Individuals with schizophrenia may sleep excessively or use alcohol or other substances to diminish the voices. Command hallucinations are the most serious and can be dangerous. The voices may command an individual to harm themselves or others. The person may feel that they must obey. It is helpful to ask someone who experiences auditory hallucinations if they are in control or the voices are in control.They will respond best to a low stimulation environment if experiencing psychotic symptoms. Examples would be low lighting, minimal people and a low noise level. Only one person should speak to the psychotic individual and requests should be direct and brief. Whispering and laughing can be misinterpreted and should be avoided. Orienting the individual to reality, such as using their name is recommended. The focus when working with a person who has schizophrenia is to decrease anxiety and build trust.
The negative symptoms of schizophrenia involve a loss of function. Examples are a loss of verbal fluency, loss of energy and motivation, loss of the experience of pleasure, and loss of emotional expression. Personal hygiene and social skills may be lacking. These symptoms may seem less dramatic than positive symptoms but they are just as debilitating. When a person with schizophrenia is being interviewed, he/she may respond with one word answers and seem to have no expression on their face. This presentation could be mistaken for low intelligence or depression. Cognitive symptoms can involve memory and language deficits. The individual may be slow to process information. They may be slow to respond to questions. Individuals with schizophrenia may lack insight and awareness of their disorder. They may resist treatment for this reason. Social skills training, anxiety management and education about the illness and medications is also helpful. Insight oriented psychotherapy is less effective
This month’s civil & criminal topic is Schizophrenia. Topics covered are:
- Case Scenario (8/4/14)
- Symptoms and Diagnosis (8/11/14)
- Approach Considerations (8/18/14)
- Medical Treatment Options (8/25/14)
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