The goal of early treatment is to identify what uniquely helps a young person get back to the life they want to lead using a range of intensive supports.
Early treatment comprises psychological, educational and family-based therapeutic support, plus lowest effective dose medications and supports aimed at maintaining or regaining full cognitive and social function. Please click below to learn how early treatment works.
Adolescence - the time when we are forming our sense of self and preparing for full independence - can be a particularly challenging time to face a potentially severely disabling condition. However, a phenomenon known as neuroplasticity offers a silver lining: the still-developing teen or young adult brain has a greater propensity to respond to treatment.
The inverse is also true. Research has shown that the longer the duration of untreated psychosis, the higher the rates of functional decline in social skills, meaningful relationships, participation in meaningful work or schooling, increased rates of substance use and abuse, hospitalizations and suicide.
The first few years following an initial psychotic episode are also the most critical. It is the time when treatment can have the greatest impact on prognosis. According to the World Health Organization, early treatment for psychosis has been shown to reduce relapse of acute symptoms by more than 50%. Early treatment can also help to improve social interactions, school and work participation, and cognitive function such as focusing, planning and memory.
The goal of specialized, early treatment is to help young people get healthy and back to the lives they want to lead as “F.A.S.T.” as possible via a comprehensive mix of treatment modalities tailored to the individual:
- Family involvement. Programs foster a high degree of family interaction, support and input.
- Appropriate medications. Lowest effective dose of medications are carefully prescribed and monitored, as needed.
- Support returning to school and work. Dartmouth’s “IPS” model is a commonly employed treatment modality.
- Therapy. Structured talk therapies such as Cognitive Behavioral Therapy (CBT) are aimed at alleviating delusions and hallucinations and improving social interactions. Cognitive training approaches may be also be offered to maintain or regain full cognitive function.
Each person’s experience of psychosis is highly individual. Participants are encouraged to work with their treatment teams to create individualized treatment plans, addressing personal needs and setting developmentally appropriate goals. Often, therapy is taken out of a clinical setting and into a young person’s home and community. Ultimately, the goal is for individuals to move down the same life paths that they would have had they never encountered psychosis.
Treatment programs vary in focus. First episode treatment programs serve clients within the first few months or years following initial onset of acute symptoms, or “first episode,” with the aim of regaining full function.
"High risk" treatment involves community outreach to identify and treat individuals at high risk of developing psychosis, but who have yet to experience a first episode of full psychosis. This period is known as the “prodromal” period, in which unusual thoughts and perceptions emerge, but aren’t yet fully established.
High risk and first episode treatment generally offer the same fundamental treatment components, with the notable exception of antipsychotic medication, which is administered cautiously, if at all, with people on the high risk continuum given the potential for high health risks. While more research must be done to clarify its merits and outline standards, high risk treatment is the next frontier, aiming to prevent progression of mild symptoms to full psychosis.
Too often, standard treatment for psychosis consists of high doses of medication administered during an initial hospitalization, followed by discharge with very little follow-up, education, or support. While medication is most often a critical element to care, it should never be a stand alone treatment. Antipsychotics can importantly alleviate some of the specific symptoms of psychosis such as hallucination and delusion. Specialized therapy for psychosis is equally important, as it targets some of the most disabling effects of serious mental illnesses: social, emotional and cognitive deficits that medication cannot.
Early intervention treatment is generally a much more personalized, collaborative, targeted approach in which it is possible that an individual may never experience hospitalization. Instead, an individual works with a treatment team to address all of the symptoms. This includes social, emotional and cognitive gains that offer the most promise for long-term wellness; as well as constructing a support network to prevent relapse.
Traditional Treatment: The Rough Road
Early Intervention: The Smooth(er) Road
Please see our Finding Treatment page for a comprehensive directory of early detection and intervention services.
Successful, nationwide early intervention treatment clinics for psychosis are already flourishing in Europe, Canada and Australia, where universal healthcare has allowed implementation with fewer policy and budgetary barriers.
We need your help to turn a gradual shift into a revolution in the standard of care for psychosis for the current generation of young Americans – 100,000 of whom will face psychosis for the first time each year.