McLean OnTrack™

Early Intervention for First-Episode Psychosis

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Overview

McLean OnTrackTM provides the best possible care for young adults in the early stages of psychotic disorders. We understand that experiencing psychosis, especially first-episode psychosis, can be overwhelming and confusing for patients and their families. Our outpatient program specializes in early recognition and treatment for young adults 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 early intervention during this time is important for good long-term results.

For more information about McLean OnTrack or to make a referral, please call us at 617.855.2179.

Our program is best suited to individuals who are:

  • Experiencing the early stages of psychosis after a recent first episode
  • Struggling with psychosis due to mood disorders or primary psychotic disorders
  • Seeking early intervention and customized outpatient treatment

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.

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. The length of time in the program varies according to the course and path of the illness, but we generally expect patients to be in the program for about 2-5 years. The frequency and intensity of treatment typically diminishes as the patient’s level of functioning improves. The program is covered by most insurance providers and 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.

McLean OnTrack is located on McLean’s Belmont campus on the ground floor of the Admissions Building. Our multidisciplinary staff is dedicated to providing high-quality care and conducting cutting-edge research to improve the lives of patients experiencing first-episode psychosis.

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

What is McLean OnTrack and how does it help patients?
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Amy has psychosis. Learn more about psychosis and how Amy can get back on track.
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Andy has bipolar disorder. Learn more about this condition and how McLean OnTrack helps individuals with this diagnosis.
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Treatment Approach

Psychotic episodes can create major disruptions in work, school, and relationships. Individuals suffering from 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. The initial years following the first episode of psychosis is the 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 OnTrackAt McLean OnTrackTM, 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. 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.

Intensity and combination of treatment approaches 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.

The program offers individual and group therapy, family support programs, medication treatment, peer counseling, and case management services. 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 and 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.

Our goal 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. The program 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.

“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

treatment team

Program Leadership

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

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.


blankRakesh Karmacharya, MD, PhD, Medical Director

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.


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 includes board-certified psychiatrists and psychologists, residents in the MGH-McLean Psychiatry Residency Training Programs, licensed clinical social workers, and a peer counselor. The team works to build trusting and collaborative relationships with patients and family members in a caring and supportive environment.

McLean OnTrackTM operates within the Psychotic Disorders Division, led by Dost Öngür, MD, PhD.

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.

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:

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

Referral Forms

Prior to admission, we review prospective patients to determine whether the program is a good fit for the individual. Patients can fill out the Patient Referral Form. Alternatively, family members, friends, or clinicians can submit the 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

McLean OnTrackTM is covered by most insurance providers. 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 financial assistance policy.

FAQ

Where is McLean OnTrackTM located?

The program is 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 McLean OnTrackTM?

Our outpatient program focuses on treating adults, ages 18 to 30, who are recently experiencing the very first onset of psychotic symptoms.

Is family involved in treatment?

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

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 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.