Child psychiatrist Perihan Esra Guvenek-Cokol, MD, an expert in psychotic disorders, doesn’t dispute their seriousness. But she knows that with the right care, people with these diagnoses can go on to live happy, fulfilling lives.
“As with many illnesses, the earlier we intervene, the better the prognosis, and it’s so true with psychotic disorders,” said Guvenek-Cokol. “Our greatest efforts should be applied to prevention and early intervention—giving young people the tools and skills to be empowered to manage whatever comes their way.”
Early intervention is the founding principle of the one-year-old Support, Treatment, and Resilience (STAR) Program, which delivers top-quality outpatient care to young people ages 14-25 who are at risk of developing psychotic illnesses.
Patients with full-blown versions of these disorders experience disruptions in their thoughts and perceptions, making it difficult to judge what is real and what isn’t. Some may suffer from hallucinations—seeing, hearing, or even smelling things that don’t exist. Psychotic symptoms often begin between ages 18-20, although some people experience them later. About one in 100 people suffers from a psychotic disorder.
Donor support has been critical to STAR, as a novel clinical program with limited reimbursable services. Nicholas Zeppos, McLean trustee and chancellor emeritus at Vanderbilt University, seeded the new clinic with a philanthropic gift in 2019 because he found its goals so compelling.
“A program like STAR can make a tremendous difference in the trajectory of a young person’s life at a critical time in their development.”
– Nicholas Zeppos, STAR donor and McLean trustee
“As someone who spent a good portion of his career working with college students, I have seen how devastating psychiatric illnesses can be,” he said. “A program like STAR can make a tremendous difference in the trajectory of a young person’s life at a critical time in their development.”
A 2020 gift from the Gildea-O’Keefe Family Foundation, a longtime supporter of the hospital, fortified the program further. “Between the pandemic and the social and political upheaval, it’s an especially fraught time for many of us, and the stressors are exacerbated,” said foundation Trustee Ann O’Keefe. “Supporting mental health causes, especially ones like STAR that are trying to intervene earlier in a disease’s trajectory, is more important than ever.”
The adolescents who are treated through STAR often have symptoms that may seem like depression or anxiety—a loss of interest in things that once gave them pleasure, neglect of personal hygiene, trouble concentrating. But layered on top of those changes are symptoms that point to possible psychosis down the line.
“They may hear their name called when it hasn’t been, see shadows out of the corner of their eye, become more preoccupied with religion, or begin mistrusting people,” explained Guvenek-Cokol. “Sometimes they’re just feeling something odd that they may not be able to articulate.”
The STAR Treatment
Patients treated through STAR see therapist Sarah Burke, LICSW, who is also the program director, at least weekly. The sessions are tailored to the young person’s specific symptoms, and Burke may incorporate tools such as cognitive behavior therapy, dialectical behavior therapy, behavioral activation, and motivational interviewing—all commonly used with other psychiatric illnesses.
“Our program puts a lot of emphasis on building skills, resilience, and routine. Good sleep, hygiene, eating well, and abstaining from substances—marijuana, most commonly—is key,” explained Burke.