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The Prevention and Recovery in Early Psychosis (PREP)

What is PREP?

PREP is a program for young adults like you, designed to help you get your life back on track.

Everybody who comes to PREP has had a similar experience: While he or she was doing the normal things young adults do (school, a job, being with family and friends), things started to go wrong. Maybe nothing made sense any more, or maybe things made sense in a new way-but it was frightening.

Sometimes people have felt that their minds slowed down, speeded up, or weren't working right. Some people, maybe you have had this experience, say that they feel their minds are playing tricks on them. When life gets this confusing, a person is likely to withdraw, become isolated, fearful, and can no longer carry out his or her usual activities. Things can become so overwhelming that time in a hospital may be necessary.

When you begin to feel a little better, you face a lot of questions: What went wrong? Was it them? Was it me? What is "psychosis" (a term you may have heard from your doctor)? What is this medicine I'm told I have to take? Can I go to college or finish high school? Am I ever going to feel comfortable again, so I can enjoy doing things that used to be fun for me?

PREP exists to help you find good and hopeful answers to your questions. PREP gives you a chance to learn or to practice skills that will help you to feel more comfortable and safer when you are out in the world.

PREP also will work with you toward achieving life goals that are important to you. For example, some people feel that getting back to school is the major thing that has been interrupted by their illness, but for others the most important goal is reducing the anxiety they feel in social situations, while yet others see family or romantic relationships as the thing that matters most. Whatever your personal goals, work, art or music, school, relationships, living on your own--PREP is the place to work toward them.

What will you be doing at PREP?

First of all, you will be talking privately at least once a week with your therapist/case manager. It is this person's job to listen with special attention to what you have to say. That way your wishes and interests can become clearer, and you can set realistic goals. Your therapist/case manager is your personal advocate, and will help you to figure out the steps you need to take in order to make a successful recovery.

Second, you will also see your psychiatrist once a week. She/he is the doctor who prescribes the medication that gets your brain chemistry back in proper balance. You can ask your psychiatrist any questions you may have about medicine, side-effects, or your physical welfare.

Third, you will join with other participants in PREP for group sessions. These sessions meet between noon and four in the afternoon every Tuesday and Thursday. (A schedule of groups is included in this packet.)

Through group sessions you can learn about what causes psychosis and what you can do to prevent its recurrence. You can also learn or practice skills that may make you feel more confident or independent, for example, how to say "No" to people you like without either shouting or feeling guilty. Groups aim at improving your physical health as well as your mental wellbeing, and some groups focus on activities that might bring more satisfaction to your life, like cooking or creative writing.

What is required of you?

When you join PREP, the first thing to do is to relax! You are in a calm, safe environment, where you don't have to "keep up appearances" or worry how people will react to you. No matter what, you are you--the very person we want to see at PREP.

Most important, every week you have to keep your appointments with your therapist/case manager and your psychiatrist and come to groups. The good effects of this program won't work for you long distance. You really have to be here to make recovery happen. (If you feel anxious or uncomfortable about being in a group or a one-to-one meeting, just say so. Then you can take a break, maybe walk around a bit, until your tension level goes down.)

Please be honest about what you are thinking or feeling. Despite what people sometimes believe, no one, however expert at psychology, can know your thoughts unless you say them out loud. So don't be shy: Speak up for yourself!

Finally, the people at PREP, both staff and participants who have been here for a while, are glad to answer questions. If you're wondering about something, please ask. (Even when we don't have the answer for you at that moment, we'll search around until we find it.) So, relax, give yourself time to get well, and enjoy your participation in PREP!

Contact Information

Department of Psychiatry
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215