Client Perspectives of Milieu Treatment in a Coordinated Specialty Care Early Psychosis Program in Western Massachusetts
Cesar Rivera, BA¹; Ashley Papineau, LICSW, M.Ed.¹; John Knutsen, PhD¹,²
¹ ServiceNet Inc., Northampton, MA
² Department of Psychology, Harvard University, Cambridge, MA
Background: Prevention and Recovery in Early Psychosis-West (PREP) is a coordinated specialty care program in Western Massachusetts that provides flexible, comprehensive, evidence-based outpatient milieu treatment for individuals experiencing early psychosis. The PREP milieu functions as the clinical core of the program’s therapeutic community, supporting individuals as they stabilize, recover, and re-engage in developmentally appropriate social, educational, and occupational roles. We are conducting a community-engaged participatory research project that examines how the milieu shapes client treatment, care coordination, and support efforts while identifying community-generated needs, support, and opportunities for intervention. The study aims to characterize PREP clients’ experiences of the milieu and identify pragmatic strategies to strengthen the therapeutic environment for the community it serves. We will present findings from focus group interviews that follow from our preliminary data collected during the initial phase of data collection.
Methods: Focus group transcripts will be analyzed using an immersion–crystallization approach, followed by line-by-line coding of data from eligible, participating PREP clients. A subsequent analytic cycle will include transcript review, recoding, and iterative codebook refinement to incorporate emergent concepts and enhance analytic rigor.
Results: Findings will be based on perspectives from approximately 85-95% (N=12) of all individuals enrolled in and actively attending the milieu and who did not participate in preliminary data collection. Currently we have held focus groups with seven clients and will complete data collection by the end of the following month. Analyses will be used to identify salient client perspectives on the therapeutic milieu, build upon previous findings, and to elaborate themes emerging from the focus groups.
Conclusion: Findings from this project will help characterize the perceived significance and therapeutic impact of the PREP milieu. Ongoing data collection will further elucidate client experiences and feedback, supporting the co-development and implementation of future milieu-based intervention strategies.