Community Outreach, Referral and Early Intervention ...€¦ · Community Outreach, Referral and Early Intervention (Delaware CORE) 2 Charles Webb Ph.D. Division of Prevention and

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Community Outreach, Referral and Early Intervention

(Delaware CORE)

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Charles Webb Ph.D.Division of Prevention and Behavioral Health Services

Adina SeidenfeldUniversity of Delaware

Implementation of the PIER model,

and conceptual comparison of

prodromal and FEP participants

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Delaware

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PIER Model

Joining ~ 1 month

Family psychoeducatioin ~ 1-4 weeks

Multi-family groups ~ 2 – 24 months

Therapeutic

Supportive

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Outreach: Institutions

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Recruitment

Active = 36

Admitted = 46

Assessed = 67

Referrals Screened = 95

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Recruitment

Referrals (n=72) Active Cases (n=38)

Mean age 17.0 17.8

Gender % 56.8 male

38.9 female

4.2 other

55.9 male

41.1 female

2.9 other

Race % 36.8 African American

37.9 White

25.3 Other

28.1 African American

50.0 White

21.9 Other

Ethnicity % 16.8 Hispanic 16.6 Hispanic

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Assessment: Structured Interview Psychosis-Risk Syndrome (SIPS)

Positive Symptoms

Unusual thought content/Delusional ideas

Suspiciousness/Persecutory ideas

Grandiose ideas

Perceptual abnormalities/Hallucinations

Disorganized communication

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Dr. Barbara Walsh @ Yale Prime Clinic @ 203-974-7052

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Structured Interview for Psychosis-Risk Syndromes (SIPS)

Unusual thought content/Delusional ideas

Score Status

0 No symptom

1 Mind tricks that are puzzling.

2 Overly valued beliefs within cultural norms.

3 Mental events that are puzzling, unwilled and recurrent.

4 Sense that ideas/beliefs are outside oneself, but doubt is intact.

5Experiences are recurrent, but doubt can be induced by contrary evidence or others’ opinions.

6 Delusional conviction (i.e., loss of insight)

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Ratio of Prodrome to FEP

2:1

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Positive Symptoms

* = <.05, **=<.001

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Negative Symptoms

* = <.05, **=<.01

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Disorganized Symptoms

* = <.05

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Psychosis Questionnaire – Brief Form

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Functioning

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Case Example 1

Michael is a 17 year old Caucasian male living in Northern Delaware and was referred to our program by his state worker. When he first started in our program, he reported visual and auditory hallucinations and believed with conviction that a ghost was taking control of his mind.

When he felt the ghost taking control, he became withdrawn and disorganized. He experienced tics that forced him to repeatedly rub his arms and sniff his fingers. He became unmotivated and disengaged in school work and other household chores.

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Case Example 2

Kendra is a 16 year old African American female recently discharged from a detention and recommended for family counseling to address conflict at home. Psychologist in detention cited suspicion of others, loss of interest, and a tendency to isolate. Kendra had been previously diagnosed with Bipolar Disorder and was prescribed medication, but felt they were not working so discontinued.

At intake, Kendra endorsed having unusual thoughts, delusional ideas and suspiciousness. Symptoms were not causing her to endanger herself or become disorganized. When asked if her beliefs and suspicions were real, she said they were not, but she stil felt something was still not quite right.