The following paper will present a clinical assessment of the subject, provided by a Mental State Examination (MSE), in order to produce a diagnosis consistent with the current ICD-10 and DSM-IV-TR classifications of psychiatric disorders. After determining a diagnosis of the patient's mental disorder, and presenting a summary of the clinical issues surrounding it, it will proceed to explore the developmental concerns associated with the client before determining an effective model of service delivery. Subsequently, the Canadian Model of Occupational Performance (CMOP), developed by the Canadian Association of Occupational Therapists, will be applied to the case study. The paper will outline and describe the proposed plan of clinical intervention for the patient, and will conclude with observations on the expected effectiveness and applicability of treatment.
Adrian is a nineteen year old Australian male displaying symptoms consistent with the onset of early-episode psychosis. He has reportedly become increasing withdrawn in the past six months, displaying an erratic and declining attendance at his university studies and a failing to attend his examinations. Adrian has demonstrated stable, paranoid delusional thoughts, including auditory hallucinations, claiming that Australian Security Intelligence Organization (ASIO) agents were conspiring to assume his identity and to kill him.
[...] He reports to using alcohol 2-3 times per week, and to consuming cannabis nearly daily reporting the use of 3-4 cones Diagnosis By the ICD-10 definitions for mental and behavioral disorders, Adrian is demonstrating symptoms which could be classified as indicators for paranoid schizophrenia. “Paranoid schizophrenia is dominated by relatively stable, often paranoid delusions, usually accompanied by hallucinations, particularly of the auditory variety, and perceptual disturbances” [ICD-10, 2007]. While many disorders possess psychotic symptoms, the DSM-IV-TR lists nine formal psychotic disorders. [...]
[...] Concomitantly, Adrian should be continued on the Risperidone under appropriate medical supervision, as the effects and consequences of the medication ought to be sufficiently monitored as a means of treatment toward managing his acute early episode psychosis. As such, a psychiatric doctor ought to be available to assist him with developing a dosage schedule and to monitor and prescribe a regiment of psychotropic medications, and to review their side-effects and results in conjunction with his rehabilitation efforts. As Adrian is at present living with his parents, he is not in immediate risk of requiring direct housing intervention as a result of being unable to support and shelter himself. [...]
[...] The goals of using the COPM interview in conjunction with the CMOP model of occupational therapy are to be as follows: to involve the patient in self-care thereby enabling him to participate into his treatment; to analyze the progress (or lack thereof) associated with the client's performed occupations as a result of therapy; to encourage the social involvement and development of autonomy and positive interaction in the patient to counteract the early onset of schizophrenia; and to offer the patient a sense of control over managing his illness, and the productive factors in his life. [...]
[...] His absenteeism and under-performance should be viewed as consequences of the early onset of untreated schizophrenia, and recognized as a disability which is receiving clinical treatment. The alternative option is to encourage Adrian to find supported employment as a means of vocational rehabilitation to assist him in securing competitive employment through direct placement in a community job. Graske finds that SE programs result in patients exercising more control over their career choices due to the client-centered approach of such initiatives utilized [Graske, 2003]. [...]
[...] Depending upon the services offered, he could receive extraneous assistance with his course-work and academic requirements, and counseling services which will assist him in the directed selection of a particular field of academic interest Programme Outcome As schizophrenia is a progressively disabling illness without proper treatment and mitigation methods, and is a chronic mental disorder which will accompany the patient throughout his or her life, it is necessary to note that any treatment outcome will not the patient from the disability. [...]
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