Mclean Hospital

McLean OnTrack™

Treatment for First-Episode Psychosis and Related Symptoms

Overview

McLean OnTrackTM provides the best possible care for young adults in the early stages of psychotic disorders. OnTrack Jr. offers treatment for those at-risk for psychotic illnesses.

We understand that experiencing psychosis and related symptoms, especially for the first time, can be a period of great uncertainty for patients and their families. Our outpatient programs specialize in early recognition and treatment for teens and young adults.

McLean OnTrack focuses on treating young people ages 18 to 30 who have had their first episode of psychosis during the previous year. The years immediately following the onset of psychosis represent a critical period, and treatment during this time is important for good long-term results.

OnTrack Jr. delivers high-quality care to teens and young adults ages 14-25 who are experiencing changes that impact thinking, emotions, behavior, and functioning. Although these changes do not indicate a first episode of psychiatric illness, they may place a person at increased risk of developing psychosis.

For more information about the OnTrack programs or to make a referral, please call us at 617.855.2179 (first episode) or 617.855.3663 (early intervention).

Our programs are best suited to individuals who are:

  • Experiencing the early stages of psychosis after a recent first episode
  • Having changes in their thinking, emotions, behavior, or functioning
  • Struggling with psychosis due to mood disorders or primary psychotic disorders
  • Seeking early intervention and customized outpatient treatment

By focusing on the unique experiences of each of our patients, we strive to find a common language to discuss struggles and to find the path forward. Therefore, each treatment plan is tailored to meet the specific needs of the individual.

At McLean OnTrack, an important part of our mission is to work toward developing effective treatments by conducting scientific research. We provide the opportunity for patients to voluntarily participate in research studies aimed at understanding the biological processes underlying psychosis. The primary goal of our clinical care and research is to work toward functional recovery and to steer the path of each individual’s life in a positive direction.

The length of time in the programs varies according to the course and path of the illness and symptoms, but we generally expect patients to be in McLean OnTrack for about 2-5 years. For OnTrack Jr. patients, length of participation is customized based on the needs of the individual. The frequency and intensity of treatment typically diminishes as the patient’s level of functioning improves.

The programs are covered by most insurance providers. McLean OnTrack also has a self-pay component for services that are not covered by insurance. So that out-of-pocket expenses are not a barrier to treatment, financial aid may be available for those who qualify.

The OnTrack programs are located on McLean’s Belmont campus in the Admissions Building. Our multidisciplinary teams are dedicated to providing world-class care and conducting cutting-edge research to improve the lives of patients experiencing first-episode psychosis and symptoms related to psychotic disorders.

Watch these videos to learn more about McLean OnTrack, psychosis, and bipolar disorder:

What is McLean OnTrack and how does it help patients?
Watch now

Amy has psychosis. Learn more about psychosis and how Amy can get back on track.
Watch now

Andy has bipolar disorder. Learn more about this condition and how McLean OnTrack helps individuals with this diagnosis.
Watch now

Treatment Approach

Symptoms that affect thinking, emotions, behavior, and functioning can be an alarming experience, especially for a young person.

Psychotic episodes can create major disruptions in work, school, and relationships. Individuals affected by psychosis may worry that they will fall behind their peers, will not be able to accomplish their long-term goals, and will not return to the lives they had prior to the onset of their episode.

We understand that new or worsening symptoms can lead to confusion and fear. McLean OnTrack and OnTrack Jr. provide support to help individuals learn to understand and cope with these changes.

At the OnTrack programs, we believe that empowering young people to act as primary and active stakeholders in their own care will improve their chances for a strong and sustained recovery. The program name “OnTrack” underscores our emphasis on functional recovery and our model of shared decision-making.

At McLean OnTrack, we focus on the initial years following the first episode of psychosis. This a period when the greatest impact can be made to change the path of the illness and to reduce the risk of long-term disability.

McLean OnTrack offers individual and group therapy, family support programs, medication treatment, peer counseling, and case management services. Since the course of illness can vary in the early stages, treatment plans are formulated around the evolving needs of each patient, incorporating best practices for the treatment of first-episode psychosis.

