Objective:
This brief report analyzes a first-episode psychosis (FEP) clinic’s shift from in-person treatment to the provision of services through telemental health during the COVID-19 pandemic. The feasibility of using this technology was examined by assessing client engagement.
Methods:
The authors created and implemented procedures for the clinic’s transition to telemental health. Once clients’ consent was obtained, a HIPAA compliant platform was used to continue service provision.
Results:
Client engagement during this period improved compared to the same quarter the previous year. Telemental health was also practical for providing groups and other supportive services to meet clients’ needs.
Conclusion:
Telemental health is an effective approach to providing care at an FEP clinic during a pandemic. Successes and lessons learned from the first wave of the pandemic can be used to prevent an uptick in symptoms and sustain engagement for this vulnerable population during the anticipated second wave.
We report the successful psychotherapy and medical treatment of a patient with an atypical presentation of Capgras syndrome, in which the patient not only believed that his parents were impostors but also believed that the entirety of what others would consider consensual reality was in fact an impostor. He insisted that a complex delusional world in which he wished to reside was authentic reality. His delusions of misidentification waxed and waned in response to discernable social stressors, and at times, he seemed to have conscious insight into the delusional nature of his beliefs. This case raises questions about whether Capgras should be considered a stand-alone diagnosis or whether it should be placed within a wider spectrum of psychotic disorders. Excepting our current report, although there are numerous reports of the resolution of Capgras after treatment with neuroleptics, we are unaware of descriptions in the literature of the successful treatment of medication-resistant Capgras with a combination of individual psychotherapy and pharmacological management.
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