Psychosis free essay sample

Summative Assessment One: Case Study There are several key issues apparent for Belinda, one of which is social isolation. Belinda has withdrawn from her family and no longer spends time with her friends. In becoming socially isolated, Belinda is at risk of disruption to her social development leading to an increased likelihood of failure to achieve in the future (EPPIC, 2001). This is evidenced by the fact that Belinda’s grades have dropped significantly over the past six months. For the purpose of this essay, three differential diagnoses will be offered, however in clinical practice it is preferable to refrain from diagnosing a client early in treatment due to the stigma associated with being ‘labelled’ (EPPIC, 2001). The first differential diagnosis formulated is Schizophrenia. According to the DSM IV criteria for Schizophrenia, (as cited in Elder, Evans Nizette, 2005), there must be at least two positive symptoms present for a period of at least one month. We will write a custom essay sample on Psychosis or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Camer explains that the symptoms of Schizoaffective Disorder are variable but include thoseseen in Schizophrenia, such as delusions, hallucinations, and thought disturbances. Symptoms indicative of a mood disorder are also present, such as emotional unresponsiveness, avolition,and anhedonia. These symptoms are in concurrence with those seen in Belinda (see Appendix A). Belinda exhibits a number of these symptoms including anhedonia, avolition, withdrawal as well as the presence of psychotic symptoms (see Appendix A). The differential diagnosis that best matches Belinda’s symptoms is Schizophrenia. With this diagnosis in mind, a plan of treatment and care can be developed for Belinda. EPPIC (2001) identifies that due to the nature of psychotic illness there is an increased risk of disruption to interfamilialand interpersonal relationships. The event of a family member suffering from psychotic illness is likely to be distressing for all concerned, added to that is uncertainty surrounding the illness regarding treatment and prognosis. Psychoeducation, providing information about the pattern of the illness, rationale for the use of medication, time frames for recovery, and expectations, is an invaluable intervention (EPPIC, 2001). Psychoeducation serves to promote understanding and encourages open and honest communication between Belinda and her family; allowing each to express their thoughts, feeling and concerns (see Appendix B). As a result of Belinda’s paranoid thoughts about her parents poisoning her food, she is not receiving adequate nutrition for her body requirements and is underweight. As previously stated, ANRED (2008) have identified several potential physical implications of sustained malnutrition. To avoid these, interventions would be best directed to improving Belinda’s nutritional intake. Offering the option of preparing her own food, or the use of sealed, pre-packaged meals and drinks, would allow Belinda to gain nourishment and avoid the distress of confronting her delusional thinking (see Appendix B). While successful interventions are an important part of the treatment process, there are also legal and ethical issues to consider. According to Elder et al. (2005), as Belinda is only 15 years of age she must have her parent’s consent to receive any form of medical intervention. In this case Belinda’s parents have sought help for their daughter and she is not currently being treated under the Mental Health Act 1992. In the pursuit of a therapeutic relationship with Belinda, the concept of confidentiality between patient and nurse and its implications would need to be discussed (EPPIC, 2001). EPPIC states that anything discussed between patient and nurse must be kept strictly confidential unless consent for disclosure is given by the patient. However, it would need to be made clear to Belinda that should she disclose any information that led the nurse to have immediate concerns about the potential safety of Belinda or others, then the nurse is morally obliged to pass that information on. Elder et al. (2005) assert that within the bounds of the therapeutic relationship the power must remain at least egalitarian and the client must never feel coerced or forced into treatment.