At OnTrack Jr., our skilled and compassionate clinicians provide treatment aimed at managing symptoms while improving and maintaining a patient’s overall functioning.

Some of the changes young people may experience include:

  • Difficulty thinking clearly/concentrating or expressing thoughts clearly
  • Changes in speech, such as vague or unusual speech patterns
  • Changes in thought content, including suspiciousness, emerging odd thoughts, or unusual beliefs
  • Perceptual disturbances, such as increased sensitivity to sights, sounds, hearing one’s name being called, or hearing or seeing things that others do not
  • Difficulty expressing or understanding emotion or increased sadness, anger, irritability
  • Decreased motivation or withdrawing from friends and family
  • New problems at school or work, including falling grades or difficulty completing assignments
  • Worsening hygiene or a lack of concern about appearance

Although symptoms do not always indicate a first episode of psychiatric illness, they may place a person at increased risk of developing psychosis.

At OnTrack Jr., we focus on helping patients to understand the changes they are experiencing in thinking, feelings, or behavior. We help develop new coping techniques for managing symptoms. Our goal is to help young people improve and maintain functioning at home, school, work, and in their social life.

We focus on individual therapy, including medication evaluation and management. Patients meet regularly with a therapist and psychiatrist.

McLean OnTrack
McLean OnTrack and OnTrack Jr. offer specialty outpatient services for individuals experiencing early symptoms of psychotic disorders

Intensity and combination of treatment approaches at both programs are tailored based on individual circumstances. Frequency of outpatient visits vary from patient to patient, but sessions are typically weekly in the early phase, and decrease over time as individuals get back on their feet and resume their usual activities.

Patients also benefit from services throughout McLean, including care and education resources and psychiatric and medical consultations.

We carefully weigh the risks and benefits of each treatment for each patient, including use of medications. Medication counseling and management is guided by the principle that treating symptoms does not always equate with functional recovery. Instead, we engage young people in the process of creating meaning in their lives by using multiple therapeutic approaches in addition to the traditional approaches.

McLean OnTrack also offers support for family members and caregivers and incorporates them as an essential part of the treatment team, providing guidance, support, and education, both individually and in a group setting.

The goal of both programs is to work with each patient to prevent further life disruptions, restore a person’s functioning, and help individuals and families regain their sense of control.

“OnTrack helps me feel like I’m not alone. The staff were warm and supportive during a difficult time for me and my family.”– Former patient

Admission & Cost

Admission

McLean OnTrackTM is suitable for adults ages 18 to 30 who have experienced a first episode of psychosis within the past 12 months.

OnTrack Jr is ideal for adolescents and young adults ages 14-25 who are experiencing changes in thoughts, behavior, emotions, or functioning.

Speaking with a trained professional about diagnosis and treatment is a critical first step in early intervention and in understanding and addressing the problem. Contact us now to get help for you or your loved one.

For further information about the program or to make a referral, please contact:

McLean OnTrack

Meghan Doherty, LICSW
Phone: 617.855.2179
Email: mcleanontrack@partners.org

OnTrack Jr.

Sarah Burke, LICSW
Phone: 617.855.3663
Email: sgburke@partners.org

Referral Forms

Prior to admission, we review prospective patients to determine whether the program is a good fit for the individual.

Individuals seeking treatment at McLean OnTrack can fill out the McLean OnTrack Patient Referral Form. Alternatively, family members, friends, or clinicians can submit the McLean OnTrack Community/Clinician Referral Form. Once one of these forms is received, we will respond by mail within 5-7 business days.

For patients seeking treatment via OnTrack Jr., please fill out the OnTrack Jr. Referral Form. Once the form is received, someone from the program will get in touch.

Cost

The OnTrack programs are covered by most insurance providers.

For McLean OnTrack, there is also a self-pay fee of $1,000 per year for services that are not covered by insurance. This out-of-pocket expense should not be a barrier to treatment, and therefore, we provide financial aid on a sliding scale for those who qualify.

McLean Hospital accepts Medicare, Massachusetts Medicaid, and many private insurance and managed care plans. More information on insurance providers accepted by McLean Hospital may be found on the Partners HealthCare website. You may also find it beneficial to review McLean’s patient billing and financial assistance information.

