Expanding the toolbox of interventions for cannabis use disorder in individuals with first-episode psychosis: A pilot randomized controlled trial of iCanChange (iCC), a novel app-based psychological intervention.

Abou-Rahal S.; Tatar O.; Abdel-Baki A.; Coronado-Montoya S.; Côté J.; Crocker C.; Daneault J.; Lachance-Touchette P.; Ouellet-Plamondon C.; Roy M. et al. · Psychiatry research · 2026

**Background & Methods** This pilot randomized controlled trial evaluated iCanChange (iCC), a novel app-based psychological intervention for cannabis use disorder (CUD) in young adults with first-episode psychosis across 6 early intervention services in Canada. A total of 101 participants aged 18-35 years were randomized to modified EIS plus iCC (n=51) or EIS only (n=50), with assessments conducted at baseline, weeks 6, 12, and 24 over a 12-week intervention period. **Key Findings** - Trial retention was high at week 12 (84% intervention group, 86% control group), meeting the feasibility threshold of >50% retention and supporting the viability of conducting a larger efficacy trial. - App completion rate was 49% in intent-to-treat analysis and 54% in per-protocol analysis, falling slightly below the 50% feasibility threshold for completion but highlighting engagement challenges in this population. - Preliminary signals of clinical benefit were observed in the intervention group, including improvements in cannabis use frequency, cannabis-related problems, dependence severity, and coping self-efficacy compared to control. **Dosage & Administration** Not reported. **Safety & Adverse Effects** Not reported. **Evidence Quality** This pilot RCT represents early-stage evidence (Level 2) with several important limitations. The study was designed primarily to assess feasibility rather than efficacy, with a modest sample size of 101 participants limiting statistical power for outcome analyses. The relatively lower app completion rate (49-54%) suggests engagement barriers in youth with first-episode psychosis, potentially limiting real-world effectiveness. The lack of reporting on adverse effects or safety monitoring is a notable gap. The preliminary nature of outcome findings requires confirmation in larger, adequately powered trials. However, the study's strengths include the multicenter design, low attrition rate supporting trial logistics, and investigation of a novel intervention addressing a significant treatment gap in early psychosis services where structural barriers limit access to psychological interventions for CUD.

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