Select An Adult Or Older Adult Client With Schizophrenia ✓ Solved

Select An Adult Or Older Adult Client With A Schizophrenia Spectrum

Select an adult or older adult client with a schizophrenia spectrum and other psychotic disorder you have seen. In 3–4 pages, write a treatment plan for your client in which you do the following:

• Describe the HPI and clinical impression for the client.
• Recommend psychopharmacologic treatments and describe specific and therapeutic endpoints for your psychopharmacologic agent. (This should relate to HPI and clinical impression.)
• Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.
• Identify medical management needs, including primary care needs, specific to this client.
• Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.
• Recommend a plan for follow-up intensity and frequency and collaboration with other providers.

Paper For Above Instructions

Schizophrenia spectrum disorders are chronic mental health conditions characterized by a profound alteration in thought processes, emotions, and behaviors. For this treatment plan, we will focus on a fictional adult client named John Doe, a 45-year-old male diagnosed with schizophrenia spectrum disorder. John presents with significant psychotic symptoms, including delusions, auditory hallucinations, and impaired social functioning.

History of Present Illness (HPI) and Clinical Impression

John's symptoms began in his late thirties, with a gradual decline in his functioning following initial episodes of paranoia, wherein he believed that he was being watched and followed. These delusions intensified over the past two years, and he experiences auditory hallucinations that command him to behave in ways that are concerning, such as isolating himself and avoiding social situations. His difficulties with social interaction have led to an estranged relationship with his family. Currently, he is unemployed, lives alone, and exhibits signs of depressive symptoms including anhedonia and low energy levels.

Clinically, John displays impaired insight regarding his condition; he does not recognize these hallucinations as part of an illness. He struggles to maintain personal hygiene and has a flat affect. His overall clinical impression points to a need for a comprehensive, multi-modal treatment approach, which includes pharmacological and psychosocial interventions.

Psychopharmacologic Treatments

The primary psychopharmacologic treatment recommended for John is an atypical antipsychotic medication, such as Risperidone. A typical starting dose might be 2 mg daily, with a plan to titrate based on clinical response and side effect profile. The therapeutic endpoints of this treatment would encompass a reduction in the severity and frequency of hallucinations and delusions, an improvement in insight, and enhanced social functioning. A target goal would be to achieve noticeable symptom relief within six to eight weeks, measured by standardized assessment tools such as the Positive and Negative Syndrome Scale (PANSS). Additionally, regular monitoring of weight, metabolic parameters, and possible side effects would be important to prevent treatment-related complications.

Psychotherapy Choices

It is recommended that John is engaged in an individualized therapy approach, specifically Cognitive Behavioral Therapy (CBT) tailored to psychosis. Therapy sessions can focus on helping him to develop coping strategies for managing delusions and hallucinations, as well as techniques to enhance reality testing and behavioral interventions directed towards improving daily functioning. Collaboratively setting specific therapeutic endpoints, such as reducing distress related to delusions by 50% within three months, will be important. Furthermore, family therapy can address the impact of John's illness on family dynamics, while incorporating psychoeducation can equip family members with the skills necessary to provide support.

Medical Management Needs

John requires ongoing medical management, especially regular follow-ups with a psychiatrist to monitor medication adherence and side effects. Additionally, he should be assessed periodically for any physical health conditions that are common among individuals with schizophrenia, such as metabolic syndrome. Primary care needs must be emphasized, ensuring that he has access to routine medical evaluations to address potential health issues that may arise as a result of his mental health medications.

Community Support Resources

Community engagement is critical for rehabilitation and recovery. John would benefit from connections with local mental health organizations such as the National Alliance on Mental Illness (NAMI), which offers support groups and educational resources for individuals with schizophrenia and their families. Furthermore, discussing available housing assistance programs and employment support services could help address socio-economic needs. Assertive Community Treatment (ACT) can also provide comprehensive, community-based support including counseling, vocational guidance, and daily living skills training.

Follow-Up Plan

A follow-up plan for John should involve regular psychiatric evaluations every four to six weeks initially, given the complexity of his presentation. Over time, as symptoms stabilize, these intervals could extend to every three months. Collaboration with a primary care physician, a licensed therapist, and community support staff will foster a consistent approach to John’s overall care. Evaluating progress at each follow-up visit will allow for any necessary adjustments in his treatment plan, ensuring holistic management of his mental health needs.

Conclusion

In conclusion, this treatment plan for John Doe outlines a comprehensive approach to managing his schizophrenia spectrum disorder through targeted psychopharmacologic interventions and psychotherapy. Attention to his medical management needs, engagement with community resources, and a structured follow-up plan lays the foundation for a supportive framework that encourages recovery and improves quality of life.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
• Gabbard, G. O. (Ed.). (2014). Gabbard's treatments of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publishing.
• Kaplan, H. I., Sadock, B. J., & Ruiz, P. (2014). Kaplan & Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
• Stahl, S. M. (2017). Prescriber’s guide: Stahl’s essential psychopharmacology (6th ed.). New York, NY: Cambridge University Press.
• National Alliance on Mental Illness. (n.d.). Retrieved from https://www.nami.org
• American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.
• Tripp, D. (2019). Community mental health services: A guide for practitioners. New York, NY: Routledge.
• Wang, L., & Liu, H. (2015). Therapeutic outcomes in schizophrenia: A review. Journal of Mental Health, 24(5), 290–293.
• Birchwood, M., & Meenagh, C. (2019). Psychosocial interventions for schizophrenia. Advances in Psychiatric Treatment, 25(4), 250–258.
• Rosenheck, R. (2015). Effective treatments for schizophrenia: Where do we go from here? The American Journal of Psychiatry, 172(10), 907–913.