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The Massachusetts Psychosis Network for Early Treatment (MAPNET) and the New England Mental Health Technology Transfer Center (MHTTC) host a virtual monthly “Early Psychosis Prescriber Consultation Series” led by Dr. Matcheri Keshavan on prescribing practices for early psychosis, including a review of a selected monthly topic. Our May topic was “Long-Acting Injectable Antipsychotics (LAIs)." ​​Dr. Keshavan is Stanley Cobb Professor of Psychiatry at the Beth Israel Deaconess Medical Center, Harvard Medical School, as well as Academic Head of the department. He is the Editor-in-Chief of Schizophrenia Research (Elsevier) and serves on the editorial board for journals such as Early Intervention in Psychiatry and Asian Journal of Psychiatry. His main areas of research include the neurodevelopmental basis of schizophrenia, neuroimaging, and early intervention. He has an active clinical practice.

This webinar provided tips for increasing engagement and understanding insight when working with individuals who experience psychosis. Some of the learning goals of this webinar include: Understanding some of the common barriers to engagement in treatment for individuals who experience psychosis Learning strategies for building rapport and trust with clients whose symptoms may interfere with having insight about their condition Developing a deeper understanding of the role of empathy for the individual’s experience and validation of their values when fostering engagement and therapeutic progress Discussing important cultural and ethical considerations to keep in mind when working with individuals who struggle with developing insight into their psychotic symptoms About the Presenters: Emily Kline is an Assistant Professor of Psychiatry at the Boston University Chobanian & Avedisian School of Medicine and the Director of Psychological Services in the Wellness and Recovery After Psychosis (WRAP) Program at Boston Medical Center. She is an expert in adolescent and young adult development, emerging psychotic disorders, and serious mental illness. She has published over 40 peer reviewed papers and several book chapters on psychosis prediction, detection, diagnosis, and treatment. Her current research focuses on improving communication between parents and youth and increasing access to high quality mental health treatment for young people in distress. Dr. Kline authored The School of Hard Talks: How to Have Real Conversations with Your (Almost Grown) Kids (2023) as well as a The School of Hard Talks Online which is an online course for parents who are hoping to learn to improve their communication with their teens. Jenny Lancet MS, MBA is a Peer Support Specialist with the WRAP Program at Boston Medical Center. She provides one-on-one support by assisting others in their own journeys of recovery through sharing her own experiences and promoting hope that recovery is possible. In her spare time she enjoys photographing the city.

Presented by: Angela Schindler-Berg, MS, LMHP Angela Schindler-Berg is a Licensed Mental Health Practitioner and has worked with primary care clinics and integrated community-based mental health services for over 25 years.   As the Nebraska Project Lead for HealthTeamWorks, Angie promotes healthcare delivery that utilizes evidence based mental health practices, effective team-based care, care management resources, quality improvement processes, and strategic population health to improve the quality of health/life for individuals.  As a practice facilitator Ms. Schindler-Berg has worked on CMS/CMMI initiatives such as the Comprehensive Primary Care (CPC+) and with SAMHSA on the Primary and Behavioral Health Care Initiative (PBHCI).   Currently, Ms. Schindler-Berg supports the University of Nebraska Medical Center-Munroe Meyer Institute as a contracted Regional Trainer with the Region 7 Mid-America Mental Health Technical Transfer Center (MHTTC) She facilitates a collaborative network of supports, focusing on resource development and dissemination, training and technical assistance, and workforce development for the mental health field.  Angie received her Master of Science with Drake University in Rehabilitation Administration and Clinical Rehabilitation Counseling. She brings expertise in integrated care, mental health, care management, crisis intervention and trauma informed care.    Learn more about this Learning Community: First Episode Psychosis Learning Community  

By the end of this webinar, participants were able to describe: The nature of insight and treatment engagement in psychotic disorders An overview of the causes of impaired insight and treatment engagement in psychotic disorders. Approaches to management of impaired insight and treatment engagement/alliance in psychotic disorders.   Presenter: ​​Dr. Keshavan is Stanley Cobb Professor of Psychiatry at the Beth Israel Deaconess Medical Center, Harvard Medical School, as well as Academic Head of the department. He is the Editor-in-Chief of Schizophrenia Research (Elsevier) and serves on the editorial board for journals such as Early Intervention in Psychiatry and Asian Journal of Psychiatry. His main areas of research include the neurodevelopmental basis of schizophrenia, neuroimaging, and early intervention. He has an active clinical practice.   This webinar was co-hosted by the Massachusetts Psychosis Network for Early Treatment (MAPNET, www.mapnet.online).

