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First Episode Clinic

The First Episode Clinic provides intensive services to people who have recently begun to experience psychotic symptoms. Clinical goals are to clarify diagnosis, minimize symptoms and prevent re-hospitalizations. Patient and family education about the course, treatment, and management of psychotic illness are central to our program.


To provide the highest quality of care available in order to:

  • improve social and occupational functioning,
  • reduce symptoms,
  • increase autonomy and
  • prevent hospitalization.

FEC Treatment Components

  • Patients are cared for in a clinical program that is personal and individualized.
  • Therapists have primary responsibility for the daily care of patients. Patients are generally seen once a week initially by the therapist. Additional appointments can be scheduled for family sessions and other patient needs. Regular visits are reduced as the individual becomes stable. Visits can be reduced up to every 1-3 months.
  • Groups are optional and offered to most clinic patients.
  • Patients are seen by a psychiatrist as needed. This generally starts every two weeks. Visits can be reduced to every month to every 3 months for most patients after they are stable.
  • Fees are not collected for clinical services, as these are funded through University of Maryland, state and federal grants.
  • Families, caregivers, and/or other significant persons are involved in the initial evaluation process.
  • Psychosocial education on the nature and course of their illness.
  • Individual therapy starting on a weekly basis.
  • Group therapy as desired.
  • Family education and support.
  • Pharmacological treatment.
  • 24-hour emergency on-call service.
  • Community outreach (transportation provided as needed).

Clinical Care Bonus Items

  • Therapy and psychiatric services are free.
  • Transportation is provided on an as needed basis.
  • We provide comprehensive treatment for patients who reside in the community, and do not serve any particular geographic area.
  • Referrals come from private-practice settings, community mental health centers or hospital admission units.
  • Patients may choose continue primary care at another institution while the FEC provides a case consultation or additional support to patients and families.

FEC Population

  • The First Episode clinic treats individuals who have recently developed a psychotic illness.
  • Clients are generally between the ages of 16 and 45, and are admitted following one of their initial psychotic breaks.

FEC Eligibility

  • Individuals 16 – 45 years old who have recently developed a psychotic illness (within the past 18 months) may be eligible for participation in the FEC.
  • Active substance abuse would make a person ineligible for our program. Patients who plan abstinence following substance use due to self-medication can be accepted on a trial basis. All patients receive random drug testing. If patients are unable to maintain abstinence after 6 months at the clinic they will be referred to a dual diagnosis program.
  • Individuals must be able to give informed consent to participate in research and must have a prodromal IQ above 70.
  • Major, unmanaged health problems would make a person ineligible for our programs. Individuals with managed illnesses, such as HTN or diabetes can be admitted.
  • No recurring violence toward others.
  • Individuals on parole and probation may be accepted, especially if the violation is related to their first episode. Individuals on parole and probation will be evaluated and accepted on a case-by-case basis.
  • Individuals who are mandated for treatment to Spring Grove may be accepted if they are not mandated to outpatient treatment. We will also consider accepting individuals who are mandated for treatment for a short period of time.

FEC Referral Contact

First Episode Clinic
Beth Steger, LCSW-C

  • If patients have a diagnosis other than schizophrenia, schizophreniform, or schizoaffective disorder, they will be referred to an appropriate clinic for treatment (e.g. bipolar disorder with psychotic features).

Research Participation

  • Patients are told about the research nature of the program. They are informed when enrolling that they will be approached for research and that some research participation will be expected.
  • Consent for specific protocols is not required until a patient is chooses to participate in a specific protocol. Patients may refuse specific studies at their discretion (i.e. drug studies; MRI).