Decision One: Differential Diagnosis
Carrie is a 13-year-old and displays a different behavior with those of her agemates. Based on the information provided by her parents and an examination of Carrie's condition, she is probably suffering from a mental health disorder. Carrie has early-onset schizophrenia, a condition that is rare but can occur in early childhood ( Grover & Avasthi, 2019) . The reasons behind this diagnosis are, first and foremost, Carrie experiences hallucinations. She has imaginary friends and talks with people who are not real. She has superior imaginations and has half-cat and half-human friends. In addition to that, she talks with "spirits" in her head. Likewise, her parents describe her as calm and have no signs of violence. She is also passive, yet she becomes so irritable sometimes, something her parents find strange. Also, Carrie has been lagging in her development milestones due to a sluggish condition she has developed over time. Carrie has a family history of schizophrenia; her grandfather was schizophrenic.
What Were You Hoping to Achieve by Making This Decision?
The diagnostic findings were meant to establish the correct underlying issue observed by her parents and physical characteristic and mental state exhibited by the patient to ascertain the extent of the problem ( Ferrin, Gosney, Marconi & Rey, 2016).
Delegate your assignment to our experts and they will do the rest.
Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?
Some noticeable differences in symptoms were: Carrie's alertness and speech clarity. She seems pleasant and preoccupied with herself, claiming she has been misunderstood. Unexpectedly Carrie looks organized in her dressing and choice of clothing. In addition to that, her speech is not disorganized; for instance, she is coherent and has no frequent derailment. Carrie is not suffering from schizoaffective disorder since she does not have mood disorders ( Zheng et al., 2016) . Carrie describes her mood as good.
Decision 2: Plan for Psychotherapy Treatment
Why Did You Select This Decision?
Research has shown that early-onset schizophrenia can be treated by psychotherapy ( Ferrin, Gosney, Marconi & Rey, 2016). I chose the psychodynamic approach to remedy Carrie's condition. Although not considered as the first line of treatment, this approach helps schizophrenic individuals, particularly in treating residual symptoms (Veerman, Schulte & de Haan, 2017).
What Were You Hoping to Achieve by Making This Decision?
The expectations are the approach will make Carrie proactive; it will reduce hallucinations and imaginary friends. Carrier will become social and gain new real-life friends.
Explain Any Difference Between What You Expected to Achieve with Decision #2 and the Results of the Decision.
Carrie still experiences hallucinations; she thinks that teachers don't understand what she thinks and that they fail her. She has not responded well to passivity and keeps isolating herself from others. Carrie is preoccupied, and her parents still complain that her condition has not improved. The perceived changes have not been achieved because the psychodynamic approach has not alleviated her schizophrenic disorder. Maybe her condition started a long time, but the onset symptoms were not sudden ( Grover & Avasthi, 2019) . Carrie's condition requires the use of medicine.
Decision 3: Psychopharmacology
Why Did You Select This Decision?
Paranoid schizophrenia is the likelihood of the cause of Carrie's myriad of problems. Administering drugs is deemed appropriate because psychotherapy has yielded no results. Lurasidone will be administered to Carrie; this drug is preferred since it has the least impact on weight and lipid-protein ( Ferrin, Gosney, Marconi & Rey, 2016) . Haldol should be initiated at 0.5 mg orally daily, with a target dose of 0.05 to 0.15 mg/kg per day for psychotic disorders.
What Were You Hoping to Achieve by Making This Decision?
There were no expectations of significant weight gains and alterations of lipid proteins profile. There are also no fluctuations in sugar level and blood pressure.
Explain Any Difference Between What You Expected to Achieve with Decision #2 and the Results of the Decision.
There was an increase in weight gain, but the conditions experienced by Carrie persisted. The reason could be the drugs were not taken as prescribed, or the patient needs a different drug specification.
Ethical Considerations on the Treatment Plan and Communication with Clients and Their Families
Ethical issues impact not only people with mental health issues but also individuals' healthy behaviors. Abuse of the patient reduces the benefits of psychotherapy. Good moods and close relations are established when ethics precede ( Fitzpatrick, 2016) . Respect and display of friendly gestures are vital for the success of mental treatment. Unethical considerations lead to miscommunication both with the client and her parents. Lack of ethics can, therefore, provoke the use of psychopharmacology as a decision ( Fitzpatrick, 2016) .
References
Ferrin, M., Gosney, H., Marconi, A., & Rey, J. M. (2016). Using antipsychotic medication for the treatment of schizophrenia in children and adolescents. Geneva: International Association for Child and Adolescents Psychiatry and Allied Professions (IACA PAP) Textbook of Child and Adolescent Mental Health .
Fitzpatrick, J. J. (2016). Moral and Ethical Issues in Mental Health. Archives of psychiatric nursing , 30 (6), 647.
Grover, S., & Avasthi, A. (2019). Clinical practice guidelines for the management of schizophrenia in children and adolescents. Indian journal of psychiatry , 61 (Suppl 2), 277.
Veerman, S. R., Schulte, P. F., & de Haan, L. (2017). Treatment for negative symptoms in schizophrenia: a comprehensive review. Drugs, 77(13), 1423-1459.
Zheng, Y., Li, H., Ning, Y., Ren, J., Wu, Z., Huang, R., ... & She, S. (2016). Sluggishness of early-stage face processing (N170) is correlated with negative and general psychiatric symptoms in schizophrenia. Frontiers in human neuroscience , 10 , 615.
