Milieu Therapy at a First Episode Psychosis Program

Poster C17, Wednesday, October 10, 11:30 am - 1:00 pm, Essex Ballroom

Zachary Faas1,2; 1Prevention and Recovery in Early Psychosis, Servicenet, inc, 2Massachusetts Department of Mental Health

At PREP (Prevention and Recovery in Early Psychosis) West, an outpatient Coordinated Specialty Care program for individuals experiencing first episode psychosis in Western Massachusetts, a vibrant and therapeutic milieu provides the foundation and centerpiece of our clinical services. The milieu has been intentionally designed to foster interpersonal and community connection, promote the development of symptom management skills, support increased independence and autonomy, and encourage engagement in meaningful and pleasurable activities. The dynamic interaction between the milieu and more traditional clinical services, such as psychotherapy groups, individual and family therapies, and psychiatry, is unique and often profound. Anecdotally, we have found that participation in the milieu can lead to a reduction in negative symptoms, increased capacity to cope with positive symptoms, and improve engagement in treatment. Some of the core features of our milieu include: weekly community meeting; family-style community lunch; participant-led cooking group; community outings (hiking, college visits, volunteering, etc.); PREP leadership group for interested participants to take on leadership opportunities and have increased ownership of the program; semi-structured free-time activities. This presentation, which will be given by the program’s Clinical Psychologist, will include a detailed discussion of the milieu at PREP West is and how it has developed over the life of the program, and how it interacts with other treatment components. The presenter will share anecdotes and case examples that highlight the value of the milieu, and may share client testimonials. Finally, the presenter will review the practical challenges, both clinical and logistical, that maintaining a milieu presents.

Topic Area: Psychosocial Interventions

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