Clinical Care

This is a consultation clinic for adolescents and young adults (14 to 25 years old) who may be showing early (prodromal) signs of schizophrenia, as there is evidence that early identification of this illness can improve treatment outcomes and even prevent disease progression.

Our team of specialists provides evaluations, which consist of a comprehensive consultation and referrals for ongoing treatment to other providers as appropriate. Follow-up in the Department of Psychiatry clinic may be available. The clinic also evaluates patients for research protocols, which may include administration of the Structured Interview for Prodromal Symptoms (SIPS), functional magnetic resonance imaging (fMRI) studies, and neuropsychological testing.

Please consider this clinic if you or someone you care about has any of the following symptoms:

  • Perceptual disturbances
    Felt distressed because they are seeing unusual things (like flashes or flames, or things appearing brighter or duller than normal) or hearing unusual sounds (like banging or clicking, or distant sounds seem louder than is normal);
  • Suspiciousness/paranoia
    Felt distressed by the feeling that people are watching/talking about them or that they are feeling mistrustful/suspicious;
  • Imagination/reality distortion
    Felt distressed because of the confusion about whether something they experienced was real or imaginary.

Clinical evaluations, screening, and treatment

PREP has two approaches to identify individuals who show risk signs of psychosis or early psychosis.  We receive referrals from the community, and we systematically screen all patients who come to the Department of Psychiatry.   Working with clinicians, we reach out to provide specialized assessment of psychosis risk not ordinarily available in regular mental health evaluations.  Although APS still remains a research diagnosis, over 80% of individuals who are evaluated in similar programs have some form of diagnosable condition.  Consultations raise awareness about the risk syndrome and also provide individuals the opportunity to enroll in research protocols (see Research Activity).   When individuals do not have insurance coverage to afford the specialized evaluations of PREP, participation in a research study provides free access to one of our evaluations.

We also provide follow-up care for patients, in the form of state-of-the-art cognitive behavioral therapy (CBT), a new approach to manage individuals with APS without resorting to antipsychotic medications. For those patients who are in the early phases of psychosis – where antipsychotic medications play a key role in treatment – CBT provides an important augmentation strategy.  Our clinical psychology members, Savanna Mueller, Drs. Patricia Deldin and Ivy Tso, have been instrumental in the development of CBT treatment materials specific for individuals with APS and early psychosis utilized in the PREP Clinic.

Clinical Psychology Training

One of the reasons that treatments such as CBT for psychosis have not become widely available is the lack of specialized training in this area.  Recognizing this problem, one of the goals of PREP has been to assist in training the next generation of professionals.  Last spring, PREP hosted a visit from Dr. Barbara Walsh from Yale University to conduct a 2-day training in the specialized APS assessment, known as the Structured Interview for Prodromal Syndrome (SIPS).  We also offer a clinical practicum for doctoral Clinical Psychology trainees, supervised by Dr. Ivy Tso, focusing on assessment and CBT treatment for APS and psychotic disorders.