Metacognitive Reflection and Insight Therapy (MERIT)

Emily Gagen, PhD

This presentation will review the metacognitive framework for understanding psychosis and will discuss a specific psychotherapeutic intervention, Metacognition Reflection and Insight Therapy. Dr. Gagen will discuss the definition of metacognition and the four main domains that are measured, the relationship between metacognitive capacity and psychological distress, research evidence that supports this approach, and an overview of the clinical intervention.

Bio: Emily Gagen, Ph.D. (she/her) is a licensed clinical psychologist at the Brookline Center For Community Mental Health. She is the director of the Massachusetts Psychosis Access and Triage Hub (M-PATH), the associate director of the Center for Early Detection, Assessment, and Response to Risk (CEDAR), and a lecturer at Harvard Medical School. Dr. Gagen has worked with individuals with psychosis and schizophrenia-spectrum disorders for over 15 years and specializes in the treatment of young adults with early psychosis.

Zoom Link: https://us02web.zoom.us/meeting/register/m2TcleKpT6mE9BktI3NKJQ

To sign up for CE credit for this event, please visit the link here: https://www.bidmcpsychfoundation.org/products/courses/MERIT

Sleep and Psychosis: Translating Research into Clinical Recommendations

Drs. Seo Ho (Michael) Song & Tony Cunningham

Sleep disruption is highly prevalent among individuals with psychosis and is increasingly recognized as a contributor to symptom severity, emotional distress, and functional impairment. This talk will summarize relevant sleep research in psychosis and focus on practical takeaways for clinicians, including how to assess sleep concerns and provide concrete behavioral recommendations.

Learning Objectives:

• Review sleep disruptions in schizophrenia.

• Understand CBTi as a method to resynchronize sleep homeostasis.

• Understand neuromodulation as a way to optimize sleep physiology.

Tony is an Assistant Professor and the Director of the Center for Sleep and Cognition (CfSC) and the Behavioral Sleep Medicine Clinic in the Psychiatry Department at Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School (HMS).  Tony received his doctorate in Clinical Psychology at the University of Notre Dame, completed his clinical internship at the VA Eastern Kansas Healthcare System, and is licensed to practice clinical psychology in the state of Massachusetts.  Tony's primary research focus is understanding the role of sleep and sleep loss in emotion and memory processing, and how knowledge of these systems can be applied to both healthy and clinical populations. In choosing to pursue clinical training within cognitive neuroscience labs, Tony's background has prepared him to carve a niche at the intersection between neuroscience and clinical practice. His long-term research goal is to understand changes in underlying brain networks responsible for emotional processing following sleep loss and translate this knowledge into the development of novel and effective therapeutic interventions. 

Michael is an Instructor of Psychiatry and Medical Director of the CfSC and Staff Psychiatrist at the Division of Interventional Psychiatry at BIDMC and HMS. Michael received his DPhil (Physiology, Anatomy and Genetics) and MD-MBA from the University of Oxford and Dartmouth College, respectively. Michael is also a recent graduate of the BIDMC Psychiatry Residency Training Program and the inaugural research track resident of said program. Michael and Tony’s interests align in the use of sleep as an optimizable platform to improve mental wellbeing. Michael’s work lies at the interface between sleep, neuromodulation, and psychiatry. Michael’s current research uses non-invasive brain stimulation—specifically, transcranial electrical stimulation—to influence sleep physiology. 

A Case of Mistaken Identity: Unmasking Non-psychiatric Causes of Psychosis

Megan Good, MD

View Slides

This presentation provides a clinical overview of non-psychiatric causes of psychosis, ranging from autoimmune encephalitis to metabolic and infectious etiologies. We will examine the critical features that distinguish secondary psychosis from primary psychiatric disorders, with a specific focus on first episode psychosis. By understanding these clinical nuances, the entire coordinated specialty care team will better identify when a client’s symptoms necessitate an urgent medical workup rather than traditional psychiatric treatment.

Megan Good, MD is the Medical Director of the ASPIRE Clinic at Beth Israel Deaconess Medical Center. She completed an Early Course Psychosis fellowship at Beth Israel Deaconess Medical Center/Harvard Medical School and her psychiatry residency at the University of Louisville, where she served as chief resident. Her research work focuses on non-psychiatric contributors to psychotic symptoms. She is a dedicated advocate for individuals and families affected by psychotic disorders. She is also a proud Kentuckian.

Helping Young People & Families Navigate School Supports

Leslie M. Leslie, JD, and Rebecca Davis, MFA

This training will provide a review of school supports for youth and families who are navigating education during a first episode of psychosis. Attendees will learn how to support clients in understanding their legal rights, identifying and advocating for appropriate accommodations, and navigating hospitalizations or other academic disruptions.

 The Federation for Children with Special Needs (FCSN) is Massachusetts' Parent Training and Information Center (PTIC), a nationally recognized non-proft organization dedicated to empowering families, engaging diverse communities, and eliminating barriers to improve life outcomes for all children and young adults, especially those with disabilities.  FCSN works with families and youth to navigate special education processes and state systems and to connect to community organizations.  The majority of FCSN's staff are family members of or identify as individuals with disabilities. 

Leslie M. Leslie joined the Federation in 2011 and serves as Project Director for the MassPAC project,  providing technical assistance to both Special Education Parent Advisory Councils (SEPACs) and district special education administrators. Leslie is the mother of two young adult sons, both of whom attended public school on an IEP. Leslie holds a Bachelor’s degree in International Relations and Political Science from Tufts University and a J.D. from Suffolk University Law School.

 Rebecca Davis is a project officer at FCSN and a former teacher, parent advocate, and speaker with nearly two decades of experience in special education and non-profit management.  She is the mother of two young adult daughters, the youngest of whom has multiple disabilities.  Rebecca is dedicated to improving systems of support for all children with disabilities and their families.  

From First Dose to Full Effect: Mastering Clozapine Initiation, Adjustments & Interactions

Jonathan M. Meyer

This module provides a deep dive into safe and effective clozapine initiation, titration schedules, and dose adjustments. Learners will explore drug interactions that affect clozapine metabolism and how to interpret plasma levels to guide treatment decisions. Build confidence in managing complex clinical scenarios from day one of clozapine therapy.

Working with Medical Interpreters: Shifting from Standards of Practice to Intersubjectivity in the Clinical Space

Margaret Lanca
2023 Mass-STEP Conference Day 2

View Slides

Optimal Treatment of Psychotic Disorders: Clozapine, Engagement, and Community

Robert Laitmain, MD & Matcheri Keshavan, MD

Hosted by the New England MHTTC

The program describes a novel approach to engaging patients with psychosis and their families. We seek the development of true collaboration. Critical in this approach is establishing a community of individuals with a common interest that provides support for each other. The support allows the treatment team to secure the patient's trust, develop a therapeutic relationship and do the hard work of creating an optimal clozapine regimen. This session will go on to:

• Describe how we develop clozapine regimens that minimize predictable side effects and optimize benefits;

• Share our results in improving patient outcomes.