Raúl Condemarín shares culturally responsive strategies that he uses as a psychiatrist with host Lola Nedic. This podcast episode is sponsored by the New England Mental Health Technology Transfer Center Network (MHTTC).

Additional resource: National School Mental Health Implementation Guidance Modules and Related Projects Presented by: Jessica Christensen, M.Ed, holds a bachelor’s degree in Secondary English Education and a master’s in Education. With over a decade of middle school teaching experience, she moved from the classroom to the non-profit sector. Following the conclusion of Please Pass the Love in May 2023, she transitioned from Please Pass the Love to a full-time role at MHTTC. Jessica offers valuable insights to enhance mental well-being in education, empowering educators, and guiding districts to strengthen their mental health frameworks. Learn more about this Learning Community: First Episode Psychosis Learning Community

About this Resource: Open Dialogue is a therapeutic approach to psychosis that operates as a system of care to facilitate continuity and recovery for individuals experiencing psychosis. This infographic, which accompanies our Open Dialogue on-demand recording, reviews the history and key principles as well as provides a case study example of this therapeutic approach.

Hosts Joey Rodriguez and Lola Nedic discuss culturally responsive strategies and the future of culturally responsive care. This podcast episode is sponsored by the New England Mental Health Technology Transfer Center Network (MHTTC).

This webinar provided tips for working with families of individuals with psychosis in outpatient community settings. Questions that were addressed include:   How can I develop a good working relationship with families in order to support care even though I don’t have a lot of experience working with families and I have a large caseload? How can I manage confidentiality? How can I help families develop a better understanding of their relative and their symptoms and treatment? What are some important considerations for providing culturally responsive care when working with families? What can I learn to feel more equipped to support families entering care in the context of a recent onset of psychotic symptoms?   Presenter: Julie M. McCarthy, PhD, is a clinician-scientist in the Division of Psychotic Disorders at McLean Hospital in Belmont, Massachusetts. Her research aims to identify neurobiological and psychosocial treatment targets and develop/evaluate treatments for individuals and families experiencing co-occurring psychotic and substance use disorders.

Coordinated Specialty Care (CSC) is an evidence-based, recovery-oriented, multidisciplinary treatment program tailored for individuals experiencing Early Psychosis. CSC involves joint treatment planning (or shared decision-making) between the people in treatment and recovery and their care team, which can include mental health providers such as peer specialists, psychiatrists, psychologists, social workers, and case managers. CSC can provide individual and family counseling, medication management, case coordination and assistance with educational and career objectives, as well as other services. Learn more in this brief and check out our free online course for more information.

  This presentation provided a brief overview of how harm risk (suicidality and self-injury) can present in young people experiencing early psychosis. We reviewed a selection of psychotherapy strategies that can be helpful in targeting these concerns, highlighting functional analysis, distress tolerance skills, and the CAMS (Collaborative Assessment and Management of Suicidality). We discussed these strategies in the context of disguised client examples, and encouraged suggestions and case consultation from the audience.   Presenter: Michelle L. West, PhD, Director, Program for Early Assessment, Care, & Study (PEACS), Assistant Professor, Department of Psychiatry, University of Colorado – School of Medicine (CUSOM). Dr. West is a clinical psychologist who specializes in assessment, treatment, and research for young people showing possible early risk for psychotic spectrum illnesses. This webinar was presented in collaboration with the Massachusetts Mental Health Center GrandRounds series.   View a recording of this 2/23/24 session here. 

