Northwestern Medicine Recovery from Early Psychosis Program
The Northwestern Medicine Recovery from Early Psychosis Program (REPP) is a time-limited treatment program for young adults with psychotic symptoms that are interfering with their ability to have fulfilling life experiences.
The REPP treats 18- to 26-year-olds who have experienced a recent onset of a psychotic illness. Diagnoses include:
- Manic depressive disorder
- Depression with psychosis
- Schizoaffective disorder
- Schizophreniform disorder
- Delusional disorder
- Substance-induced psychosis
- Psychotic disorder not otherwise specified
The goal of the REPP is to foster the development of skills, to provide information and to offer treatment interventions which enable the person to move on from the acute impact of a psychotic episode and thereby redefine or resume experiences they wish to pursue.
The core principles of the REPP are to:
- Utilize a team of professionals who work as partners with the young adult and their social support network to restore and enhance function.
- Evolve treatment plans in which the young adult plays an increasingly greater role as he/she moves from first understanding, to managing and preventing psychosis, and then to developing and engaging opportunities which foster a sense of mastery of life’s challenges.
- Promote skill development that empowers the young adult to define, revise and travel along a life path of their own making.
The Northwestern University Department of Psychiatry includes preeminent research and clinical faculty whose major interests are understanding and optimizing the treatment of severe mental illness.
The REPP utilizes these faculty as well as an array of staff who are focused on functional outcomes in this population. The team members are part of the Norman and Ida Stone Institute of Psychiatry and include occupational therapists, nurses and nurse practitioners, psychiatrists, social workers, psychiatric and psychology trainees and peer supports (i.e. young adults who are completing or have completed the program).
The REPP offers a variety of services for patients, including:
- Functional assessments: Occupational therapy evaluations are at the center of treatment planning and focus on maximizing functional outcomes and personal mastery. Additional assessments are obtained by the neuropsychology services to target cognitive remediation and optimize academic and vocational functioning.
- Therapy groups:
- Education about psychiatric illnesses, medications, minimizing symptoms and maximizing productive use of time
- Cognitive behavioral therapy (CBT) for psychosis
- Enhancement of function in social, occupational, educational and family roles particularly during times of stress
- Promotion of communication, understanding and mutual support within and between families/support network of afflicted young adults.
- Planned groups for the near future include:
- Cognitive remediation
- Peer-initiated topics
- Medication management: Dosing at lowest possible levels to reduce adverse side effects while also minimizing symptom severity.
- Crisis management: Acute interventions through clinic staff or Northwestern Memorial Hospital emergency room to arrange admission to NMH inpatient psychiatric unit or our SMHC-intensive outpatient program.
- Individual therapy: Multiple modalities based on training and interests of the primary clinicians.
- Substance abuse: Basic substance abuse treatment services are provided. Individuals with primary substance abuse issues which prevent successful participation in the program are referred for additional services
- Intensive case management: Facilitates transportation, stable housing and engagement with the program. Assist in initiation of occupational and educational activities.
- Supported employment: Job training and coaching are provided in partnership with Thresholds, Inc. More extensive in-home and community services as well as assistance with supported employment are available with Thresholds, as well.
Young adults may gain entry following discharge from inpatient hospitalization or an intensive outpatient program (SMH, SMHC or elsewhere), following referral from a mental health professional or educational institution, or by contacting our intake office.
The basic REPP evaluation involves two one-hour back-to-back meetings with a psychiatrist and occupational therapist who then present their findings the following week to the team. The team makes recommendations which may include further evaluations, individual and group therapy, case management, and medications.
A recommendation for a primary clinician who is one of the team members will be based on the young adult’s needs and the clinician’s expertise. The team leader then meets that same day with the young adult (and support network) to share these recommendations and devise a treatment plan.
The primary clinician fosters communication with other team members regarding the young adult, and provides therapy and other supports, as needed. The occupational therapist reassesses the young adult’s progress, evolving goals, strengths and areas for further growth on a regular basis. Using this information the primary clinician and team make quarterly revisions to the treatment plan.
Each young adult will determine the nature, depth and course of their involvement with the program. We anticipate, however, the first year will focus on illness education and mastery while the second will focus on goal development and implementation.
Young adults may be approached about their interest in participating in a number of pharmacologic and non-pharmacologic research studies which are being conducted by various principal investigators.