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Department of Psychiatry

Individual Therapist Onboarding

Welcome to EPI-NC First Episode Psychosis Programs!

We are glad you joined our team, and we hope this will help you navigate your understanding of First Episode Psychosis (FEP), Coordinated Specialty Care (CSC), and the role of Early Psychosis Intervention of North Carolina (EPI-NC). Please ask questions and let us know what you may need to adjust your new role.

First, please contact EPI-NC to gain access to the EPI-NC Teams folder. Additional onboarding documents can be found in the EPI-NC Teams folder.

Please review the following training: Basics of Coordinated Specialty Care for Early Psychosis.

Orientation to CSC Fidelity Guidelines

Orientation to the Individual Therapist Fidelity Guidelines

  • Minimum frequency of individual therapy services
    • First 3 months: weekly therapy, minimum of 8 sessions over weeks 1-13
    • 3-24 months: monthly therapy, minimum of 21 sessions
    • 24 months: criteria in development
  • Utilize the IRT wellness Plan module or similar structured tool to guide relapse prevention planning with your clients*
    • Conduct initial relapse prevention planning session within the first year of program participation.
    • After the first year, conduct wellness/relapse prevention plan review at minimum annually.

*Please clarify with your team lead that you are the person to complete wellness planning and relapse prevention with clients. In some clinics, family therapist, peer support specialists, or others may complete this process.

Orientation to IRT

Familiarize yourself with the IRT Training Manual, including the following activities:

  1. Read the first 12 pages of the manual, which give an overview of all standard and individualized modules
  2. Practice core components of Module 2: Assessment and goal setting, including completing the brief strengths test, satisfaction with areas of my life questionnaire, and IRT goal setting worksheet.
  3. Review the diathesis-stress model and positive versus negative symptoms of psychosis in Module 3: Education about Psychosis
  4. Learn about the most common causes of relapse and become familiar with the wellness planning materials in Module 5: Developing a Wellness Plan.
  5. Review the importance of resiliency of recovery from FEP. Reflect on the different ways to define and develop resilience, and practice some of the resiliency skills (positive psychology and mindfulness-based) from Modules 7 and 13: Developing Resiliency (Standard/Individualized)
  6. Read the clinical guidelines for Module 6: processing the psychotic episode to better understand the prevalence and impact of trauma-related experiences before, during, and after experiencing an acute episode psychosis. Review other information from this module, including Michael’s store and prompts for guiding the discussion about trauma-related experience.

Ongoing Consultation and Training Requirements

Participate in the live IRT Training within one year of being hired

  • If the next IRT training date has not been scheudled within six months of starting the position, therapists will be provided training tasks to become familiar with the IRT content, materials, and strategies to incorporate IRT in their clinical work. You will be asked to meet with Drs. Reddy or Ludwig 1-3 times to discuss the IRT materials, ask questions, and practice foundational IRT skills. The duration, frequency, and makeup of these meetings will vary depending on your experience working clinically with young people with psychosis, training on CBTp or IT, and the like
  • NAVIGATE Site and Training Videos.

IRT Certification Process

  • Any individual therapist who is part of the FEP CSC team in North Carolina for 3+ days per week (.60 FTE or greater) is expected to be certified in IRT
  • To meet the minimum requirements for certification, a therapist needs to submit two standard module session recordings and on specialty (individual) module session recording that meet fidelity (i.e., an Overall Quality of Session rating of 3 or highter).
  • Attend monthly IRT consultation calls with CSC providers across the state. Regular attendance is part of the fidelity guidelines for Individual Therapists.
    • Calls take place the second Thursday of each month form 1-2pm. Please contact Kelsey Ludwig if you need to be added to the call.

Other Important Information

Culturally competent and trauma-informed care for young people with psychosis

Important things to consider when struggling to communicate effectively with your clients

  • Learn about anosognosia and how to effectively communicate with someone who might not be aware of certain aspects of their illness. Xavier Amador’s Ted Talk delves into the clinical importance and implications of anosognosia, and ways to communicate effectively with someone who might not be aware of some aspects of their illness.

Ways to enhance individual therapy when clients have a health or wellness goals

  • Individuals in the early course of a psychotic disorder already have risk factors for developing diabetes, cardiovascular disease, and respiratory illness. Without intervention, these issues can result in excess mortality, an estimated 20-year reduction in life expectancy for people with serious mental illness.
  • NC HeAL is a unique, flexible, client-centered, and free wellness program that addresses the modifiable risk factors contributing to chronic physical illness. Clients can meet with a health coach to set realistic goals and personalized action plans with practical steps to make the lifestyle changes they are interested in. Please use this Qualtrics referral form to connect the client to the NC HeAL program. Additionally, if you need support or would like to augment IRT sessions (Module 4: Healthy Lifestyles Module) with the expertise of a board-certified specialist psychiatrist please use the Qualtrics referral form.