By Zan Hale

Jerome Taylor, MD, and Alexander Moxam, MD, Jerome Taylor, MD, and Alexander Moxam, MD, lead CHOP’s First Episode Psychosis Program, the only program of its kind in Philadelphia that treats children younger than 18. Students reading the mind of a classmate through the school’s Zoom connection. Hearing strangers whispering your deepest secrets. Seeing monsters in the corner of the room. Believing you have superpowers, including the ability to fly.

These aren’t plots from some new sci-fi thriller. They’re examples of psychosis in youth and young adults.

“There’s a misunderstanding that teens can’t have psychosis,” says CHOP psychiatrist Jerome Taylor, MD, “when, in fact, it’s not uncommon for the first episode to happen in adolescence. We also know the earlier we intervene, the bigger impact we can have on the child’s wellness overall.”

Effectively treating a young person with a psychotic diagnosis — such as schizophrenia, schizoaffective disorder and bipolar disorder with psychotic features — requires more than medication. The best outcomes occur when the person also has access to coordinated specialty care that includes resilience-oriented therapy, support from a peer and an education and employment specialist, and psychoeducation for family members, so they can understand the illness and learn how they can help.

New program, new facility

CHOP began offering those crucial collaborative services last summer when Taylor and Alexander Moxam, MD, launched the First Episode Psychosis Program, which is funded in part by a federal and Pennyslavania state grant. It is the only program in Philadelphia that accepts patients as young as 12. Outpatient appointments are in CHOP’s new Center for Advanced Behavioral Healthcare.

Psychosis can be tricky to detect because some early symptoms, such as withdrawing socially or refusing to go to school, could be seen as typical teen behaviors. During a psychotic episode, the teen may have delusions or hallucinations and believe things that aren’t based in objective reality, leading them to drop favorite activities or be afraid to leave home.

Because their delusions and hallucinations seem so real, teens often don’t think they’re ill, which adds challenges to treatment. “They may not want to take their medication or keep their therapy appointments,” Taylor says. “The coordinated specialty services help them overcome this resistance.”

The need for first episode psychosis treatment exceeds CHOP’s current capacity. Donations to the program would allow it to treat youth from areas outside Philadelphia County and expand into more intensive programs for patients who would benefit from having therapy every day or three times a week.

To learn about supporting the program, contact Jeremy Wang at wangjp@chop.edu or 215-495-4949.