinical outcomes. In line with these findings, best practice guidelines recommend trauma and PTSD are routinely assessed in psychosis services, including Early Intervention, and that therapy is offered when indicated. Unfortunately, it is rare for trauma and PTSD to be recognised in psychosis services, preventing access to psychological treatments. The challenge is to effectively disseminate trauma-informed practice within frontline EIP services to ensure people’s needs are met. This symposium will reflect on progress and challenges in the area, illustrating our current theoretical understanding, clinical trial evidence, and routine service developments. Sandra Bucci will provide an overview of research highlighting the complex and multiple pathways from trauma to psychosis. David van den Berg will present the long-term results of a randomised controlled trial of trauma-focused treatment (TFT) for PTSD in psychosis. Mark van der Gaag will present on cost-effectiveness of TFT in psychosis. Amy Hardy will describe initiatives aiming to implement and build on these research findings in the early intervention in psychosis services of a National Health Service Trust in inner city London. The discussion will focus on how to move forward into the realm of early intervention and prevention.