(PS13-C67) The CBT Care Pathway initiative: Enhancing Care Continuity and Outcomes for Clients with Psychosis

Treatment discontinuity is a major contributor to setbacks in recovering from a psychotic episode. Cognitive Behavioral Therapy (CBT) can support care continuity across settings by providing a common set of concepts and skills across treatments teams. When provided during an inpatient hospitalization, CBT can target disease management and daily living skills, reduce stigma and symptom-related anxiety through psychoeducation and normalization, expedite the hospitalization process by targeting key symptoms, and/or prepare the individual to engage in CBT in a lesser restrictive environment. A systematic transition from inpatient to outpatient care would minimize disruptions to treatment upon discharge and reduce the likelihood of rehospitalization. Unfortunately, there is little empirical guidance on how to optimize the transition from inpatient to outpatient care while maintaining care continuity and reducing the risk of destabilizing the patient. We co-developed the CBT Care Pathway in partnership with inpatient and outpatient behavioral health organizations as well as with state mental health administrators. We mapped out the key intervention elements in pre-discharge, bridging interventions, and the post-discharge phase of care, all of which are intended to enhance access to CBT across the care continuum, enhance continuity of care for individual patients that transition between settings, support the successful transition from inpatient to community-based care, and reduce the likelihood of readmission. Data collection is ongoing across two inpatient and three outpatient sites. We engaged in a comprehensive SWOT Analysis to identify the strengths, weaknesses, opportunities, and threats to CBT Care pathway adoption. Preliminary outcomes suggest that the CBT Care Pathway is acceptable, feasible, supports patient engagement in CBT, and enhances post-hospital engagement in outpatient care. Learner, programmatic, and clinical outcomes from our partner sites will be collected by Fall 2023 and preliminary data will be presented. Finally, we will highlight the facilitators and challenges of implementing the CBT Care Pathway and provide recommendations for future research and practice.