Treatment Team

Program Leadership

Kirsten W. Bolton, LICSWKirsten W. Bolton, LICSW, Program Director, McLean OnTrack

Since 2008, Ms. Bolton has been working with patients and their families in the Psychotic Disorders Division. A graduate of Simmons College, she began her work at McLean as a clinical social worker in the Schizophrenia and Bipolar Disorder Inpatient Program.


Sarah Burke, LICSW, Clinic Director, OnTrack Jr.

Ms. Burke began working at McLean Hospital in 2016 as a clinical social worker at the Schizophrenia and Bipolar Disorder Inpatient Program. She holds a BA in Social Work from Providence College, and earned her Master of Social Work degree from Simmons College.


Rakesh Karmacharya, MD, PhD, Medical Director, McLean OnTrack

Dr. Karmacharya is an associate professor of psychiatry at Harvard Medical School. He is a physician-scientist with expertise in the treatment of psychotic disorders. Author of numerous journal articles, his research focuses on using patient-derived stem cells to investigate the cellular-molecular underpinnings of schizophrenia and bipolar disorder, and to develop novel therapies through the application of chemical biology approaches.


Perihan Esra Guvenek-Cokol, MDPerihan Esra Guvenek-Cokol, MD, Medical Director, OnTrack Jr.

Dr. Guvenek-Cokol is a child, adolescent, and adult psychiatrist, specializing in psychotic disorders and childhood anxiety disorders. In addition to her role as medical director for OnTrack Jr., she is an inpatient attending psychiatrist in the Schizophrenia and Bipolar Disorder Inpatient Program.


Joseph Stoklosa, MD

Joseph Stoklosa, MD, Clinical Director, Psychotic Disorders Division

Dr. Stoklosa is also the assistant program director for the MGH/McLean Adult Psychiatry Residency Training Program. He is actively involved in educational research and founded the Clinician Educator Program for the MGH/McLean residency program. Dr. Stoklosa also developed the Schizophrenia and Bipolar Disorder Inpatient Program’s clinical care model, which is focused on improving the use of evidence-based treatment.


Staff and Associates

Our multidisciplinary staff at McLean OnTrack includes board-certified psychiatrists and psychologists, residents in the MGH-McLean Psychiatry Residency Training Programs, licensed clinical social workers, and a peer counselor. At OnTrack Jr., our clinical social worker works together with our psychiatrists.

The teams build trusting and collaborative relationships with patients and family members in a caring and supportive environment.

McLean OnTrack and OnTrack Jr. operate within the Psychotic Disorders Division, led by Dost Öngür, MD, PhD.

FAQ

Where are the OnTrack programs located?

The programs are located on the Belmont campus, in the Admissions Building. For more information on directions, parking, and local accommodations, please visit our Maps & Directions page.

Who benefits most from the OnTrack programs?

McLean OnTrack’s outpatient program focuses on treating adults, ages 18 to 30, who are recently experiencing the very first onset of psychosis and related symptoms.

OnTrack Jr.’s outpatient care focuses on early intervention for symptoms that may or may not lead to a psychotic disorder for teens and young adults 14-25. Individuals may be experiencing changes in thoughts, emotions, functioning, or behaviors.

Is family involved in treatment?

Family involvement in their loved one’s treatment is strongly encouraged. McLean OnTrack offers individual and group support for family members.

2 boys outside talking
Our compassionate staff are committed to providing high-quality patient care for young people and their families

Is smoking permitted?

Smoking is allowed in designated outdoor areas only. No smoking is allowed inside any of our buildings.

Are cell phones allowed?

Cell phone use is strongly discouraged during treatment and in the waiting room to prevent disruption of the program and others.

Can McLean OnTrackTM help me return to college?

A particular strength of the McLean OnTrack program is its close partnership with the McLean Hospital College Mental Health Program, whose mission is to work closely with college students with mental illness and adjustment issues, their families, and their institutions of higher education to ensure the greatest probability of academic success.

Can former patients access their medical records?

All requests for medical records should be directed to McLean’s Health Information Management Department.