As a therapist, I have been presented with many psychology cases; however, one case got my attention. A nine-year-old boy named Christopher Robin, from Winnie the Pooh was brought to my clinic by his concerned and worried parents. Christopher Robin's parents described him as a child who seemed to be detached from reality. His parents went ahead to describe further the problems that he had, this included, disorderly conduct, delusion, poor concentration capabilities, and social segregation considering that all of Christopher Robin's friends were stuffed toys. With all these, characteristics, I suspected that the little boy was suffering from Schizophrenia; however, an immediate diagnosis would be inaccurate due to the fact that a majority of the mental conditions have the same characteristics and symptoms. It was, therefore, essential to critically analyze his symptoms using the DSM-5 criteria in order to diagnose his psychological condition correctly.
The DSM-5 approach enables therapists to easily classify mental disorders due to the fact that most of these problems comprise a variety of different behavioral, cognitive, and emotional symptoms, this makes it difficult to diagnose. Since I had initially suspected that Christopher Robin was suffering from schizophrenia, I used it as the basis of my DSM-5 (Messinger & Julie, 2011). Basically, this approach consists of five main stages which are meant to critically and correctly analyze and diagnose any mental condition that is of interest. In this specific case, the suspected mental condition was schizophrenia. Below are the steps that I used in my DSM-5 for the diagnosis of schizophrenia.
To begin with, I did an in-depth analysis of all the possible behaviors, signs and symptoms associated with schizophrenia. This step enables one to rule out other mental disorders with the same symptoms as schizophrenia. Considering the fact that Christopher Robin had manifested disorderly conduct, delusion, poor concentration capabilities, and social segregation for at least a month, I had to rule out other possible psychological problems such as bipolar or schizoaffective. This first step was critical in my diagnosis as it enabled me to eliminate other potential disorders and narrow down to a specific disorder.
The second phase of the DSM-5 required that I conduct an analysis of advanced schizophrenia signs and symptoms. From my practice as a therapist, I was fully aware that the main symptoms included the deficiency in derealization, social interactions, and depersonalization. My patient, Christopher Robin, unmistakeably had all these symptoms as he lacked social interaction with real friends, this was a sign of derealization.
Thirdly I analyzed the functional repercussion of Schizophrenia with relation to Christopher Robin. Considering the fact that my patient lacked active social relationships and encounters, it was evident that his condition had altered his social functioning. From my previous cases, most of my Schizophrenic patients had limited interactions with other people, and in this particular case, Christopher Robin had the same exact symptoms in a way that he would talk to his stuffed toys as if they would actually respond back.
Assessment Procedure and Instruments
Lastly, I performed an assessment procedure using specific instruments necessary in the diagnosis of Schizophrenia. The process of impairment that is normally associated with Schizophrenia is usually acute, long-lasting and could lead to persistent mental disability. Considering the fact that is difficult to access the process due to the lack of perfunctory instruments, new procedures have been developed to create more awareness of schizophrenia (Bell et al., 2007 ). In this particular case, for my assessment, I used the Brief Cognitive Assessment (BCA) since its analyzing capabilities is effective for analyzing and assessing patterns and levels of the lack of awareness of mental disorders due to the fact that this particular instrument has the capability to work well in different cases of mental disorders. Other than that, it is speedy and has the ability to be administered in a short time, mostly in less than 15 minutes (Bell et al., 2007). The speedy nature of this instrument allowed me to analyze and develop the right diagnosis in the shortest time possible. I would recommend this particular instrument to other therapists as it can be used to develop easy yet coherent methods that can be used on schizophrenia subjects.
Having concluded that my little patient, Christopher Robin was, in fact, suffering from schizophrenia, I went ahead to discuss the most effective treatment plans with his parents. The main objective of schizophrenia treatment is to minimize the possibilities of health deterioration in patients. To begin with, I advised Christopher Robin's parent to consider the use of antipsychotics, which is a special type of medication dedicated to mental disorders such as schizophrenia. Despite the fact that these medications do not permanently cure schizophrenia, they play an essential role in minimizing the signs and symptoms associated with the condition. This could greatly help his parents control and manage his mental condition.
In addition to that, I suggested that Christopher Robin's parents try another treatment type known as the Coordinated Speciality care approach, a treatment that involves the use of both therapeutic and medical approach. (Thornton et al., 2006). This treatment would require that Christopher robins family be involved as much as possible due to the fact that the Coordinated Speciality care approach requires the regular intervention of people who have a close relationship with the patient. I suggested this particular type of treatment since it helps in the improvement of the social interaction of the patient, in this case, I hoped that Christopher Robin would slowly make positive progress by interacting with more people and make new friends rather than only interact with his stuffed toys.
Lastly, I counseled his parents on the use of intense psychosocial therapy on Christopher Robin. Intense psychosocial therapy is known to play an important role in the improvement of the social and behavioral complications associated with patients suffering from schizophrenia. Psychosocial therapy would mainly involve cognitive remediation, rehabilitation, and individual therapy sessions between me and Christopher Robin (Dixon et al., 2009). Through this specific type of therapy, his parents could gain enough knowledge on how to manage his symptoms by observing signs that could be a possible change in mental deterioration, and this would greatly help them as they would be able to assess whether there would be an improvement in their son's condition or not condition or not. Despite the fact that these sessions play a major role in the treatment process, the most effective way to treat and manage schizophrenia is through early diagnosis as it enables parents to children suffering from schizophrenia to know the best treatments to use to manage this condition. All of the suggested treatments could greatly improve my patient's health.
Bell, M., Fiszdon, J., Greig, T., Wexler, B., & Bryson, G. (2007). Neurocognitive enhancement therapy with work therapy in schizophrenia: 6-month follow-up of neuropsychological performance. Journal of Rehabilitation Research & Development, 44(5).
Dixon, L. B., Dickerson, F., Bellack, A. S., Bennett, M., Dickinson, D., Goldberg, R. W., ... & Peer, J. (2009). The 2009 schizophrenia PORT psychosocial treatment recommendations and summary statements. Schizophrenia bulletin, 36(1), 48-70.
Messinger, J. W., Tremeau, F., Antonius, D., Mendelsohn, E., Prudent, V., Stanford, A. D., & Malaspina, D. (2011). Avolition and expressive deficits capture negative symptom phenomenology: implications for DSM-5 and schizophrenia research. Clinical psychology review, 31(1), 161-168.
Thornton, A. E., Van Snellenberg, J. X., Sepehry, A. A., & Honer, W. G. (2006). The impact of atypical antipsychotic medications on long-term memory dysfunction in schizophrenia spectrum disorder: a quantitative review. Journal of Psychopharmacology, 20(3), 335-346.
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