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Schizophrenia Case Study

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2 Schizophrenia Case Study
Mark James, 22 year old client is being discharged from his first hospital admission for schizophrenia to the home he shares with his father and his two sisters. Mark has been alienated from his mother since his parents’ divorce when he was 17 years old. Mark’s mother has failed to show up for the discharge conference. The mental health team has recommended family therapy to the James family. You perceive what you think is annoyance on Mr. James’s face, and one of Mark’s sisters appears embarrassed. Although you would not be the James family therapist because you are not a clinical specialize, you recognize how important Mark’s family can be to his progress. What actions can you take to address the family's unspoken concerns and needs?

3 Schizophrenia – the First Family Interview
Use open-ended questions to gather each members’ concerns Ask how this illness has affected interaction with the family Ask each person about his/her understanding of this illness Ask how each perceives his/her role in management of this issue Ask what coping strategies have worked in the family in the past (divorce etc). Is there anything else you feel I must know to help you? Assess/evaluate family communication and need for intervention. Ask about burdens that the family may be facing

4 Schizophrenia – What it is/is not
Schizophrenia is A brain disease, with concrete and specific symptoms due to physical and biochemical changes in the brain An illness that strikes young people in their prime – age of onset is usually between 16 and 25 Highly treatable with medication, although there is no cure More common than most people think (1% worldwide) Schizophrenia is not A split personality Caused by childhood trauma, bad parenting, or poverty The result of any action or personal failure by the individual

5 Schizophrenia – medical management
Positive Symptoms hallucinations delusions disorganized speech and behavior Negative Symptoms flat affect poverty of speech an inability to pursue and persist in goal directed activities inability to enjoy anything, apathy Drug Therapy Two major classes of antipsychotic medications “Atypical” antipsychotics Newer drugs that can help reduce both positive and negative symptoms with fewer side effects Conventional antipsychotics help reduce positive symptoms

6 Schizophrenia –Family Psychoeducation
Benefits to the patient of family therapy: Family support has been shown to reduce psychotic relapse Family support creates a safe setting in which the patient can share his feeling about his illness Family involvement demonstrates caring and trust and can help decrease stress in the patient Family involvement enlists the family as an ally in promoting and bringing about therapeutic progress

7 Schizophrenia –Family Psychoeducation
Benefits of Family therapy to the family caregivers: Continual learning about the disorder, treatments, and meds Strategies for handling day to day problems due to symptoms Strategies for helping the patient accept treatment Help in recognizing signs and symptoms of relapse Provides a safe place to share hopes, fears, and expectations of one another Introductions to local and national support groups

8 Schizophrenia Recovery Services
Area where assistance may be needed Daily Activities Health Family Life Medication Support Housing Assistance

9 Schizophrenia Recovery Services Assistance Areas
Entitlement Financial Management Substance Abuse Treatment Counseling How Do Families Benefit?

10 Schizophrenia – Resources
Schizophrenics Anonymous – Southfield, Brighton, Clinton National Organization for Mental Illness National Mental Health Information Center (part of SAMHSA Substance Abuse Mental Health Service Administration). Clinton Valley Center Citizens Advisory Council Assertive Community Treatment Association – Brighton Michigan Michigan Vocational Rehabilitation Muesser, Kim and Gingerich, Susan (2006) “Complete Family guide to Schizophrenia.”

11 Schizophrenics Anonymous
Support groups can help to move one to a direction of independence and renewed energy. Instill hopes to help one gain a sense of control in relationships by taking small manageable steps. Helps to promote a feeling of mastery and optimism. Support groups often lead to related social groups which further enhance the quality and quantity of client’s social behavior. Uncommunicative clients can benefit from being in the presence of others if they feel safe, and do not have to interact. Social activities are easier if a close friend initially accompanies client and if one knows it is possible to leave at any time.

12 Schizophrenia Sounds/Sights
Enjoy a simulation of a schizophrenic as he tries to refill a lost prescription. Review true life stories from Michigan schizophrenics who regularly attend Schizophrenics Anonymous meetings.

13 Not all hallucinations need to be frightening

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