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PEPP utilizes an assertive case management model, modified to suit the needs of mostly young people and their families, as its central framework and all aspects of assessment and treatment operate through this framework (See Figure 2).

The model involves a comprehensive approach with intensive medical and psychosocial management being provided by a nurse case manager (or social worker). In essence, a case manager walks the client through the mental health system, though whenever possible, relying on generic community services to reintegrate the young adult to his/her full potential over a two-year follow-up period. This model includes a close partnership with families.

The majority of case managers are registered nurses who often hold degrees in other social science programs. Professionals from other disciplines such as social work can be effective case managers and bring a unique set of skills to bear on their own work as well as that of other case managers. However, individuals from non-nursing disciplines must be prepared to take some ownership to provide comprehensive care including an involvement in monitoring of psychopathology and medical management. The case manager should possess a sophisticated level of knowledge in psychiatric disorders, particularly severe mental illness. It is equally important for case managers to be aware of and knowledgeable about the developmental stages of adolescence and young adulthood. Recognizing that adolescent turmoil is a normal stage of growth and development will help the clinician maintain perspective while working with youth who have experienced psychosis. Flexibility in work style is also a necessary characteristic as the model of care incorporates outreach, both direct and liaison contact on hospital units, as well as providing screening, assessment and treatment in the clinic setting, client's home, school or workplace. The case manager must work closely with other members of the interdisciplinary team on a formal and informal basis.

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