Client-Centered Outcomes Research (CCOR™)

Felton Institute’s Client-Centered Outcomes Research (CCOR)™

Developed in 2016, Felton CCOR™ (see-core) aspires to provide exceptional training and technical assistance to mental health providers and organizations to leverage their experience in the service of innovation, health equity, and sustainable impact.

As a public mental health-focused training and technical assistance resource, Felton CCOR™ grounds its work in the belief that stakeholder and community insights are fundamental for transformative change. At the forefront of CCOR’s work is the intersection of culture/race/ethnicity, social adversity, and access to quality services.

Felton CCOR™ partners across the public and private sectors, developing organizations and improving capacity for mental health services implementation, providing training and education on specialized mental health approaches, as well as technical assistance and resources for the sustainability of our community partners.

CCOR™ works hand in hand with Felton Institute’s award winning programs and training and technical assistance initiatives throughout California and across the United States.

Training and Technical Assistance

Felton CCOR™ provides technical assistance, including consultation, training, and implementation guidance for early psychosis-coordinated specialty care.

 Focus Areas include:

  • Youth & client outreach & engagement;
  • Program implementation, improvement and innovation within early psychosis treatment programs;
  • Infrastructure building and staff capacity development to support high-quality performance monitoring and data collection, in mental health organizations;

Felton CCOR™ provides training, consultation and rigorous needs assessments for organizations implementing early psychosis-coordinated specialty care.

Some of our past and current partners include:

  • National Association of State Mental Health Program Directors (NASMHPD)
  • National Council on Behavioral Health
  • National Association on Mental Illness (NAMI)
  • Cenpatico, Southern Arizona

Trauma & Psychosis Statistics

A growing body of research attests to the high prevalence of trauma among individuals with psychosis and to the developmental links between adversity and psychosis onset.

  • The attributable increased risk for psychosis from childhood adversity is 33% (Varese et al., 2015).
  • Childhood trauma is significantly more prevalent in young people at ultra-high risk for psychosis compared to healthy controls, with a mean prevalence rate of 86.8% (Kraan et al., 2015).
  • Patients attending early psychosis clinics report high rates of childhood trauma: 54% report emotional abuse, 28% report sexual abuse, 46% report emotional neglect and 42% report physical neglect. Women are significantly more likely to experience emotional and sexual abuse (Duhig et al., 2015).
  • People who have been sexually assaulted as children are 3.3 times more likely to see visual hallucinations and 3.5 times more likely to hear voices than those who have not (Shevlin et al., 2011).
  • Rates of psychosis are significantly higher in certain ethnic minority groups because rates of childhood adversity are higher (Berg et al., 2015)
  • While sexual abuse has been linked most strongly to voices, experiences that disrupt child-parent attachment bonds such as neglect or abandonment, are more strongly correlated with the later development of delusions and paranoia (Bentall et al., 2014).


Bentall, R.P., de Sousa, P., Varese, F., Wickham, S., Sitko, K., Haarmans, M. & Read, J. (2014). From adversity to psychosis: pathways and mechanisms from specific adversities to specific symptoms. Social psychiatry and psychiatric epidemiology, 49(7), 1011-1022

Berg, A. O., Aas, M., Larsson, S., Nerhus, M., Hauff, E., Andreassen, O.A., & Melle, I. (2015). Childhood trauma mediates the association between ethnic minority status and more severe hallucinations in psychotic disorder. Psychological medicine, 45(01, 133-142

Duhig, M., Patterson, S., Connell, M., Foley, S., Capra, C., Dark, F., … & Scott, J. (2015). The prevalence and correlates of childhood trauma in patients with early psychosis. Australian and New Zealand Journal of Psychiatry. 

Kraan, T., Velthorst, E., Smit, F., de haan, L., & van der Gaag, M. (2015). Trauma and recent life events in individuals at ultra high risk for psychosis: review and meta-analysis. Schizophrenia Research, 161(2), 143-149.

Shevlin, M., Murphy, J., Read, J. Mallett, J., Adamson, G., & Houston, J. E. (2011). Childhood adversity and hallucinations: a community-based study using the National Comorbidity Survey Replication. Social Psychiatry and Psychiatric Epidemiology, 46(12), 1203-1210.

Verese, F., Smeets, F., Drukker, M., Lieverse, R., Lataster, T., Viechtbauer, W., … & Bentall, R.P. (2012). Childhood adversities increase the risk of psychosis a meta-analysis of patient-control, prospective and cross-sectional cohort studies. Schizophrenia Bulletin, 38(4) 661-671.

Interested in CCOR™?

In addition to providing consultation, training, and implementation guidance in coordinated specialty care for early psychosis, Felton CCOR™ provides infrastructure building and staff development for community mental health organizations to perform at their highest potential.

Contact Information:

Adriana Furuzawa, LMFT, CPRP
Early Psychosis Division Director
phone: 415.474.7310 ext. 314
fax: 415.931.0972

Felton Institute
1005 Atlantic Ave,
Alameda, CA 94501