Measuring Social and Role Recovery: Barbara Cornblatt and Colleagues' Global Functioning Scales and Their Role in Psychosocial Interventions for Clinical High-Risk and Early Psychosis.

BACKGROUND: Functional outcomes, social and role, are key to the lives of people at clinical high-risk for psychosis (CHR) and with early psychosis. Recognizing this, Barbara Cornblatt and colleagues created the Global Functioning: Social (GF:S) and Global Functioning: Role (GF:R) scales. In doing so, they provided developmentally appropriate, domain-specific measures of functioning. Primary goals of this article were to (1) quantify and describe the scales' usage, and (2) summarize key findings from studies employing the scales in psychosocial intervention.

STUDY DESIGN: We systematically reviewed studies citing Cornblatt et al., which introduced GF:S and GF:R. Data were extracted with Elicit (AI) and verified manually.

STUDY RESULTS: Of 742 citations from Google Scholar, 334 studies explicitly used the scales and were included for review. Of these, 39 examined psychosocial interventions across CHR, first episode psychosis (FEP), or both. Patterns of findings suggest that functional change is domain- and stage-specific. In CHR samples, interventions that explicitly targeted social functioning more often yielded improvements on the GF: Social scale than on the GF: Role scale. In FEP samples, role functioning showed clearer gains, particularly in multi-component interventions that combined psychosocial and pharmacological or exercise-based approaches.

CONCLUSIONS: The GF:S and GF:R scales have shaped interventions and research. The development of these tools reflected a thoughtful vision from Dr. Cornblatt and colleagues that placed functioning at the center of early intervention, advancing a more person-centered field. This review highlights the broad reach of the GF scales, as well as Dr. Cornblatt's legacy as a pioneer who shaped the field of early psychosis.