Psychosocial rehabilitation early after the onset of psychosis

Intervention at the onset of psychotic disorders is a highly attractive theoretical notion because its goal is secondary prevention, that is, the prevention of chronic illness. As such, early intervention has practical relevance as well, given the enormous social and economic impact of chronic mental illnesses. It is all the more curious, then, that few mental health programs have been designed to identify and treat individuals who are in the throes of their first psychotic episode. One such program, developed by Lili Kopala, David Whitehorn, and their colleagues in Nova Scotia, incorporates many of the basic principles of psychiatric rehabilitation such as providing a supportive environment, identifying clients' goals and aspirations, involving families, and emphasizing social and academic or vocational reintegration into community life. It also includes several aspects unique to the experiences of young people who have experienced a first psychotic episode, such as a group designed to help members overcome obstacles encountered when returning to school, work, and social settings. The following description of the program may remind us of the value of rapid early detection of a first psychotic episode followed by intensive and persistent intervention.