Author: Dr. Nicholas Breitborde, Ph. D. Dr. Nicholas Breitborde is Professor and Vice Chair for Academic Affairs in the Department of Psychiatry and Behavioral Health at The Ohio State University and Director of the OSU Early Psychosis Intervention Center (EPICENTER). He serves as a Content Area Expert for the Global Burden of Disease Study and is a member of the American Psychological Association Task Force on Serious Mental Illness/Severe Emotional Disturbances. To date, his research has been cited over 40,000 times and has been funded by agencies such as the National Institute for Mental Health (NIMH) and the Substance Abuse and Mental Health Services Administration (SAMHSA). Learn more about this Learning Community: First Episode Psychosis Learning Community

Dr. Gagen reviewed a metacognitive framework for understanding psychosis and discussed a specific psychotherapeutic intervention--Metacognition Reflection and Insight Therapy. We discussed the definition of metacognition and the four main domains that are measured, the relationship between metacognitive capacity and psychological distress, and the research evidence that supports this approach.   Presenter: Emily Gagen, Ph.D., is a licensed clinical psychologist at the Brookline Community Mental Health Center. She is the director of the Massachusetts Psychosis Access and Triage Hub (M-PATH) and a member of the team at the Center for Early Detection, Assessment, and Response to Risk (CEDAR). Dr. Gagen has worked with individuals with psychosis and schizophrenia-spectrum disorders for 15 years and specializes in the treatment of young adults with early psychosis.   View a recording of this 1/26/24 session here.

Presented by: Angie Schindler-Berg, MS, LMHP Angela Schindler-Berg is a Licensed Mental Health Practitioner and has worked with primary care clinics and integrated community-based mental health services for over 25 years.   As the Nebraska Project Lead for HealthTeamWorks, Angie promotes healthcare delivery that utilizes evidence based mental health practices, effective team-based care, care management resources, quality improvement processes, and strategic population health to improve the quality of health/life for individuals.  As a practice facilitator Ms. Schindler-Berg has worked on CMS/CMMI initiatives such as the Comprehensive Primary Care (CPC+) and with SAMHSA on the Primary and Behavioral Health Care Initiative (PBHCI).   Currently, Ms. Schindler-Berg supports the University of Nebraska Medical Center-Munroe Meyer Institute as a contracted Regional Trainer with the Region 7 Mid-America Mental Health Technical Transfer Center (MHTTC) She facilitates a collaborative network of supports, focusing on resource development and dissemination, training and technical assistance, and workforce development for the mental health field.  Angie received her Master of Science with Drake University in Rehabilitation Administration and Clinical Rehabilitation Counseling. She brings expertise in integrated care, mental health, care management, crisis intervention and trauma informed care.     Learn more about this Learning Community: First Episode Psychosis Learning Community

This session informed participants about a variety of innovative strategies providers can share with families to assist them in supporting people who hear voices or experience other unusual beliefs or extreme states that are often labeled as psychosis. Internationally recognized educator, consultant, and presenter Cindy Hadge draws from her own experiences overcoming childhood trauma as well as her experiences supporting family members to fuel her passion and inform her work resulting in invaluable information and tools shared with participants.   Presenter: Cindy Hadge has become an internationally recognized educator providing training and consultations to mental health providers worldwide who are looking for innovative ways to approach voice-hearing and extreme states. She is also passionate about developing and facilitating healing spaces and workshops for families whose loved ones are not responding well to the current mental health system’s offerings. As Lead Trainer of the Wildflower Alliance, Cindy has keynoted a variety of conferences.   View a recording of this 1/9/24 session here. 

Amanda Weber and host Joey Rodriguez discuss culturally responsive care for youth experiencing early psychosis. This podcast episode is sponsored by the New England Mental Health Technology Transfer Center Network (MHTTC).

View the slides: Implementing Peer Support Specialists in a First Episode Psychosis Program Author: Marla Smith, MS, LMHP, LMHC Marla Smith has been an integral part of the Mid-America Mental Health Technology Transfer Center (MHTTC) since November 2020. Her primary role involves coordinating behavioral health training, particularly focusing on individuals diagnosed with serious mental illnesses. As a licensed Mental Health Counselor in both Nebraska and Iowa, Marla brings extensive experience, having worked directly with clients of all ages for nearly 20 years. Her approach emphasizes the importance of connection, meeting individuals where they are, and using respectful, trauma-informed communication to support positive change. Marla holds a Master's degree in Youth and Family Services from Bellevue University. Outside of work, she cherishes family time and indulges in crafting as a favorite pastime.  Learn more about this Learning Community: First Episode Psychosis Learning Community

  This talk discussed when, how, and why to prescribe clozapine. Dr. Laitman gave specific approaches to minimize predictable side effects and maximize benefits. He also presented his own data supporting this approach.   Presenter: Dr. Robert Laitman is an internist who specializes in the use of clozapine in an optimal fashion for individuals with schizophrenia or other psychotic spectrum disorders.   This webinar was co-hosted by the Massachusetts Psychosis Network for Early Treatment (MAPNET, www.mapnet.online)   View a recording of this session here. 

