Horyzons USA: A moderated online social intervention for first episode psychosis

Abstract

Aim We evaluated the feasibility and acceptability of Horyzons, an online social media platform designed to facilitate relationship development among, and introduce therapeutic content to, first‐episode psychosis (FEP) clients. We also evaluated whether participation in the platform was related to reduced loneliness, improved social integration and increased psychological well‐being. Methods Twenty‐six participants diagnosed with a schizophrenia spectrum disorder were provided access to the moderated Horyzons platform for 12 weeks. During the intervention period, participants were encouraged to access therapeutic content and social components embedded within the site. Participants were recruited from three first‐episode coordinated specialty care clinics in North Carolina and assessed at four time points: baseline, mid‐treatment, post‐treatment and 1‐month follow‐up. Results Findings indicated that Horyzons was both feasible and very well tolerated, with a 92.3% retention rate and 79.2% of participants actively engaged in the platform. The most commonly identified personal strengths selected by Horyzons users were creativity (61.5%), curiosity (42.3%) and courage (38.5%). Feedback from participants indicated Horyzons could be improved by the development of a smartphone application, expanding the size of the Horyzons community and facilitating private messages between users. Preliminary results with engaged participants showed the greatest improvements in psychosis‐related symptoms, followed by self‐reported experience of negative emotions, depressive symptoms and loneliness. Conclusions This open trial found that Horyzons is both feasible and acceptable to FEP persons early in the course of illness living in the United States.

Adaptation of a Digital Health Innovation to Prevent Relapse and Support Recovery in Youth Receiving Services for First-Episode Psychosis: Results From the Horyzons-Canada Phase 1 Study

“…Feedback offered insights into attitudes toward the innovation, potential barriers to its implementation, and adaptations to make before piloting the intervention within a Canadian context. Some of the suggestions from participants in this study are consistent with those reported in previous research on Horyzons (eg, making the intervention accessible via mobile devices) [ 11 ]; concurrently, many of the suggestions for adaptations and improvement are novel. This may be due to the qualitative nature of our process, the elicitation of feedback from multiple stakeholder groups (ie, clinicians in addition to patients), the multiple opportunities given to reflect and contribute, the active engagement of participants in the adaptation process, and the factors related to context (eg, different characteristics of the employment and health sector).…”

“…Horyzons has been tested on a sample of 20 young Australian adults for its feasibility, acceptability, utility, and safety [ 9 , 10 ], and more recently, it has been pilot-tested in other international contexts [ 11 ]. There is also a randomized controlled trial of Horyzons [ 12 ] that was completed in 2018 and is currently undergoing data analysis.…”

The Horyzons project: a randomized controlled trial of a novel online social therapy to maintain treatment effects from specialist first‐episode psychosis services

“…Horyzons has now been adapted and successfully piloted in specialized FEP services in the US 46 and Canada 47 , with clinical implementation efforts underway in both countries as well as Australia. Ultimately, with specialized FEP services now being available across the US, Canada, Europe, Asia and Australasia, Horyzons holds significant promise as a novel, engaging and sustainable intervention to improve vocational recovery, reduce utilization of emergency services and provide continuous support for young people with FEP beyond specialized care.…”

Interest and readiness for digital mental health in coordinate specialty care for early course psychosis: A survey study of 42 programs in 30 states

“…An online social media platform for people with early psychosis, known as MOST, works to promote relationship development and present therapeutic information to this population. This platform was tested on first‐episode psychosis patients and was found to be feasible, effective, and well‐received (Ludwig et al, 2020). In response to the growing potential of technology implementation into care, the National Institute of Mental Health commissioned a report to assess the current state and technology readiness of CSC in the summer of 2019.…”