Transcript Schizophrenia

Case Study
Schizophrenia
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?
Schizophrenia – the First Family
Interview
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Use open-ended questions to gather each members’ concerns
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Ask how this illness has affected interaction with the family
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Ask each person about his/her understanding of this illness
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Ask how each perceives his/her role in management of this issue
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Ask what coping strategies have worked in the family in the past
(divorce etc).
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Is there anything else you feel I must know to help you?
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Assess/evaluate family communication and need for intervention.
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Ask about burdens that the family may be facing
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
Schizophrenia – medical management
Positive Symptoms Negative Symptoms

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hallucinations
delusions
disorganized speech and
behavior
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
Conventional antipsychotics
help reduce positive symptoms
“Atypical” antipsychotics
Newer drugs that can help reduce
both positive and negative
symptoms with fewer side effects
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
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
Schizophrenia Recovery Services
Area where assistance may be needed
 Daily Activities
 Health
 Family Life
 Medication Support
 Housing Assistance
Schizophrenia Recovery Services
Assistance Areas
Entitlement
 Financial Management
 Substance Abuse Treatment
 Counseling
 How Do Families Benefit?
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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.”
Schizophrenics Anonymous
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Support groups can help to move one to a direction of
independence and renewed energy.
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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.
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Support groups often lead to related social groups which further
enhance the quality and quantity of client’s social behavior.
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Uncommunicative clients can benefit from being in the
presence of others if they feel safe, and do not have to interact.
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Social activities are easier if a close friend initially accompanies
client and if one knows it is possible to leave at any time.
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.
Not all hallucinations need to be frightening