Abstract
Objective:
To describe some of the practical considerations and dilemmas that were faced in setting up an Early Psychosis program in the Noarlunga region of Adelaide, South Australia.
Conclusions:
The clients had high rates of illicit drug use and forensic problems and experienced rates of rehospitalisation of around 60% over the first two years after registration. It was noteworthy that 19% of admissions occurred within three months of registration. The therapeutic relationship between staff and clients with early psychosis was complex, and the ambivalence noted by clients in satisfying dependence/independence needs in the therapeutic relationship appeared to reflect the influences of illness and life stage development. Collaborative relationships with clients were supported by steps such as feedback from clients, leading to simplification of the content of the psychoeducation program, reduction in written information, and co-facilitation of the group by a client who had undergone a psychotic episode. A change in the venue to a local youth group was well received by clients. However, at other times, clients appeared to seek more direction from staff and possess more basic care needs, particularly when seriously ill. Maslow's ‘Hierarchy of Needs’ offered a useful framework for conceptualising many of these issues. A local community network of agencies was formed, allowing clients to address self-identified needs.