Wellness and Recovery After Psychosis (WRAP) Program

What is Psychosis ?

WRAP provides expert care for psychosis. Psychosis includes a variety of symptoms which have different causes, and is not specific to one diagnosis. Psychotic symptoms can be stressful and interfere with daily function.

Symptoms may include (but are not limited to):

• Hearing voices or seeing things that others do not
• Feeling watched, monitored, or persecuted by people or organizations
• Thinking that feels fragmented or difficult for others to follow
• Beliefs or behaviors that seem markedly unusual to those around you

However, symptom relief is possible with high quality treatment. Evidence-based treatment in WRAP includes medication and non-medication options.

What Services does WRAP Offer?

Long-term expert care for eligible patients with psychosis:

• First Episode Psychosis Care: Team-based specialty care for individuals within the first five years of psychotic illness. WRAP’s flexible care model allows for folks to continue to receive specialized care after the first 5 years of illness if indicated. Our team provides care using the evidence based NAVIGATE model of coordinated specialty care and we are apart of the statewide learning health system through the LEAP Center and the national Early Psychosis Intervention Network.
   
• Specialized Longitudinal Care for Psychosis: Long-term expert medication management for individuals outside the first 5 years of illness for individuals with schizophrenia with complex illness (e.g. treatment refractory schizophrenia or medical comorbidities that interfere with treatment) and/or need for specialty treatment (e.g., long acting injectable antipsychotics).

Other services :

• Expert Consultation: One-time consultation for diagnostic clarification and/or treatment recommendations. Typically these are appointments for individuals, but if their provider is affiliated with BMC’s care network we may offer a peer: peer provider e-consultation.
   
• Psychosis Education & Community Outreach: Education about psychosis for those with lived experience, families, healthcare professionals, and our community

What types of treatment does WRAP for our patients?

Medication Management

Our team of psychiatrists and nurse practitioners (NPs) regularly evaluate symptoms and prescribe medications to treat symptoms of psychosis. We use a collaborative shared decision making approach with patients and families around treatment. When medication treatment is indicated, we aim to use the lowest effective doses of medications. We prioritize ongoing physical health monitoring (blood glucose, cholesterol, weight), and monitoring closely for side effects. We also make sure there has been an appropriate medical work-up of symptoms.

Specialized Medication Services:

• Long-Acting Antipsychotics: For individuals who prefer not to take medications by mouth or who struggle to take daily medications, we offer long-acting antipsychotic treatment options. Many individuals find this medication option is more convenient and helps adherence.
• Clozapine is a medication that is often used to treat persistent psychotic symptoms despite multiple medication trials. Especially at the start of treatment, close side effect monitoring is required. We offer this specialized clinic for regular check-ins, lab-work, and appropriate medication titration all in one visit.

Family Support and Education

• WRAP offers both individual family support and education and peer support through virtual groups for family members of loved one's with psychosis.
• We offer one virtual group in English and one in Spanish.
• Family education is individualized to a family's needs, but often includes: education on psychosis, treatment options, and strategies to support their loved ones through the recovery process.
• Our team has expertise in helping parents and other family members strengthen communication skills with their teen or young adults.
• Motivational Interviewing for Loved One’s (MILO)
  • We offer parents or other family caregivers 4-5 sessions of coaching on how to approach communication with adolescents and young adults suffering from psychosis or other mental health difficulties.
  • Email LearnAboutMILO@bmc.org if you would like to work with a MILO coach to have better conversations with your family. Participation can be either on Zoom or in person.

Psychotherapy

• Our team of social workers, psychology interns, and psychologists use talk therapy to help treat psychosis, depression, anxiety, and other symptoms.
• Talk therapy can also be used to help build self-esteem, problem-solve around stressors, strengthen coping mechanisms, and improve social and community functioning.
• Types of therapy include supportive, Individual Resiliency Training (IRT), and Cognitive Behavioral Therapy (CBT), and more.

Peer Support

• Peer support specialists are mental health professionals who provide support to individuals by using their own lived experience with psychosis to help others.
• Peer support specialists can help advocate for people in recovery, provide mentorship, help with setting goals, share resources, help with building skills.
• Peer support specialists can meet with young adults virtually, at the clinic, or often in the community.
   

Young Adult Group Therapy

• We offer weekly group therapy for young adults with psychosis
  • This virtual groups allow individuals to talk to and connect with peers who are facing similar challenges or who have gone through a shared experience.
  • Participants develop new skills that help them achieve their goals. The group is led by two clinicians experienced in group therapy.

Community-Based Care for Adolescents and Young Adults with substance use and psychosis

• The Wellness and Recovery After Psychosis (WRAP) Without Walls (WWW) Program is a new clinical program funded by the Jack Satter Foundation targeted towards adolescents and young adults with frequent substance use and psychosis symptoms. WWW is made up of a multidisciplinary team providing community-based services including individual therapy, family psychoeducation, medication management, peer support, advocacy, and patient navigation. Our model for WWW is an adaptation of Assertive Community Treatment (ACT) model. WRAP Without Walls is led by psychosis and substance use disorder experts who are leaders of specialized programs at BMC.

Support Education & Employment (SEE) Support

• Using an individualized, strengths-based approach, SEE specialists provide practical support including job searching, resume building, interview preparation, enrollment in educational programs, and navigating workplace or academic accommodations

Physical Health Care /Nutrition Support

• In partnership with BMC’s Teaching Kitchen we offer regular nutrition groups for patients and their families. Visit the WRAP/Teaching Kitchen Website to learn more! Our patients are also eligible to receive food from BMC’s Preventative Food Pantry.  

• We also collaborate closely with primary care providers who are located in our clinic through the PRIME (Psychiatric Reverse Integration for Medical Expertise). PRIME doctors are dually trained in both family medicine and psychiatry and are uniquely trained to work with individuals with complex mental and physical health needs. 

   

How to Refer to WRAP?

Questions about eligibility or the referral process?
Click "Refer a Patient" at the top of this page for information about diagnostic criteria and referrals.

Ready to refer someone? Complete the WRAP Referral Form and email (WRAP@BMC.org) or Fax 781-987-6050