Identify medical management needs, including primary care needs, specific to this client
Assignment: “Captain of the Ship”Project
– Schizophrenia Spectrum and Other Psychotic Disorders
There are many disorders that result in the development of “positive” symptoms,
such as hallucinations and delusions, but not all of these conditions represent schizophrenia. When treating schizophrenia spectrum and other psychotic disorders, emphasis should be placed not only on treating the positive symptoms but the negative and residual symptoms as well.
This week, you will explore a wide variety of disorders along the schizophrenia spectrum as you become “captain of the ship” once again. You also will analyze issues involved with state practice agreements.
Assignment
In this assignment, you will become “captain of the ship” as you take full responsibility for a client with schizophrenia spectrum by recommending psychopharmacologic treatment and psychotherapy, identifying medical management needs and community support, and recommending follow-up plans.
Remember that there is an excellent example for ‘Captain of the Ship’ project attached with this ASSIGNMENT.
Instructions:
To prepare for this Assignment
Select an adult or older adult client with a schizophrenia spectrum and other psychotic disorder that you have seen in your practicum/clinical rotation site.
In 3-4 pages, write a treatment plan for your client. In which you do the following:
· Describe the history of the present illness (HPI) and clinical impression for the client.
· Recommend psychopharmacologic treatments based on evidence-based practice and describe specific and therapeutic end points for your psychopharmacologic agent. (This should relate to HPI and clinical impression.).
· Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.
· Identify medical management needs, including primary care needs, specific to this client.
· Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.
· Recommend a plan for follow-up intensity and frequency and collaboration with other providers.
N: B. (1)The Captain of the Ship project needs to show that you are evaluating the patient, making a diagnosis, providing treatment plans and outcomes as well as collaborating with other providers. The project MUST meet all these requirements. (2) The choice of medications should be clear, and the medical management should be clear. (3) Consider using the bipolar disorder algorithm from http://www.psychiatrictimes.com/bipolar-disorder/new-psychopharmacology-algorithms
Learning Resources
Required Readings
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
Chapter 7, “Schizophrenia Spectrum and other Psychotic Disorders” (pp. 300–346)
Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.
Chapter 8, “Early-Stage Schizophrenia”
Chapter 9, “Toward a Dimensional Understanding of Psychosis and Its Treatment”
Chapter 10, “Psychosocial Treatments for Chronic Psychosis”
Chapter 11, “Pharmacological Treatment of Psychosis”
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
“Schizophrenia Spectrum and other Psychotic Disorders”
Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.
To access information on specific medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.
Psychosis
alprazolam (adjunct)
amisulpride
aripiprazole
asenapine
blonanserin
carbamazepine (adjunct)
chlorpromazine
clonazepam (adjunct)
clozapine
cyamemazine
flupenthixol
fluphenazine
haloperidol
iloperidone
lamotrigine (adjunct)
lorazepam (adjunct)
loxapine
lurasidone
mesoridazine
molindone
olanzapine
paliperidone
perospirone
perphenazine
pimozide
pipothiazine
quetiapine
risperidone
sertindole
sulpiride
thioridazine
thiothixene
trifluoperazine
valproate (divalproex) (adjunct)
ziprasidone
zotepine
zuclopenthixol
Schizoaffective disorder
amisulpride
aripiprazole
asenapine
carbamazepine (adjunct)
chlorpromazine
clozapine
cyamemazine
flupenthixol
haloperidol
iloperidone
lamotrigine (adjunct)
l-methylfolate (adjunct)
loxapine
lurasidone
mesoridazine
molindone
olanzapine
paliperidone perospirone
perphenazine
pipothiazine
quetiapine
risperidone
sertindole
sulpiride
thioridazine
thiothixene
trifluoperazine
valproate (divalproex) (adjunct)
ziprasidone
zotepine
zuclopenthixol
Schizophrenia
amisulpride
aripiprazole
asenapine
carbamazepine (adjunct)
chlorpromazine
clozapine
cyamemazine
flupenthixol
haloperidol
iloperidone
lamotrigine (adjunct)
l-methylfolate (adjunct)
loxapine
lurasidone
mesoridazine
molindone
olanzapine
paliperidone
perospirone
perphenazine
pipothiazine
quetiapine
risperidone
sertindole
sulpiride
thioridazine
thiothixene
trifluoperazine
valproate (divalproex) (adjunct)
ziprasidone
zotepine
zuclopenthixol
Seasonal affective disorder
bupropion
Sedation-induction
hydroxyzine
midazolam
Cataplexy syndrome
clomipramine
imipramine
sodium oxybate
Catatonia
alprazolam
chlordiazepoxide
clonazepam
clorazepate
diazepam
estazolam
flunitrazepam
flurazepam
loflazepate
lorazepam
midazolam
oxazepam
quazepam
temazepam
triazolam
Extrapyramidal side effects
benztropine
diphenhydramine
trihexyphenidyl
Ferreira, C. D., de Souza, M. G. D., Fernández-Calvo, B., Machado-de-Sousa, J. P., Cecilio Hallak, J. E., & Torro-Alves, N. (2016). Neurocognitive functions in schizophrenia: A systematic review of the effects of typical and atypical antipsychotic drugs. Psychology & Neuroscience, 9(1), 12–31. doi:10.1037/pne0000045
Granholm, E., Holden, J., Link, P. C., & McQuaid, J. R. (2014). Randomized clinical trial of cognitive behavioral social skills training for schizophrenia: Improvement in functioning and experiential negative symptoms. Journal of Consulting and Clinical Psychology, 82(6), 1173–1185. doi:10.1037/a0037098
Required Media
Murphy, L. (2011, July 21). Types of schizophrenia – A day in the life (scary) [Video file]. Retrieved from https://www.youtube.com/watch?v=LWYwckFrksg