Psychosis
Introduction
Psychosis is a mental condition that makes people lose touch with reality (Galletly et al., 2016). Psychotic individuals exhibit symptoms characterised by hallucinations, thought disorder portrayed by unsystematic speech patterns, and delusions. The impact of psychotic disorder, like many other illnesses such as cancer, depends on the stage of diagnosis. That is, the duration of untreated psychosis (DUP) determines the outcome of the condition (Yung, 2017). Longer DUP leads to poor outcomes and is usually more expensive to treat. Although psychosis cannot be cured, there are different treatment options to help reduce the occurrences of the disorder symptoms (Burns et al., 2014). Therefore, it is important to induce treatment which is dependent on the stage of psychosis. Consequently, to effectively treat the condition, it is important to diagnose its phase correctly.
Also, during the diagnosis process, it is important to identify the catalysts that led to the development of psychosis such as biological factors, psychological and social determinants (Nolin et al., 2016). The phases of psychosis constitute; premorbid, possible prodrome(ultra-high risk of psychosis, first episode of psychosis, late-stage associated with incomplete recovery, and development of chronicity (Lana et al., 2015). The best practice of working with psychotic patients is dependent on the phase of the illness. The possible recovery treatments include; pharmacotherapy, psychotherapy, cognitive behavioral therapy(CBT), family therapy, and community support programs (Schmidt et al., 2015). For effective recovery, mental health facilities should adopt a recovery-oriented approach that actively involves the patients and family members in the recovery plan.
Pharmacotherapy
Psychotherapy involves the use of medication to treat psychosis. The duration of medication and the type of medication used is determined by DUP and the phase of the psychotic disorder. Drugs used to manage psychosis are known as antipsychotics and are prescribes once symptoms start to show, the first episode of psychosis and also during later phases (Galletly et al., 2016). The drugs are structured to work on brain chemical that causes psychosis symptoms such as serotonin and dopamine (Hetrick et al., 2017). In most cases patients are required to take antipsychotics for their entire lives and a stop may lead to a relapse. According to research, it is estimated that about eighty percent of psychotic patients who stop taking psychosis drugs relapse compared to the twenty percent relapse of individuals that are on medication (Bingham et al., 2017). Consequently, patients need to be monitored both with the physicians and close relatives and friends and ensure that they do not stop medicating. Furthermore, the choice of antipsychotic drugs to use is dependent on various reasons such as the cost, acceptability, side effects, the technique of delivery, accessibility, and effectiveness (Correll et al., 2015). Possible side effects of the medications include restlessness, seizures, sexual challenges, obesity, reduced immunity due to a reduction in white blood cells count, drowsiness and low blood pressure.
Antipsychotics are further subdivided into two categories, that is, atypical and typical (Correll et al., 2015). The former refers to antipsychotic drugs that were first to be developed around the 1950s. Their use was discouraged by their nature of causing severe side effects. To reduce the faced side effects in antipsychotic drug use, second generation or atypical antipsychotics were developed and their use approved in the 1990s (Bingham et al., 2017). However, the side effects of both first and second generation antipsychotic drugs varies with each patient. Therefore, it is important for a recovery-oriented practice to test and involve the patient in deciding which medication to use (Reinhardt & Cohen, 2015). Moreover, involving the patients in the medication decision making gives them a sense of obligation towards working to better their health (Le Boutillier et al., 2015). Consequently, the chance of stopping medication and thus relapse is reduced.
Psychotherapy
Various psychosis symptoms such as depression and hallucinations have proved difficult to be treated through pharmacotherapy alone; they further need psychotherapy for effective treatment (Dobson & Dobson, 2018). As per research, patients who integrate both medication and therapy recover faster and effectively than individuals who use medication alone. Over time the need for psychotherapy treatment of the disorder has been globally recognised. For effective psychotherapy treatment, the therapist needs to create rapport with the patients since it has been proven more effective than the methodologies of executing psychotherapy (Ogden, 2018). The treatment methods do not only help the patients’ recovery but also provides fundamental insights about their illness to them. Therefore, they will be able to comprehend better the effects of the disorder and know how best to manage their lives.
Psychotherapy further helps the physicians to develop an effective treatment plan for the patients (Farmer & Chapman, 2016). For instance, during the UHR phase, a therapist may be able to identify triggers that lead to the development of psychosis such as stress (Yung, 2017). In such a situation, stress management techniques may be implemented and may result in avoidance of psychosis. Therefore, since UHR is common in teenagers and young adults, it is important to develop well-structured psychotherapy sessions in schools (Dimaggio & Lysaker, 2015). Consequently, the therapist may train the patients on social methods that may help manage and prevent psychosis. Additionally, during the first episode of psychosis (FEP), many patients, but not a must are considered a risk to themselves and other owing to the lost touch with reality (Nolin et al., 2016). As such, they need to be psychologically managed to prevent any violence. Therefore, psychotherapy helps identify triggers and symptoms, thus help in initiating coping plans which results in effective treatment.
