CLINICAL HANDBOOK OF SCHIZOPHRENIA

378 VI. SPECIAL POPULATIONS AND PROBLEMSvices described earlier. Specialized programs are a way for health providers to organizeand deliver services to a group of patients; they are not discrete treatment packages thatare separate from other mental health services. Mental health services for individualswith an early psychosis should be organized to provide timely, necessary, and appropriateservices for the defined population, whether within a specialized program or as part ofgeneral services. The debate over specialized programs is in part about competition forresources for patients, and in part a scientific debate about the necessary and sufficientevidence-based services a provider needs to deliver. Absent from this debate has been a setof broadly accepted performance measures by which early-psychosis services can be evaluated.Establishing standards and norms for performance measures for such services,however they are delivered, would put the focus on outcomes rather than on the organizationof services.KEY POINTS• Improved services for first-episode psychosis require strategies to promote early interventionand optimal care.• Much of the evidence base for components of early-psychosis treatment services comesfrom research on schizophrenia services; some of it from specific trials in early psychosis,and some from early intervention programs.• Services derived from the treatment of patients with multiepisode psychosis need to beadapted to this population.REFERENCES AND RECOMMENDED READINGSAddington, D., Mckenzie, E., Addington, J., Patten, S., Smith, H,, & Adair, C. (2005). Performancemeasures for early psychosis treatment services. Psychiatric Services, 56(12), 1570–1582.Addington, J., & Addington, D. (2006). Phase-specific group treatment for recovery in an early psychosisprogramme. In J. O. Johannessen, B. V. Martindale, & J. Cullberg (Eds.), Evolving psychosis:Different stages, different treatments. Hove, UK: Routledge.Addington, J., McCleery, A., & Addington, D. (2005).Three-year outcome of family work in an earlypsychosis program. Schizophrenia Research, 79(1), 77–83.American Psychiatric Association. (2004). Practice guideline for the treatment of patients with schizophrenia(2nd ed.). Arlington, VA: Author.Canadian Psychiatric Association Working Group. (2005). Clinical practice guidelines: Treatment ofschizophrenia. Canadian Journal of Psychiatry, 50(13, Suppl. 1), 1S–56S.Dickerson, F. B., & Lehman, A. F. (2006). Evidence-based psychotherapy for schizophrenia. Journalof Nervous and Mental Disease, 194(1), 3–9.Drake, R. E., Essock, S. M., Shaner, A., Carey, K. B., Minkoff, K., Kola, L., et al. (2001). Implementingdual diagnosis services for clients with severe mental illness. Psychiatric Services, 52(4), 469–476.Drake, R. E., Mueser, K. T., Brunette, M. F., & McHugo, G. J. (2004). A review of treatments for peoplewith severe mental illnesses and co-occurring substance use disorders. Psychiatric RehabilitationJournal, 27(4), 360–374.Haddock, G., & Lewis, S. (2005). Psychological interventions in early psychosis. Schizophrenia Bulletin,31(3), 697–704.Jones, P. B., Barnes, T. R., Davies, L., Dunn, G., Lloyd, H., Hayhurst, K. P., et al. (2006). Randomizedcontrolled trial of the effect on quality of life of second- vs first-generation antipsychotic drugs inschizophrenia: Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS1). Archives of General Psychiatry, 63(10), 1079–1087.Lieberman, J. A., Stroup, T. S., McEvoy, J. P., Swartz, M. S., Rosenheck, R. A., Perkins, D. O., et al.