Grounded in national and regional EPINET data on discharge in early psychosis services, this presentation focused on social and cultural vectors underlying the 'hard' problem of disengagement and presented alternative approaches for addressing distrust, and strengthening clinical relationships by centering lived experiences of psychosis, socioeconomic disadvantage, racism, and cultural difference.   Presenter: Nev Jones PhD is a patient-alumna of specialized early psychosis services and currently assistant professor in the School of Social Work and Department of Psychiatry at the University of Pittsburgh. As a program developer, evaluator and researcher, her work has sought to amplify the perspectives of those most impacted by the public mental health system, foreground the role of social and structural determinants, and support transformative change.   View a recording of this session here. 

Chia Hsuan Sabrina Chang and host Lola Nedic discuss culturally responsive care and strategies for clinicians. This podcast episode is sponsored by the New England Mental Health Technology Transfer Center Network (MHTTC).

Vera Muñiz-Saurré and host Joey Rodriguez discuss experiences with culturally responsive care in early psychosis and strategies for providers. This Changing the Conversation podcast episode is sponsored by the New England Mental Health Technology Transfer Center Network (MHTTC).

This two-day hybrid conference explores progress and updates on the Massachusetts Strategic Plan for Early Psychosis (Mass-STEP). Our theme this year was Scaling Up: Access & Equity for Psychosis, and explored strategies to expand the reach of high-quality psychosis services across Massachusetts. This effort includes partners from many different backgrounds, including individuals and families, government stakeholders, researchers, clinicians, teachers, faith leaders, emergency responders, and all others who are invested in improving our statewide system of care for psychosis. The second day explored different areas of health equity in psychosis, spotlighting ways to bridge service gaps in geography, race, and language.   Racial and Ethnic Disparities in Psychosis Diagnoses & Risk Deidre Anglin, PhD City University of New York View a recording of this 11/7/23 session here.   Working with Medical Interpreters: Shifting from Standards of Practice to Intersubjectivity in the Clinical Space Margaret Lanca, PhD Cambridge Health Alliance View a recording of this 11/7/23 session here.   Psychosis Care for Rural Populations Kristen Woodberry, MSW, PhD & Sarah Lynch, LCSW Maine Medical Center View a recording of this 11/7/23 session here.   Expanding & Strengthening the Mental Health and Early Psychosis Career Pipeline for Black and Latinx Youth S. Kwame Dance, PsyD, MBA Mental Health ACCESS & Boston Arts Academy View a recording of this 11/7/23 session here.      

Prolonged delays from psychosis onset to care (or Duration of Untreated Psychosis-DUP) can imperil the benefits even of evidence-based Coordinated Specialty Care (CSC) clinics. Early detection efforts to shorten DUP are thus a necessary component of modern early intervention  services for schizophrenia. The NIMH-funded Mindmap campaign reported the first successful demonstration of DUP reduction in a U.S. region. Details of the design and implementation of Mindmap will be presented with lessons for future early intervention efforts.   Presenter: Vinod Srihari, MD is a staff psychiatrist at the Connecticut Mental Health Center, Professor of Psychiatry at Yale University, and the founding Director of the Program for Specialized Treatment Early in Psychosis (STEP). STEP completed the first U.S. based RCT of specialty team based care for early psychosis and followed this with the first successful replication of the Scandinavian TIPS study of DUP reduction. The Program delivers a care pathway that integrates early detection with CSC and within a population health framework that targets geographically defined populations. This webinar was co-hosted by the Massachusetts Psychosis Network for Early Treatment (MAPNET, www.mapnet.online).   View a recording of this 11/3/23 session here. 

About this Resource: The Southeast MHTTC Newsletter highlights upcoming events and recently released products as well as shares information on available resources from SAMHSA and the MHTTC network.  The November 2023 issue promotes Native American Heritage Month. This issue also highlights our upcoming events and recently developed products, celebrates efforts being done by Region IV states, and provides resources available through the MHTTC Network and SAMHSA to connect individuals to needed treatment and support.