Case Study
John Nash is a 22-year-old patient suffering from schizophrenia. His condition started developing at the onset of adolescence. He is socially withdrawn, depressed, suspicious, and forgetful, experiences hallucinations and has suicidal thoughts. John has been hospitalized once and is currently on aripiprazole medication.
Treatment and Management of Schizophrenia
Based on the case study above, this paper will develop Johns’ clinical psychology medical intervention. Studies indicate that the treatment and management of schizophrenia mainly depends on a combination of pharmacological and psychosocial interventions (Leucht et al., 2012, Harrow & Jobe, 2013).
Pharmacological Intervention
The primary treatment of schizophrenia would be the use of antipsychotic medications that reduce positive symptoms of psychosis within one to two weeks (Smith, Weston, & Lieberman, 2010). Antipsychotic drugs have been in use since mid-1950’s, and are well known for symptoms reduction. In addition, antipsychotics improve a patients’ quality of life and enable them enjoy an improved look. Studies conducted reveal that, continuous use of antipsychotic medication decreases the risk of relapse (Leucht et al., 2012, Harrow & Jobe, 2013).
Trained and experienced physicians, based on individual symptoms and degree of sickness, mainly give dosage and medication. For John’s case, clozapine depot injections would be recommended. Clozapine has proved to be the best antipsychotic medication in people with recurring symptoms. (Essali, Al-Haj Haasan, Li, & Rathbone, 2009). Furthermore, clozapine reduces suicidal feelings in schizophrenics. Normally, a trained medical personnel or a nurse gives an injection. As a rule, the first injection is given a small dose to ensure that side effects do not occur. If there are no side effects, the patient can start having higher doses at regular bi-weekly intervals. This intervention can be conducted at home by a visiting nurse, at a community mental health center or at a General Practitioner’s office.
The use of clozapine is a medical intervention that targets the biological functioning of patients by blocking serotonin receptors and thus bringing about the release of dopamine receptors in specific parts of the brain. Consequently, motor side effects are reduced, and cognitive and affective symptoms improved. In addition, clozapine blocks dopamine receptors, hence, reducing positive symptoms of psychosis.
Psychosocial Intervention
According to the National Institute of Mental Health (n.d.), patients with schizophrenia may be free of psychotic symptoms, but “many still have extraordinary difficulty with communication…and establishing and maintaining relationships with others” (par. 2). As a result, most of the patients have emotional problems and lack important social skills required to integrate with other people in the society. Based on the reasons identified by the National Institute of Mental Health, these social, occupation and psychological problems require psychosocial treatment that may be useful to patients with mild symptoms. Johns’ case that guides this study reveals a mixture of emotional and social problems that can be treated using psychosocial interventions. In order to focus on a patients’ social functioning, most medical practitioners recommend the following interventions.
Cognitive Therapy and Rehabilitation
This entails the application of cognitive behavior therapy techniques that aim at improving a patients social functioning. Practitioners employ techniques that reduce hallucinations like rational analysis. Cognitive rehabilitation programs that employ the use of computerized neurocognitive tasks are used to improve the memory capacity of patients. This intervention mostly targets the psychological factors of an individual.
Family Intervention
This is the most important intervention that emphasizes on the positive effects of family psychoeducation. The model entails providing families with information about schizophrenic and its treatment, as well as teaching and training members about helpful communication strategies to adopt when dealing with a patient. This intervention mostly targets the social factors of an individual.
Conclusion
In conclusion, the combinations of both pharmacological and psychotherapeutic interventions in treating and managing schizophrenic have yielded positive and promising results. However, the use of psychotherapy is minimal due to lack of continuous training and most treatment has been confined to pharmacological and psychiatric treatment. It is more likely that, the combination of both medications could play an important role in facilitating schizophrenic treatment.
References
Essali, A., Al-Haj Haasan, N., Li, C., & Rathbone, J. (2009). Clozapine versus typical neuroleptic medication for schizophrenia. Cochrane Database of Systematic Reviews (1). Web.
Harrow, M., & Jobe, H. (2013). Does long-term treatment of schizophrenia with antipsychotic medications facilitate recovery?. Schizophrenia bulletin 39 (5), 962–5. Web.
Leucht, S., Tardy, M., Komossa, K., Heres, S., Kissling, W., Salanti, G., & Davis, J. (2012). Antipsychotic drugs versus placebo for relapse prevention in schizophrenia: a systematic review and meta-analysis. Lancet, 379 (9831), 2063–71. Web.
National Institute of Mental Health. (n.d.). Psychosocial Treatments for Schizophrenia – Psych Central. Psych Central.com. Web.
Smith, T., Weston, C., & Lieberman, J. (2010). Schizophrenia: maintenance treatment. American Journal of Family Physician, 82 (4), 338–9.