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UTSW Psychosis Project to Test Intensive, Early Stage Treatment

This story was originally posted on Center Times Plus on Jan. 3, 2019.

This spring, the Peter O’Donnell Jr. Brain Institute will launch a program that focuses on treating psychoses at the earliest stages, potentially transforming the way people with these disorders function in society – and improving their quality of life.

The Dallas Early Psychosis Project, to be located in the Paul M. Bass Administrative and Clinical Center, will treat individuals experiencing either their first episode of psychosis or who have experienced several episodes within five years of diagnosis.

Dr. Elena Ivleva (left) and Dr. Carol Tamminga

Dr. Elena Ivleva (left) and Dr. Carol Tamminga

“Evidence from brain-based biomarker studies shows that the most severe brain changes underlying psychotic disorders may occur within the first few years of illness,” said Dr. Elena Ivleva, Assistant Professor of Psychiatry and the project’s lead. “This initial disease stage may correspond to an effective ‘therapeutic window’ during which individuals with a shorter duration of illness derive maximum benefits from early treatment, just as in many medical conditions like diabetes and cancer.”

With funding from UT Southwestern and federal research grants, the Department of Psychiatry project will feature an intense two-year outpatient treatment course that goes beyond medication. Modeled after the RAISE Early Treatment Program, a large-scale multisite research study implemented in 21 states, the Dallas Early Psychosis Project will be one of the first academically based programs of its type in Texas.

“Early detection and intensive psychosocial treatment services for psychotic illness are not widely available in the Dallas-Fort Worth area,” Dr. Ivleva said. “With the Dallas Early Psychosis Project, we propose to set up a comprehensive early detection and treatment program for people with psychotic disorders in the local community, combining clinical care and research.”

In addition to medication therapy, family psychoeducation is implemented to help the patient and their families learn about the illness, reduce family stress, recognize triggers and illness signs, and develop a plan to enhance treatment success. Also, individual resiliency training for the patient provides long-term, in-depth psychotherapy focusing on goal-setting, coping mechanisms, social interactions, and personal development.

Individualized coaching will be provided to guide patients who wish to continue their education or enter the workforce. Meanwhile, group psychotherapy will incorporate social skills training designed to improve social engagement and cognitive remediation that is focused on various aspects of cognitive function, such as problem-solving, memory, and learning new information.

“This is a program that helps people affected by psychosis keep engaged in productive life tasks to preserve psychosocial function while receiving treatment,” said Dr. Carol Tamminga, Chair of Psychiatry and Chief of the Division of Translational Neuroscience in Schizophrenia.

The program will target those with schizophrenia, schizoaffective disorder, bipolar disorder with psychotic features, and other related psychotic disorders. Specialists will be consulted prior to beginning treatment for those who may be battling substance abuse. Throughout the program, patients will have access to a psychiatrist, a psychologist, and licensed social workers who will serve as integral members of the circle of care.

The Dallas Early Psychosis Project will accept private insurance patients through self-referrals or referrals by primary care physicians, specialists, and community resource centers. In the future, Drs. Ivleva and Tamminga hope the project will be able to participate in state health care programs.

“Psychiatric illnesses are being looked at as diseases of the brain,” Dr. Tamminga said. “Treating a psychiatric illness is like treating any other medical condition.”

Dr. Tamminga holds the Lou and Ellen McGinley Distinguished Chair in Psychiatric Research and the Communities Foundation of Texas, Inc. Chair in Brain Science.