Ch. 15 - Treatments for Schizo

Question 1

Today’s treatments ____ _____ for patients, families, and communities

Answer 1

varies dramatically

Question 2

Severe mental disorders are very difficult to treat, only ______ of people with schizo receive ________ _____

Answer 2

40%; adequate care

Question 3

What happened in 1955 regarding mental institutions?

Answer 3

states throughout the US were required by law to establish public mental institutions (state hospitals) for those who couldn’t afford care.

Question 4

Social breakdown syndrome

Answer 4

~ extreme withdrawal, anger

~ loss of interest in appearance and functioning

Question 5

Milieu Therapy

Answer 5

~ based on humanistic principals
~created social climate that promoted productive activity, self-respect, and responsibility in hopes to help patients
~ moderate success

Question 6

Token Economy

Answer 6

~ based on operant conditioning principles
~ used in institutions to change behavior of patients w schizo
~ patients rewarded (tokens) when behaved in socially acceptable ways and aren’t rewarded when they behave unacceptably

Question 7

Beginnings of antipsychotic drugs

Answer 7

~ discovered in 1950s

~ chlorpromazine (thorazine) approved in 1954

Question 8

Types of antipsychotic drugs

Answer 8

~ Conventional or 1st gen (60s-80s: produced undesired movement effects)
~atypical or 2nd gen (developed in recent years)

Question 9

Effectiveness of antipsychotic drugs

Answer 9

~ symptoms reduce in about 70% of patients
~ more effective than any other approach used alone
~ (+) symptoms are reduced more completely/quickly than (-) symptoms

Question 10

1st gen: Extrapyramidal effects

Answer 10

~ medication induced movement disorders

~disturbing movement problems from antipsychotic drugs (can be reduced w anti-parkinsonian drug)

Question 11

1st gen: Medication-induced movement disorders

Answer 11

1. neuroleptic malignant syndrome (elderly)

2. Tardive dyskinesia

Question 12

1st gen: Tardive Dyskinesia

Answer 12

~ tic-like involuntary movements usually of the mouth, lips, tongue, legs, or body
~ affects more than 10% taking drugs
~ difficult sometimes impossible to eliminate

Question 13

2ng gen: antipsychotic drugs

Answer 13

~ as or more effective than 1st gen

Question 14

1st gen vs 2nd gen drugs

Answer 14

2nd gen causes:
~ fewer extrapyramidal side effects
~ less likely to cause tardive dysk
~ agranulocytosis (risk of life-threatening drop in white blood cells)

Question 15

Psychotherapy

Answer 15

~ more successful than schizo treatment

~ cog-beh & socio-cultural therapies

Question 16

Psychotherapy: Cog-beh

Answer 16

~ change how individs view and react to their hallucinatory experiences

1. cognitive remediation
2. avatar therapy

Question 17

cognitive remediation

Answer 17

~ psychotherapy that focuses on difficulties in attention, planning and memory

Question 18

Avatar therapy

Answer 18

~ clients interact with computer-generated on-screen virtual human figures who sound and look mean
~ decreased hallucinations, depressions, suicidal thoughts

Question 19

New Wave cognitive-behavioral therapies…

Answer 19

help clients to accept their stream of problematic thoughts

Question 20

Family therapy

Answer 20

~ addresses family-related issues & psychoeducation
~ over 50% of ppl recovering from schizo live with family members
~ those who live with members of high levels of expressed emotion are more likely to relapse than living w supportive members

Question 21

Social therapy (personal)

Answer 21

~ addressed social and personal difficulties in clients lives: practical advice, problem solving, decision making, social skill training, med management, counseling, housing etc
~ reduces hospitalization

Question 22

Community approach to therapy

Answer 22

~ CMHA (1963) patients should b able to recieve care in their own communities rather than being transported far from home
~ massive deinstitutionalization of patients w schizo
~ assertive community treatment

Question 23

Other key features of community approach

Answer 23

~ coordinated services

~ short-term hospitalization

Question 24

Features of effective community care

Answer 24

~ partial hospitalization (daily supervised activities and programs to improve social skills
~ supervised residences (Halfway houses, etc)
~ occupational training and support

Question 25

Community treatment failure

Answer 25

~ 40 - 60% of all people w schizo receive no treatment at all
~ poor coordination services & shortage of services

Question 26

Poor coordination of services

Answer 26

challenges:
~ failure of communication between and within community agencies
~ poor communication between state hospitals and community health centers
Solution
~ case managers

Question 27

Shortage of services

Answer 27

~ primarily for economic reasons

Question 28

how many homeless ppl in America suffer from sever metal disorders?

Answer 28

one-third

Question 29

Bottom line for community approach to treatment:

Answer 29

proper community care has shown great potential for assisting in recovering from schizo & well-coordinated community treatment is crucial solution to severe mental dysfunction

Question 30

Experts say that prisons and jails…

Answer 30

have become the country’s largest mental health institutions

~ 16 -20% of prisoners are mentally ill