# InVEST: Individualized Vocational and Educational Support and Training for Clinical High Risk for Psychosis (CHR-P)

> **NIH NIH R34** · BETH ISRAEL DEACONESS MEDICAL CENTER · 2022 · $189,793

## Abstract

Project Summary
Despite emphasis on the importance of targeting functional impairments in early psychosis treatments, there is
no current evidence-based intervention for academic functioning in the clinical high risk for psychosis (CHR-P)
stage. Functional impairments should be a key treatment priority, given evidence that functional decline begins
during the CHR-P stage, impacts treatment engagement, and may impact other symptoms. We seek to develop
“InVEST” (Individualized Vocational and Educational Support and Training), an intervention focused on
improving educational functioning in clients ages 12-18 that are exhibiting CHR-P. Conceptualized as a
component of coordinated specialty care (CSC) for youth at CHR-P, InVEST builds on prior research on
supported employment, along with real world experience helping youth at CHR-P to pursue educational/
vocational goals within a CHR-P specialty clinic. InVEST is implemented individually (in person or via
videoconference) by bachelor's level clinician “coaches” who serve as members of a CSC team. InVEST is
designed to engage the following mechanisms which are believed to interact and to negatively impact
educational and vocational functioning during the CHR-P stage: 1) executive functioning difficulties (a
cognitive mechanism), 2) stress sensitivity (an emotional mechanism), and 3) task initiation difficulties (a
behavioral mechanism). InVEST is a novel intervention for a prioritized treatment outcome (i.e., role
functioning) in a high-risk population, and is distinct from other empirically examined approaches during the
CHR-P stage, including cognitive behavioral therapy for psychosis. InVEST takes into account the diverse
needs of youth at CHR-P by 1) prioritizing client preferences in a personalized approach and 2) teaching
strategies designed to be used independently to maximize broad access. The project will test InVEST in two
phases: 1) an open trial with 8 participants, and 2) a small randomized control trial with 30 participants
comparing InVEST against a treatment as usual waitlist control. Our treatment development objectives align
with NIMH's strategic objectives 3.2 (“Develop ways to tailor existing and new interventions and to optimize
outcomes”) and 3.3 (Test interventions for effectiveness in community practice settings). As recommended, we
are specifically optimizing supported employment programs by targeting individuals earlier in their disease
progression. Furthermore, we seek to study InVEST in a real-world community practice setting. Pilot data may
support the basis for a future, larger study, adequately powered to examine efficacy of InVEST in improving
functional outcomes and to examine potential mechanisms of change. This intervention is particularly timely
during the COVID-19 pandemic, as youth at CHR-P may be particularly vulnerable to school failure and
disengagement without the structure of in-person connection with school staff for supporting learning needs.

## Key facts

- **NIH application ID:** 10450808
- **Project number:** 5R34MH122648-02
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **Principal Investigator:** Michelle S Friedman-Yakoobian
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $189,793
- **Award type:** 5
- **Project period:** 2021-07-14 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10450808

## Citation

> US National Institutes of Health, RePORTER application 10450808, InVEST: Individualized Vocational and Educational Support and Training for Clinical High Risk for Psychosis (CHR-P) (5R34MH122648-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10450808. Licensed CC0.

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