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Department of Psychiatry

Family Therapist Onboarding

Welcome to the EPI-NC First Episode Psychosis (FEP) Programs!

We are glad you joined our team and hope this will help you navigate your understanding of FEP, CSC and the role of EPI-NC. Please ask questions and let us know what you need to best adjust.

First, please contact EPI-NC in order to gain access to the EPI-NC Teams folder. Onboarding documents can be found on this page and the General Onboarding tab.

Introduction:

Families are an essential component of an individual’s recovery from the first episode of psychosis. Families are often the first to observe symptoms, initiate treatment, and support involvement in treatment. In fact, they are often the bridge to clients reluctant to be in treatment. Given that many young people live with family members, the family often provides and sustains a psychosocial environment that impacts a person’s recovery.

Families are often impacted by psychosis through:

  • Stigma
  • Situation burden
  • Negative impact on other children
  • Economic burden
  • Social isolation
  • Fear of the future

The families’ expressed emotion (EE) or the emotional under or overinvolvement of family members, is one potential predictor of relapse. Family treatment helps moderate expressed emotion and reduce stress in the family structure and the subsequent exacerbation of symptoms.

Please review the following training: Basics of Coordinated Specialty Care for Early Psychosis (CSC Basics)

NAVIGATE Manual

The NAVIGATE Family Education Program was initially developed in 2014 with an updated version in 2020. The manual contains: clinical guidelines, assessments, and handouts. Early sessions are meant to mirror Individual Resilience Training (IRT) sessions. The manual can serve as a guide for your family sessions and provides a base model for providing family education, communication and problem-solving skills training.

  • Week 1:
    • Read through the table of contents to familiarize yourself with the manual
  • Week 2:
    • “Philosophical Foundation of Family Work in NAVIGATE” pp. 5-9
    • “Logistics for NAVIGATE Family Work” pp. 9-16
  • Week 3:
    • “Techniques in NAVIGATE” pp. 16-21
    • “Overview of the NAVIGATE” pp. 22-29
  • Week 4:
    • “Format of Education Sessions in NAVIGATE” pp. 30-40
  • Week 5:
    • Review “Clinical Guidelines with accompanying participant and family handouts for the Engagement, Orientation, and Assessment Phase of Family Education” pp. 43-52, pp. 77-106
  • Week 6 and 7:
    • Review Clinical Guidelines with accompany participant handout for “Just the Facts” Participant education handouts, pp. 53-76, pp. 108-209
  • Week 8:
    • Read supplemental material in manual
    • Problem Solving, pp. 214-227
    • Modified Intensive Skills Training (MIST), pp. 228-238

The clinic should account for the time it takes to work through treatment manuals as well as accommodate for different learning styles to provide the new clinician with the opportunity and time to complete the reading during work hours in the first month.

NAVIGATE Training

You will be able to join NAVIGATE training virtually that is offered around the United States throughout the year at different first episode clinics. These training courses are typically a 1–2-day workshop (5-10 hours) and an opportunity to learn more about the NAVIGATE model.

Contact EPI-NC to coordinate a NAVIGATE Training.

Consultation Calls

Consultation calls are held monthly on the first Friday of the month from 10:00AM-11:00AM. These are an opportunity to meet with other family therapists in North Carolina to present cases, troubleshoot challenging clinical issues, and learn from each other. Attendance is fidelity requirement and required.

Contact EPI-NC to be added to the consultation call.

Family Therapy Partner (FTP)

When you join the team of family therapists in NC, you will be assigned a Family Therapy Partner (FTP), another family therapist in the state who has been practicing family therapy for at least 1 year and who can be a resource for logistical or clinical questions. In the first 6 months of your work, you will meet with your FTP monthly for 30 minutes.

There are opportunities for shadowing or having an FTP join a family session and provide feedback.

Contact Emily Parsons to be paired.

Multi-Family Group (MFG)

Family therapy will look different at each site as different strategies work for different client populations. Multi-Family Group is an optional opportunity for group therapy where parents meet to explore important topics in first episode recovery and problem-solve challenges that they are having.

MFG also helps a clinic meet fidelity for the number of family sessions that each family member should receive within first year. The MFG varies from site to site. Here are some potential options for MFG:

  • Held virtually or in person in the evenings
  • Monthly or bi-weekly
  • The sites have collaborated on a deck of slides that they have presented to MFG for your reference. You may edit/revise these to meet your needs.

Enhancing Family Engagement 

Please take the time to review the slides from this two-day training conducted by Michelle Friedman-Yakoobian, Ph.D. The training videos are linked here. Passcode: zWW.R67w 

Presentation Slides: Working with Families Workshop

Appendices