Over the past 25 years, there is strong evidence that intervening early in the course of schizophrenia, within the first 5 years, has the potential to change the trajectory of the illness. This has led to the development of “Coordinated Specialty Care” (CSC) clinics devoted to treating young people with psychosis.
In 2005, Dr. David Penn, with colleagues in Psychiatry and Social Work: Dr. Diana Perkins and Dr. Bebe Smith, started one of the first CSC clinics in the United States, the Outreach and Support Intervention Services (OASIS) program. Since then, OASIS has treated well over 150 young people with “First Episode Psychosis” (FEP), published the first outcome study of a CSC in the US (Uzenoff et al. 2012), and was a model for the Recovery after Initial Schizophrenia Episode (RAISE) NAVIGATE treatment program, which formed the heart of the largest treatment study for FEP ever conducted in the United States (Kane et al. 2016).
Despite the promise of CSC for first episode psychosis, some young people don’t fully recover and remain vulnerable to future relapse. To address this issue, Dr. Penn looked outside of the schizophrenia field for answers. Specifically, he is eager to consider strategies for improving clients’ sense of well-being and ability to manage stress. This led Dr. Penn to the field of positive psychology.
In collaboration with colleague Dr. Barbara Fredrickson, as well as others in the positive psychology field, Dr. Penn piloted interventions focused on meditation (Johnson et al. 2011) and positive coping strategies (Meyer et al. 2012) for people with schizophrenia which yielded promising findings. These pilot studies subsequently led to a successful National Institutes of Mental Health R21/R33 grant application (PIs: Meyer, Penn and Perkins) to develop and evaluate Individual Coping Awareness Therapy (ICAT) for individuals with FEP.
ICAT combines mindfulness and positive therapy, with the goal of reducing stress reactivity and improving eudaimonic well-being. A small open trial showed that ICAT was feasible and associated with improvements in stress management, resiliency and symptoms (Meyer et al., under review). Currently, Dr. Penn and his research team are in the midst of a 3-year randomized controlled trial (RCT) comparing treatment as usual (TAU) to TAU+ ICAT in 40 individuals with FEP on a variety of outcomes, including heart rate variability, cortisol, stress, resilience, and social functioning.
Dr. David Penn is a Linda Wagner-Martin Distinguished Professor in the Clinical Psychology Program within the Department of Psychology and Neuroscience at UNC Chapel Hill. His work focuses on social cognition and psychosocial treatment for schizophrenia, particularly how social cognition (i.e. emotion perception, attributional style, and theory of mind) changes across the course of schizophrenia, its neural basis, and how social cogniton relates to social functioning. Learn more about his research online.