Recovery-oriented mental health facilities should enhance psychotherapy by encouraging patients to voice their thoughts (Park et al., 2014). Such a practice results in the empowerment of patients in their recovery process. It enables them to have a sense of pride in taking control of their life. Due to the sense of being the driving force in their life and not being driven, there is an increase in satisfaction with psychotic patients (Reinhardt & Cohen, 2015). Consequently, the quality of their health improves which in turn hastens the recovery process. Moreover, patient involvement enables the therapist to denote the best treatment plan and how to cater to all health requirements. For instance, a psychotic patient may show disapproval towards a certain drug and then be able to choose another medication that best suits them.
Cognitive Behaviour Therapy (CBT)
CBT is a short-term form of psychotherapy that engages a feasible approach to problem-solving. It aims to change the behavior of people and thus change how they feel (Farmer & Chapman, 2016). CBT is effective in treating psychosis symptoms such as depression. The technique entails alternating an individual’s cognitive processes such as the way they perceive certain things and thus help in changing how they feel which helps curb emotional difficulties (Dobson & Dobson, 2018). According to research, CBT help in the long-term recovery of psychosis through strengthening the connection between particular brain areas and psychotic disorder (Burns et al., 2014). Moreover, the strengthened connection included brain regions that dealt with emotions. Consequently, the connections led to rapid and consistent recovery.
A recovery-oriented practice ensures that throughout the duration of CBT, approximately 8-10 months involving weekly meetings, the therapist is fully transparent with the patient (Park et al., 2014). Openness builds trust and hence rapport which is fundamental in treating psychotic patients. Moreover, throughout the CBT process, therapists can help patients track and manage their own recovery (Lana et al., 2015). Also, a recovery practice will help individuals overcome stigma through CBT implementation.
Family Therapy
As per research, family therapy is important in the diagnosis of psychosis and also its treatments. It is evident that psychotic individuals who live with their families are prone to frequent relapses as compares to those who live alone (Gladding, 2015). In many cases, family members of psychotic patients perceive them as high maintenance and always want to offer their assistance. Consequently, their increased attention with the aim of assisting results in the psychotic patients being hyper-aware of their situations which often leads to relapse (Kline & Thomas, 2018). On the other hand, the increased normal stress of taking care and dealing with psychotic may lead to the development of psychosis in the family caregivers. The increases the emotional sensitivity of both the patient and family members call family therapy.
A health cleaning with recovery-oriented health practices should formulate family therapy sessions for effective recovery (Waldemar et al., 2015). The therapeutic sessions will help in identifying a potential area of concern and dealing with them accordingly. The family therapies will improve the interpersonal and generally the social operational of the whole family thus curb relapses and development of a new psychosis case (Pincus et al., 2016). A recovery-oriented organisation should ensure that the interventions help with the patients’ interest in mind thus should involve the patient in the decision making of when the interventions will be scheduled (Ogden, 2018). The meeting should further be flexible as per the family members’ preferences. Generally, family therapies last for 6-12 months.
Community Support Programs
A large percentage of psychotic patients are prone to relapse due to various factors such as stigmatisation, family stress or substance abuse. Moreover, many psychotic patients face unemployment due to their mental condition (O’Donoghue et al., 2018). The community may seclude psychotic individuals either through under demining them or through increased attention. The seclusion often leads to depression and thus relapse. To manage such problems, a recovery-oriented health practice should initiate strategies to eliminate them. For instance, such healthcare facilities should organise support groups for the psychotic patients (Dimaggio & Lysaker, 2015). Such groups are highly beneficial in the recovery process for some reasons. For instance, talking to people with the same medical condition helps patients get different perspectives on issues. The increased insight helps to understand the situation better and helps in managing personal recovery (Sabbioni et al., 2018). Moreover, as the name suggests, support groups provide support to psychotic individuals since they acknowledge the fact that they are not alone. The sharing of many experiences provides a sense of relief consequently reducing the stress that may cause a relapse (Nordentoft et al., 2014). Support groups further help in the establishment of social skills that eases the process of psychotic individuals getting back and associating with the whole community.
