Strengths and Limitations
psychosis
To our knowledge, this is the largest ultrahigh risk for psychosis trial to date, reflecting the utility of primary care youth mental health platforms, particularly when recruiting medication-naive participants. However, the treatment provided was insufficient for a large proportion of our sample. Despite high dropout rates, the achieved sample sizes (192 at step 2 and 92 at step 3) were similar to original expectations because of the higher than expected nonremission rates. The moderate fidelity to CBCM, the low adherence to medication, and high degree of treatment discontinuation and missing data may have limited the ability to test hypotheses and identify benefits of treatments.