Life Skills Learning And Readiness for Resilient Youth (LARRY): a day treatment program for teens with serious emotional disturbance
Kimberley Hurdle-Carter (1), Olivia Naya (1), Rebecca Stocker (1), Daryn Lowe (1), Rachael Lauterbach (1), Tarshe Derival (1), Emily Kline (3, 4), Melanie Schanche (2), Kimberly Irving (2), Charlene Zuffante (3), Cynthia Berkowitz (2, 5)
1. Riverside Community Care, Somerville, MA
2. Massachusetts Department of Mental Health Metro Boston Region Child, Youth, and Family Team, Boston, MA
3. Massachusetts Department of Mental Health Central Office, Boston, MA
4. Boston Medical Center, Boston, MA
5. Boston University School of Medicine, Department of Psychiatry, Boston, MA
6. UMass Chan School of Medicine, Department of Psychiatry. Worcester, MA
Abstract
Background: Recent decades have seen the development of intensive biopsychosocial treatment innovation for early psychosis and clinical high risk. Adolescents experiencing psychosis may present with significant social isolation and disengagement from school and other structured, age-appropriate settings. Given the significant numbers of youth who have new onset psychosis and clinical high risk for psychosis as well as psychosis beginning in early life, we have recognized the need to develop a similar program that provides a recovery-oriented milieu for adolescents. Life Skills: LARRY is a previously established, successful day treatment program for adolescents with significant emotional struggles who can benefit from a daytime milieu. When a third Life Skills setting opened in Somerville, the Metro Boston Child Youth and Family team collaborated with Riverside Community Care to give this team specialization in treatment of emerging psychosis - early psychosis, clinical high risk, and psychosis beginning in early life.
Methods: Admissions to Life Skills LARRY were tracked from 2020 to present via chart review. For each youth, the primary diagnosis, whether the youth had experienced psychosis, and non-diagnostic presenting concerns were recorded. Concerns were categorized as: school refusal, substance use, self-harm or suicide risk, social isolation, aggression toward others, and conflict with family.
Results: We will present the number of admissions each year of the program including the number with a primary psychotic disorder, those with psychosis symptoms, and their chief presenting concerns. We will describe the treatment model in the process of development.
Conclusions: Life Skills LARRY seeks to treat emerging psychosis primarily by providing a socially supportive therapeutic milieu model. Those with primary psychoses as well as psychosis symptoms can benefit from the model. The LARRY team provides the therapeutic milieu as well as psychoeducation, social skills training, and motivational interviewing. Clinicians focus on referring teens to specialized early psychosis treatment teams that can offer specialized pharmacotherapy and continue treatment over years. We are developing a collaboration with the Wellness and Recovery After Psychosis (WRAP) program at Boston Medical Center that will emulate the coordinated specialty care treatment model.