Recovery-oriented mental health facilities should also set clinics in communities that help track psychosis recovery. The clinics will further diagnose relapse in early stages and thus treat it effectively or prevent it. The continuous care will ensure long-term recovery of the disorder (Waldemar et al., 2015). Additionally, recovery-oriented practices should implement strategies for presenting employment opportunities for the psychotic patients. For instance, the physicians can clear the patients and recommend them for jobs (Strand et al., 2017). Moreover, the clinics can develop programs that create awareness that will lead to employment of the patients. The clinics can also work with the government and private firms in the struggle to provide jobs for the patients. Consequently, working will provide the patients with a sense of normality which helps in increasing functionality (Kline & Thomas, 2018). Moreover, relapse occurrence will decline. Similarly, while working, patients will be around other people which helps in their acceptance in the community.
Importance of Early Intervention for Better Prognosis
Help-seeking duration often delays early intervention (O’Donoghue et al., 2018). Delayed intervention increases the DUP which leads to poor outcomes. Therefore, a recovery-oriented health center should employ techniques that encourage early intervention. For instance, the mental health care facilities should be easily accessible and open 24/7 (Hetrick et al., 2017). Advertisements should be undertaken to ensure that the community is aware of the services offered and the accessibility of the center. Additionally, the skilled specialist should be hired to help reduce the assessment time (Schmidt et al., 2015). Moreover, the center should engage in mental health education to educate patients and the wider communities on psychosis and how to access assistance. The community awareness will further help in the stigmatisation of psychotic patients (Iyer et al., 2015). Enhancing early intervention will help enhance the treatment plan since the prognosis will be better. Physicians will be able to note where medication is mandatory or whether therapy will be effective. Therefore, treatment will be implemented for patients to increase functionality at a faster rate. Furthermore, shorter DUP results in better response to antipsychotics thus improving the possibility of a good recovery.
Other merits of early intervention include a reduced impact on the disruptive nature of psychosis in teenagers. Psychosis affects the overall growth in studies, sexual and social development. Therefore, early intervention will entail faster treatment thus faster return to their development process. Moreover, psychotic patients, not all, pose a physical danger to themselves and their surroundings. Therefore, the early prognosis will help reduce the duration of the possible risk of harm (Iyer et al., 2015). Longer DUP is associated with the constant development of psychosis symptoms such as depression which may result in social isolation and suicide (Nordentoft et al., 2014). Therefore, early intervention reduces the adverse development of such symptoms.
After the prognosis, the recovery-oriented health care centers will need to implement measures to reduce the risk of relapse. The centers need to enrich the patients’ insight into psychotic disorder by providing education about the condition (Le Boutillier et al., 2015). Consequently, patients will be able to understand their situation better which will enhance their involvement in their recovery plan. Moreover, the clinics should encourage family involvement since they will form a support network for the patients (Pincus et al., 2016). Family involvement can be encouraged by organising family therapy sessions (Gladding, 2015). To further reduce the risk of relapse, recovery-oriented mental centers should address substance misuse or dependence (Strand et al., 2017). Substances such as hallucinogens are catalysts for psychosis relapse. Drug use can also induce the development of the psychotic disorder. To avoid relapse measures such as support groups should be implemented to curb the problem of drug use and independence (Sabbioni et al., 2018). Moreover, for total addicts, rehabilitation sessions should be implemented to help the psychotic patient overcome.
Conclusion
Delayed psychosis treatment leads to the development of adverse symptoms that pose a risk to patients and those around them. Therefore, recovery-oriented practices should employ measures that will reduce the duration of untreated psychosis such as creating community awareness of the disorder. Moreover, timely assessment techniques should be implemented for faster treatment plans. The various treatments plan for psychosis involves pharmacotherapy which refers to the use of antipsychotics to curb the disorder. The treatment plan requires consistency to avoid the risk of relapse. Therefore, caregivers should engage patients in the decision of the drug to use. Patient involvement enhances the degree by which patients will take care of their recovery and thus avoid relapse. Another treatment plan is the use of psychotherapy. Individual therapy sessions increase psychotic patients’ insight on the disorder and thus helps them manage it better. Additionally, therapy helps them develop social skills that play a big role in patients’ rehabilitation into the society.
CBT helps patients change their behaviour which in turn affects their feelings. The methods entail strengthening the connection between brain chemicals and psychosis which aid in the recovery process. Family therapy and community support programs further help psychotic patients in the recovery plan. To ensure that the recovery is consistent and thus reducing the risk of relapse, recovery-oriented practices should employ measures that reduce the possibility of relapse. For instance, the centres should address the use and dependence of substances such as hallucinogens since they act as relapse catalysts and can also induce psychosis onset. The patients should be treated with integrity and all their rights upheld. Furthermore, they should be engaged in all issues pertaining to their health.
TOTAL WORD COUNT = 2490 words.
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