Counselor Toolbox Podcast with DocSnipes

1010-Practical Tools to Support Those with Psychosis _ Counselor Training

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1. Introduction

2. Understanding Psychotic Symptoms

  • Symptoms Defined: Psychotic symptoms include hallucinations, delusions, disorganized behavior, and speech.
  • Associated Disorders:

    3. Causes of Psychotic Symptoms

    • Breakthrough Symptoms: These can occur even in individuals who are generally functional.
    • Causes:
    • Unmedicated State: By choice or due to forgetfulness.
    • Medication Non-compliance: Due to side effects or difficulty maintaining a regimen.
    • Stress: A major trigger for acute episodes.
    • Medication Imbalances: Can be caused by dehydration, heat, dietary changes, weight fluctuations, and drug interactions (e.g., antibiotics, caffeine, nicotine).
    • Other Factors: Conditions like hypoglycemia, severe sleep deprivation, and chronic stress can exacerbate symptoms.

      4. Strategies for Support

      • Medication Management: Ensuring compliance and adjusting for lifestyle changes.
      • Stress Reduction:
      • Identify stressors (physical, cognitive, emotional) and work to mitigate them.
      • Develop emergency plans to address prodromal symptoms (early signs of relapse).
      • Cognitive Behavioral Therapy (CBT) for Psychosis:
      • Typically more effective during remission than in acute episodes.
      • Focuses on reducing symptoms, distress, and interference with quality of life.
      • Techniques include relaxation training, graded exposure, scaffolding, and activity scheduling.
      • Environmental Modifications: Adjusting surroundings to minimize stressors and support daily functioning.

        5. Recognizing and Managing Prodromal Symptoms

        • Prodromal Symptoms:
        • Chronic anxiety, mood swings, sleep disturbances, memory problems, social withdrawal, decline in hygiene, and inability to perform daily tasks.
        • Early Intervention: Recognizing these signs allows for early intervention to prevent full-blown episodes.

          6. Addressing Hallucinations and Delusions

          • Safety and Reality Testing:
          • Initially, join the individual in their reality to establish safety.
          • Avoid arguing or reasoning with delusional beliefs during acute episodes.
          • Use CBT techniques to challenge and reframe delusions during remission.
          • Behavioral Strategies: Encourage comparison of their behavior to others, use of distraction techniques, and reinforcing positive behaviors.

            7. Enhancing Functionality

            • Daily Living Support: Use lists, schedules, and guides to help individuals manage daily tasks.
            • Token Economies: Reward systems to encourage participation in therapeutic activities.
            • Environmental Prompts: Reminders and tools to support memory and task completion.

              8. Cognitive and Executive Functioning

              • Support Strategies:
              • Break tasks into smaller components (chunking).
              • Minimize distractions and create structured environments.
              • Roleplay problem-solving scenarios.
              • Use alarms and reminders for medication and daily tasks.
              • Cognitive Behavioral Therapy (CBT): Applied during remission or prodromal phases to manage residual symptoms and improve quality of life.

                9. Final Considerations

                • Relapse Prevention:
                • Continuous monitoring of stress levels and medication effectiveness.
                • Developing a strong support system and improving stress management skills.
                • Therapeutic Engagement: Ensuring clients feel safe and validated in discussing their symptoms.

                  10. Conclusion

                  Further Resources: Dr. Snipes mentions an upcoming on-demand class for more in-depth learning about CBT for psychosis.



                  Chapters:

                  00:00:00 - Supporting Functional Individuals with Psychotic Symptoms

                  00:06:51 - Factors Affecting Psychosis Management

                  00:13:38 - Managing Prodromal Symptoms and Breakthrough Episodes

                  00:20:25 - Understanding and Supporting Disorganized Behavior

                  00:27:09 - Token Economy and Motivational Enhancement

                  00:34:00 - Scaffolding for Learning and Cognitive Impairment

                  00:40:43 - Managing Hallucinations and Delusions

                  00:47:14 - Understanding the Pre-Delusional Beliefs

                  00:54:14 - Addressing Hallucinations and Delusions

                  01:00:58 - Understanding Cognitive Behavioral Therapy for Psychosis

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                  Counselor Toolbox Podcast with DocSnipesBy Dr. Dawn-Elise Snipes
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