h) Additional clinical interventions
Given Jane’s developmental level (58 I.Q.), it is not surprising that she could not fully understand everything that was happening to her. Jane is actually a very sweet young woman, but she can be a handful when her environment is not well structured. Jane’s mother and I agreed that Jane would benefit from separate behavioral therapy sessions. I discussed the linkage of psychosocial stress and the onset of psychotic symptoms (Zubin & Spring, 1977, as cited in Castonguay & Oltmanns, 2013). We both agreed that reducing the stress in Jane’s environment is wise for many reasons. This will also help to prevent the return of Jane’s depressive symptoms.
Periodic sessions with Jane and her mother would also be …show more content…
The mother and I were advised last week that the psychiatrist intended to switch Jane from Abilify to Latuda, and to take her off of Congentin. The psychiatrist’s hope is that Jane will have reduced weight gain, and reduced anticholinergic side effects (dry eyes in particular). While the risks seem low, my biggest concern is that Latuda will not control Jane’s psychotic symptoms, as these have been very stable on Abilify. There is also a risk that new side effects will manifest from the change in medications. Lastly, I see the psychotic symptoms as the most important ones to manage. I shared these concerns with the psychiatrist. She felt the risks were low enough, and planned to proceed with the change in medications.
It is interesting to note that antipsychotic pharmaceuticals are not universally supported. Whittaker (2010) makes a strong case that antipsychotics should be used only minimally, instead of in nearly every episode of psychosis. He favors their use with psychosocial tools, which he believes lead to more recoveries than purely antipsychotic treatments.
j) Legal and ethical
Given Jane’s developmental level (58 I.Q.), it is not surprising that she could not fully understand everything that was happening to her. Jane is actually a very sweet young woman, but she can be a handful when her environment is not well structured. Jane’s mother and I agreed that Jane would benefit from separate behavioral therapy sessions. I discussed the linkage of psychosocial stress and the onset of psychotic symptoms (Zubin & Spring, 1977, as cited in Castonguay & Oltmanns, 2013). We both agreed that reducing the stress in Jane’s environment is wise for many reasons. This will also help to prevent the return of Jane’s depressive symptoms.
Periodic sessions with Jane and her mother would also be …show more content…
The mother and I were advised last week that the psychiatrist intended to switch Jane from Abilify to Latuda, and to take her off of Congentin. The psychiatrist’s hope is that Jane will have reduced weight gain, and reduced anticholinergic side effects (dry eyes in particular). While the risks seem low, my biggest concern is that Latuda will not control Jane’s psychotic symptoms, as these have been very stable on Abilify. There is also a risk that new side effects will manifest from the change in medications. Lastly, I see the psychotic symptoms as the most important ones to manage. I shared these concerns with the psychiatrist. She felt the risks were low enough, and planned to proceed with the change in medications.
It is interesting to note that antipsychotic pharmaceuticals are not universally supported. Whittaker (2010) makes a strong case that antipsychotics should be used only minimally, instead of in nearly every episode of psychosis. He favors their use with psychosocial tools, which he believes lead to more recoveries than purely antipsychotic treatments.
j) Legal and ethical