Early Rehabilitation in Young People with First-episode Psychosis: experience From the Day Centre for Psychiatric Early Rehabilitation (Taf, Psd Vienna)

Abstract

Since 2008, the Psycho-Social Services Vienna (PSD) have provided one of the very first comprehensive ambulant early rehabilitation programs for young people suffering from first-episode psychosis (Day Centre for Psychiatric Early Rehabilitation, TAF) in German-speaking countries.

The TAF-services stand on five pillars: (1) Ambulant setting, (2) Multiprofessional treatment, (3) Individuality, (4) Peer effects, (5) Time. The interdisciplinary treatment is based on individually agreed treatment plans. Paramount are: Dealing with the psychosis experience, personal growth, empowerment, recovery, and the return to a self-determined life. Young people suffering from first-episode psychosis are additionally confronted with the developmental tasks of individuation, autonomy, relationships, and career development. Yet, because of their young age, they generally lack previous experience with illness, coping strategies and resources. This particular situation requires a great deal of motivational work as well as addressing the individual potentials of each and every one of them.

This program has been developed in order to tackle the inadequate mental healthcare provision for individuals suffering from schizophrenic disorders: on average, it still takes five to six years until treatment is received; this is particularly concerning for the first years of illness are decisive for the further course of the disorder. The resulting consequences remain a major burden for these individuals, their social environment, and the healthcare system. That's why in the 1990s a paradigm shift has taken place: prevention, early detection and intervention instead of aftercare. Early rehabilitation aims at preventing and minimising a chronification of the illness and its related consequences.