rhonda nelson, m.s. ed, lcpc aimee anderson, ms. a serious mental disorder characterized by...
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PSYCHOTIC SYMPTOM DE-ESCALATIONRhonda Nelson, M.S. Ed, LCPC
Aimee Anderson, MS
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What is psychosis?
A serious mental disorder characterized by thinking and emotions that are so impaired that they indicate that a person experiencing them has lost contact with reality
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Early Stage Symptoms
Difficulties concentration Depressed mood Sleep changes – sleeping too much or not
enough Anxiety Suspiciousness Withdrawal from family and friends Ongoing unusual thoughts and beliefs
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Late stage symptoms
Delusions Hallucinations Disorganized speech – switching topics
erratically Depression Anxiety Suicidal thoughts or actions Difficulty functioning
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What Are Delusions?
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Delusions - Definition
A firmly held false belief or impression even when contrived by reality and what is commonly known as true. Delusions of Paranoia Grandiose delusions Somatic delusions
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What Are Hallucinations?
A sensory perception in the absence of outside stimulus. Seeing Hearing Smelling Feeling
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Positive and Negative Symptoms
Delusions and Hallucinations are the positive symptoms of psychotic disorders. They seem real to the person experiencing them
Negative symptoms include: Loss of motivation Social withdrawal Blunted emotions Thinking difficulties
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DSM-V Diagnoses
Schizophrenia Delusional Disorder Brief Psychotic Disorder Schizophreniform Disorder Schizoaffective Disorder
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Psychosis can also occur
Bi-polar disorder During periods of mania
Major Depressive Disorder During periods of severe depression
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Other possible causes
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Illnesses
Brain diseases: Parkinson’s, Huntington’s, and some chromosomal
Brain tumors or cysts Dementia (including Alzheimer's disease) HIV, syphilis, and other infections that attack
the brain Some types of epilepsy Stroke
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Possible environmental causes
Alcohol Illegal drugs:
Simulants Methamphetamine Cocaine
Hallucinogenic Drugs (LSD) Bath salts; synthetic drugs (K2)
Long periods without sleep Prescription drugs: steroids and
stimulants
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Risk Factors for Psychotic Disorders
Possibly genetic 50% chance of developing a psychotic
disorder if identical twin has been diagnosed Higher risk if immediate family (parent/sibling)
member has been diagnosed Brief reactive psychosis
Response to an extreme situation, death of family member, short-lived response (days)
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Treatment Considerations
Rapid tranquilization Medications Therapy Psycho-education Case Management
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Tools for Your Toolkit: How?
Approach the person in a caring and non-judgmental way to discuss your concerns
Allow the person to talk about their experiences and beliefs if they want to, but do not force them
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Where?
Choose a private time and place, free from distractions
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What?
Let the person know you are concerned and want to help- state the specific behaviors that concern you
Let the person know you are available to talk in the future
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Why?
Be sensitive to the way the person is behaving
Respect the person’s privacy and confidentiality
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Who?
Let the person set the pace and style of interaction
Do not touch the person without permission
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“Tips” to assist with the “Tools”
Assist the person by remaining calm Talk in a clear, concise way Use short, simple sentences
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More Tips…….
Speak quietly in a non-threatening tone at a moderate pace
Answer questions calmly Comply with reasonable requests
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More tips…….
Maintain your safety and access to an exit
Do not do anything to further agitate the person
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Key “Tip” - Listening
Understand the symptoms for what they are
Empathize with how the person is feeling about his/her beliefs and experiences
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Communication
Be patient and allow plenty of time for responses
Be aware that just because the person may be showing a limited range of emotions this does not mean they are not feeling anything
Do not assume the person cannot understand you, even if the response is limited
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Information
Give the person hope for recovery
Provide practical help
Do not make any promises that you cannot keep
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Treatment Options - Professionals
Doctors – Primary Care Physicians Psychiatrists Social workers, counsellors & other mental
health professionals Certified Peer Specialists
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Treatment Options – Non Professionals
+ Peer support groups
+ Family, friends, faith and other social networks
+ Family support groups
+ Discontinuation of alcohol and other drugs
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If the person does not want help
Encourage the person to talk with someone he/she trusts
Never threaten the person with hospitalization
Remain patient
Remain friendly and open
The person may want your help in the future
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Questions ?