Psychology's Olga Santesteban-Echarri receives CIHR fellowship supporting work with youth at high risk for psychosis

May 31, 2018

Psychology's Olga Santesteban-Echarri receives CIHR fellowship supporting work with youth at high risk for psychosis

New app could help maintain post-therapy social skills

Olga Santesteban-Echarri, who is developing a mobile-based application for treatment maintenance for youth at risk of psychosis, has been awarded a Canadian Institutes of Health Research (CIHR) fellowship.

Olga Santesteban-Echarri, who is developing a mobile-based application for treatment maintenance for Riley Brandt, 91��ɫ

Could an app amplify the benefits of group therapy for youth at risk for developing psychosis?

That’s the question Cumming School of Medicine postdoc Olga Santesteban-Echarri, above, is hoping to answer in her clinical psychology research, which has just been awarded a prestigious Canadian Institutes of Health Research (CIHR) Fellowship.

The app is novel in that it will focus on social functioning by monitoring and measuring relationships pre-illness. It has grown out of the foundational group therapy study , a multi-institutional National Institute of Mental Health-funded randomized control trial of youth at the prodromal level of symptoms led by Santesteban-Echarri’s supervisor .

“Detachment from peers, quitting hobbies, disinterest in school and increased loneliness can be a sign that someone is spiralling toward psychosis, in particular in this cohort that has already been found to be at high risk,” Santesteban-Echarri says. Understanding the trajectory of those changes could help mitigate that pathological process and to predict who is most at risk and when.

“Recruiting postdocs of Olga Santesteban-Echarri’s calibre deepens our research expertise and broadens our understanding in important areas such as brain and mental health,” says Carolyn Emery, director of the postdoctoral program and professor in the Faculty of Kinesiology. “Postdoctoral scholars build research capacity alongside world-class researchers like Jean Addington, helping to grow the university’s national and international reputation in the field.”

Being there on day one

Without the ReGroup study there is no app, Santesteban-Echarri makes clear. “We plan to create a mobile app that will monitor and provide support and followup after the group therapy. It will work to assess the maintenance of the skills learned in the group, monitoring progress of the study participants.”

Whereas antipsychotic drugs very often work for primary symptoms of psychosis like hallucinations, this study is innovative in that it focuses on social skills and functional recovery before the onset of any illness or diagnosis. Social deficits can be a sign of and contributing factor to psychosis.

The ReGroup trial studies the effectiveness of Cognitive Behavioural Social Skills Training for youth who have been assessed to be at high clinical risk for developing psychosis. Among this cohort, even those who do not go on to develop psychosis are likely to have poor social functioning, which is why an emphasis on improving social skills is considered a priority.

“We might not be able to prevent people developing the illness, but what’s different in working with high-risk youth is we would be there on day one when the person becomes sick to introduce treatments,” says Addington, professor of psychiatry and a member of The Mathison Centre for Mental Health Research and Education, and Hotchkiss Brain Institute.

“We had plans to add on some technology aspect to the treatment program,” Addington says. “Olga was particularly interested in working with this population and had done research previously in Australia with a group developing online treatments and apps for use with mental illness therapies, so it has been a very good fit.”

App-assisted therapy followup

The benefit of an app, Santesteban-Echarri explains, is that it is anonymous, non-stigmatizing and gives researchers real-time information. It will ask questions like: How many times did you see your friends today? Did you initiate contact? When you go with them do you actually enjoy it? Did you have any conflict today?

For her, the collaboration and involvement of ReGroup project participants in the creation of the app is a priority. “We don’t want to build an app that we think is good. We want to build an app they actually want,” she says.

“In our development of the app, we will follow a participatory design approach where youth will be part of all the process of the design. Feedback from youth will be sought through a collaborative process over three focus groups,” she says.

“Focus groups have been previously used with adolescents to gather information regarding eHealth tools and have demonstrated acceptability and good effects. Adolescents and young adults are capable of providing valuable feedback related to eHealth tools and their features such as avatars, social interaction, frequency, duration, timing, and mode of delivery.”

Santesteban-Echarri says she’s learned in her previous research that for her it is particularly rewarding working with youth and adolescents.

“I notice the things you do with these kids together with their parents and families, you could see the change, the improvement,” she says. “That got me really excited because I thought, oh, I can really do something to help here.”

The following CIHR Fellowships were also awarded for the 2017-2018 competition:

Georgia Balsevich – "The Endocannabinoid System in Glucocorticoid-Induced Metabolic Outcomes: A Focus on Genetic Variants of Fatty Acid Amide Hydrolase"
Colleen Cuthbert – “Developing a Wellness Focused Self-Management Program for Colorectal Cancer Survivors Using a Patient-Oriented Research Approach”
Justin Deniset – “The Role of Pericardial Macrophages in Cardiac Repair"
Maria Gandini – "Quantitative Imaging of Fluorescent Cav3.2 T-type Calcium Channel Biosensor: A Novel Tool for Studying Processing of Pain Signals”
Simon Gebremeskei – “5T4-CAR-NKT Cell Therapy for Paediatric Rhabdomyosarcoma”
Rebecca Green – “Interactions Between Cilia and Folic Acid During Craniofacial Development”
Paul Metzak – “Neuroimaging Biomarkers for Transition to Mental Illness in Youth”
Amity Quinn – “Comparing How Fee-For-Service and Salary-Based Specialist Physician Payment Affects Patient Selection, Visit Frequency, Delivery of Recommended Services, and Health Care Costs of Albertans with Chronic Disease”
Olga Santesteban-Echarri – “Development of a Mobile-based Application for Monitoring Functional Gains and Maintenance After Treatment for Youth at Risk of Psychosis”
Helen Tam-Tham – “Improving Palliative Care in Long-Term Care: Exploring the Changing Role of Family Physicians in Multidisciplinary Care Teams through Qualitative and Quantitative Methods”
Amanda Wurz – “Moving Knowledge to Practice: Developing, Implementing and Evaluating In-Hospital Physical Activity Practices to Enhance Health for Children During Treatment for Cancer”