STEP’s First-Episode Service (FES)

Individual therapy is a key element of STEP’s FES. Patients will meet with their primary clinician usually on a weekly basis at an agreed upon time. The patient and the clinician will work to develop a safe and trusting relationship and collaborate to identify goals and targets of treatment. STEP clinicians utilize a variety of evidence-based psychotherapies to support the following:

• Understanding and reducing symptoms
• Identifying early warning signs/relapse prevention
• Stress management and relaxation
• School and/or work goals
• Promoting skills (e.g., coping, distress tolerance, reality testing, changing relationship to internal experiences, problem-solving, communication)
• Addressing co-occurring issues (e.g., anxiety, trauma)
• Physical health and wellness
• Managing and reducing substance use
• Other topics of interest (e.g., relationships, identity, processing past episodes, navigating disclosure)

Family support and education is an important part of early psychosis care and is recommended for all families and support people. Engaging in family support and education can have a variety of benefits including fewer symptoms and hospitalizations, improvements in overall functioning, more effective family communication, and decreased caregiver stress.

STEP offers a variety of supportive and educational opportunities for family/support people, based on an individual family’s needs, interest, and the young person’s preference. Such opportunities include:

• Education about psychosis, treatment, recovery, and other important topics
• Communication, problem-solving, and crisis-management skills
• Connection to local and virtual resources
• General support

Download the STEP Family Information Packet

As part of STEP family services offerings, the clinic hosts regular group orientation workshops for families (and interested clients). The STEP Family Orientation Workshop will help families become familiar with services and team at STEP, common symptoms of psychosis and how to support your young person’s recovery. All families and support people of recent STEP enrollees are encouraged to attend!

Please email Laura Yoviene Sykes, PhD, for Zoom info.

STEP Family Orientation Workshop - TBD

The STEP program hosts periodic educational workshops aiming to bring in experts to discuss topics relevant to the young people we serve and their families. Workshops are open to STEP clients, their families and support system, as well as the general public. RSVP required.

If you are interested in presenting at a STEP Family Workshop, please email Nina Levine.

Please join us on Wednesday, March 1st, 2023 5-6pm(Note: This workshop is open to the public)

Goals of the workshop include:

• Increase awareness and understanding of early psychosis
• Learn to recognize early warning signs
• Learn strategies for asking about symptoms of psychosis
• Dispel common myths about psychosis

Registration Link for Zoom

Download the flyer

Please join us on Wednesday, April 5th, 2023 5-6pm(Note: This workshop is open to the public)

Goals of the workshop include:

• Increase awareness and understanding of early psychosis
• Provide general guidelines families can use to support young people with psychosis
• Demonstration of various communication strategies for interacting with people experiencing psychosis
• STEP Learning Collaborative overview & opportunity for Q&A

Registration Link for Zoom

Download the flyer

With your permission, your STEP team will coordinate with other providers and supports in your community, such as: Primary care providers (PCPs), school counselors, and advisors

Your STEP team will also provide assistance with day-to-day needs, such as:

• obtaining financial support (e.g., SNAP benefits, SSI/SSDI)
• transportation
• liaising around legal issues
• gaining assistance with housing

STEP strives to support young people’s (re)engagement with important “instrumental” and “expressive” roles (e.g., school and work)

STEP patients have the option of meeting with dedicated staff to support their engagement with various vocational and educational pursuits. Support is individualized and may include a wide range of activities such as: resume building, job applications, interview skills and etiquette, college applications, and class selection

STEP also supports and encourages young people in fostering healthy relationships, including connecting with peer support networks and organizations

Many distinct disorders can cause psychotic symptoms, and while laboratory tests and imaging can sometimes help, repeated assessments by trained clinicians over several months (‘longitudinal evaluation’) is often the best way to determine an appropriate diagnosis and to not miss known medical disorders (e.g. epilepsy) that require separate treatment. Thus longitudinal evaluation is a core element of STEP care, and is first initiated in Module A, through rapid assessment of eligibility for STEP services by the STEP outreach and admissions coordinator. Evaluation and initiation of treatment (Module B), includes learning as much as we can about a patient as quickly as possible through in-depth evaluation, case formulation, establishing working diagnoses, and treatment plan. While mostly completed during evaluation phase (Module B), evaluation remains an active task of Continuing Treatment in Coordinated Specialty Care (Module C) given the need for longitudinal follow-up to sometimes fully evaluate diagnostic possibilities.

Thus, throughout STEP care, regular outcomes assessments take place (~ every 6 months), as well as continuous updating of clinical formulation as more information is gathered through working with the patient.