Recent Developments in The Support, Treatment, and Resilience (STAR) Program for Youth at Clinical High-Risk for Psychosis
Halle R. Singer (a) , Joey Rodriguez (a,c), P. Esra Guvenek-Cokol (a,b), Hyun Jung Kim (a,b),Dost Ongur (a,b), Tamara Welikson (a,b), Emily E. Carol (a,b), Zachary B. Millman (a,b)
a. Psychotic Disorders Division, McLean Hospital
b. Department of Psychiatry, Harvard Medical School
c. Northeastern University
Abstract
Background: The Support, Treatment, and Resilience (STAR) clinic at McLean Hospital was established in 2019 as an outpatient program for youth at clinical high-risk (CHR) for psychosis. STAR’s mission is to provide high-quality, insurance-based, outpatient care while serving as a hub for training and research on the high-risk stages of illness. We previously reported STAR’s referral and clinical activities through 2021. Here we provide updates on recent clinic developments including referral progress, clinical services, training, and research, highlighting years 2022 and 2023.
Methods: Frequencies of client referrals, intakes, consultations, and discharges are reported and compared across 2022 and 2023 with further updates at the time of presentation. Additional metrics of clinic growth are reported including staff additions, clinical programming, training opportunities, and affiliated research grants.
Results: In fall 2022, STAR initiated a consultation service to complement its active treatment program and added five new professional staff and trainees. In 2022, the number of referrals, evaluations, and clients who met CHR criteria once assessed were 29, 7, and 4, respectively. In 2023, these numbers are 39(34.48% increase), 20(184.71% increase), and 12(200% increase). 14 additional clients received ongoing treatment through STAR in 2023; to date, 7(35%) of 20 discharged clients since the clinic opened have transitioned to psychosis. STAR also began a new psychotherapy group, established a longitudinal clinical monitoring battery, and obtained numerous federal and local research and service awards. Conclusions: The STAR clinic continues to grow in terms of community impact and there continues to be a need for these services. Referrals are increasing and clinical services are expanding. The clinic is providing valuable training opportunities for psychology and psychiatry trainees and supports several promising research studies focused on CHR youth. Moving forward, standardized longitudinal data collection will provide valuable insights into the clinical course and treatment of this population.