Developing a Substance Use Practice Approach for Peer Support Specialists in Early Psychosis Coordinated Specialty Care

INTRODUCTION: Substance use is common and developmentally normative among transition-age youth and linked to poor outcomes among individuals with early psychosis. Peer Support Specialists (PSSs) are increasingly part of early psychosis Coordinated Specialty Care (CSC). CSC team substance use-specific practices are lacking despite the prevalence of CSC client substance use. This study describes the development of a substance use practice approach for CSC PSSs. METHODS: This study occurred within the 'Advancing Early Psychosis Intervention Network in Texas' (EPINET-TX), a university-affiliated Learning Health System with 15 community mental health providers and 29 CSC teams. A research team composed of a study coordinator with PSS experience, community mental health intervention researchers and a current CSC PSS leveraged EPINET-TX research findings, a literature review and expert consultation to design 'Peer Approaches to Substances for Early Psychosis Programs' (PAS-EPP). The team developed a conceptual model, practice principles and core practices and training materials. RESULTS: PAS-EPP has eight practice principles and four core practice domains. The PAS-EPP toolkit provides an adaptable, accessible harm reduction approach to substances for CSC PSSs intended to promote self-exploration of personal beliefs and biases, intentional sharing and team collaboration strategies and confidence building in capacity to explore and share information about substance use that is relevant to young people. CONCLUSION: PAS-EPP is a promising practice approach for CSC PSSs. Future evaluation of PAS-EPP will provide insight into its feasibility and impact.