Services for the Treatment of Early Psychoses (STEP)
STEP is an outpatient clinical program for the evaluation, treatment, and rehabilitation of people who may be experiencing early symptoms and signs of psychotic illness in a recovery-oriented setting. Our goal is to determine how early symptoms may contribute to the onset and course of psychotic disorders so we may then make better treatment decisions.
Individuals who come to a primary care setting with symptoms such as disconnected, illogical thoughts, or unusual auditory or visual sensations are among the most difficult to diagnose and treat. Student health services, general doctors' offices, and other care centers may lack the focus and specialized expertise on early psychosis which are provided by the high quality services available through STEP.
STEP is part of the Comprehensive Recovery Services (CRS) division of Western Psychiatric Institute and Clinic of UPMC. Rehabilitation and recovery are central to the mission of CRS.
Who qualifies for the STEP Program?
STEP provides evaluation and treatment services for individuals, ages 14 to 40, who are having psychotic symptoms or difficulties separating reality from unreal experiences or false beliefs.
Symptoms of Psychotic Illness
Symptoms may be substance-induced, related to medical illness, or part of an adjustment to developmental changes, especially in adolescents or young adults. The early symptoms may mimic mood disorders, such as depression and anxiety disorders, but also may be a sign of a potentially serious psychotic illness.
Symptoms may include:
Delusions or false beliefs
- The person may believe that people are talking about or trying to hurt him or her; he or she has special powers or is “specially chosen;” he or she is receiving messages from television or other unlikely sources; parts of his or her body have changed (having two hearts, for example) or stopped working
Hallucinations or other perceptions without an external source
- The person hears voices, sees things that others cannot see, or experiences strange sensations of the skin or within the body.
- The person may shift rapidly from idea to idea without a clear connection. The person’s speech may be illogical, and his or her way of speaking may be unusual. Changes in concentration and/or attention also may be present.
Social or emotional difficulties
- The person may become socially withdrawn and may have diminished expression of emotions. He or she may express emotions inappropriately (for example, smiling while describing distressing events).
What STEP Offers
The STEP treatment team offers continued therapy and follow-up care, including state-of-the-art psychotherapeutic and medical treatment, along with regular contact with a psychiatrist.
Appropriate treatment may include medications, which are effective in relieving many of the symptoms. These medications may have side effects, so it is very important that the decision to use them is based on an accurate and thorough assessment. Individuals experiencing these difficulties should be thoroughly evaluated by mental health professionals trained in recognizing the early features of psychotic disorders.
STEP uses Western Psychiatric Institute and Clinic's clinical facilities and diagnostic technologies to help understand the origins, development, treatment, and course of psychotic illnesses. In addition to working closely with their treatment teams (psychiatrist and therapist), individuals in the STEP Program have access to several recovery-oriented programs, a clinical pharmacist, and case management services through CRS.
These services may help individuals achieve their learning, working, living, socializing, and health goals. Support and educational meetings are offered for the families of patients.
The STEP coordinator may determine whether people are eligible to participate in research studies that focus on the early course of psychotic disorders. Research studies may include detailed clinical assessments, physical examination, neuropsychological testing, blood studies, and brain imaging. These research assessments may be completed in an inpatient or outpatient setting. Consent for research is obtained separately and is conducted under the rules and regulations of the Human Research Protection Office of the University of Pittsburgh. There is no cost involved for research procedures.
Referrals to STEP
To discuss the STEP Program or to schedule an initial evaluation, call 412-246-5432.
For more information regarding research opportunities, contact the STEP research coordinator, at 412-586-9009.
In an emergency, call resolve Crisis Services at 1-888-7 YOU CAN, or refer/bring the person to Western Psychiatric's emergency department at 3811 O'Hara Street, in the Oakland section of Pittsburgh; or call 412-624-2000.
Child and Adult
- Srihari Bangalore, MD
- Shabana Kahn, MD
- Janet Gilmore, LCSW
- Todd Pungratz, MSW, LCSW
- Pamela White, RN