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Published on: November 21, 2013
The NAVIGATE Program for First-Episode Psychosis: Rationale, Overview, and Description of Psychosocial Components
Kim T Mueser1, David L Penn1, Jean Addington1
1Dr. Mueser, Dr. Gottlieb, and Dr. McGurk are with the Center for Psychiatric Rehabilitation and the Department of Occupational Therapy, Sargent College, Boston University, Boston (e-mail: mueser@bu.edu ). Dr. Penn and Dr. Saade are with the Department of Psychology, University of North Carolina, Chapel Hill. Dr. Penn is also with the School of Psychology, Australian Catholic University, Melbourne. Dr. Addington is with the Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada. Dr. Brunette is with the Department of Psychiatry, Geisel School of Medicine, Lebanon, New Hampshire. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Dr. Glynn is with the Mental Illness Research, Education and Clinical Center (MIRECC), Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles. Mr. Lynde is an independent consultant and trainer in Concord, New Hampshire. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul. Dr. Cather is with the Department of Psychiatry, Massachusetts General Hospital, Boston. Dr. Robinson and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York. Dr. Schooler is with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Rosenheck is with the Department of Psychiatry, Yale Medical School, New Haven, Connecticut, and with the MIRECC, VA New England Healthcare System, West Haven, Connecticut. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section.
Abstract:
Comprehensive coordinated specialty care programs for first-episode psychosis have been widely implemented in other countries but not in the United States. The National Institute of Mental Health's Recovery After an Initial Schizophrenia Episode (RAISE) initiative focused on the development and evaluation of first-episode treatment programs designed for the U.S. health care system. This article describes the background, rationale, and nature of the intervention developed by the RAISE Early Treatment Program project-known as the NAVIGATE program-with a particular focus on its psychosocial components. NAVIGATE is a team-based, multicomponent treatment program designed to be implemented in routine mental health treatment settings and aimed at guiding people with a first episode of psychosis (and their families) toward psychological and functional health. The core services provided in the NAVIGATE program include the family education program (FEP), individual resiliency training (IRT), supported employment and education (SEE), and individualized medication treatment. NAVIGATE embraces a shared decision-making approach with a focus on strengths and resiliency and on collaboration with clients and family members in treatment planning and reviews. The NAVIGATE program has the potential to fill an important gap in the U.S. health care system by providing a comprehensive intervention specially designed to meet the unique treatment needs of persons recovering from a first episode of psychosis. A cluster-randomized controlled trial comparing NAVIGATE with usual community care has recently been completed.
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