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Professional Referral Process when Students are Referred to the School Counselor

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Professional Referral Process when Students are Referred to the School Counselor

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Supporting Students Experiencing Early Psychosis

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Supporting Students Experiencing Early Psychosis

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What Are Psychotic Disorders?

Psychotic disorders are mental disorders in which a person's personality is severely confused and that person loses touch with reality. When a psychotic episode occurs, a person becomes unsure about what is real and what isn't real and usually experiences hallucinations, delusions, off-the-wall behavior, chaotic speech and incoherency. A person behaving in this manner is often referred to as being schizophrenic.

A hallucination is an internal sensory perception that isn't actually present and can be either visual or auditory. Smelling odors or having a funny taste in the mouth are other hallucinations that may occur. A delusion is defined as a false, inaccurate belief that a person holds on to. A grandiose delusion occurs when a person believes that their life is out of proportion as compared to what is really true. For example, a patient may believe that she is God or Jesus Christ. A persecutory delusion occurs when a person believes that there is a conspiracy amongst others to attack, punish or harass him. Although these hallucinations and delusions appear odd to others, they are very real to the person with the disorder.

What Are the Types of Psychotic Disorders?

Schizophrenia

The most common psychotic disorder is schizophrenia. Patients with this condition experience changes in behavior, delusions and hallucinations that last longer than six months. Those diagnosed with this type of disorder often show a decline in social function, school and work.

Schizoaffective Disorder

Patients with schizoaffective disorder have symptoms of both a mood disorder, such as depression and schizophrenia.

Schizophreniform Disorder

When a patient with schizophrenia has symptoms that last fewer than six months are diagnosed with schizophreniform disorder.

Brief Psychotic Disorder

When a patient has only short, sudden episodes of psychotic behavior, the condition is diagnosed as brief psychotic disorder. These episodes are typically a response to a stressful situation and usually last less than a month.

Delusional Disorder

Patients that have false, fixed beliefs involving real-life situations that could be true, such as having a disease or being conspired against, are diagnosed with delusional disorder. These delusions persist for at least one month.

Substance-Induced Psychotic Disorder

Sometimes, withdrawal from substances like methamphetamines and alcohol cause delusions and hallucinations. This is known as substance-induced psychotic disorder.

Psychotic Disorder Due to a Medical Condition

When psychotic disorder symptoms are a result of illnesses that affect the function of the brain, such as a brain tumor, the patient is diagnosed with psychotic disorder due to a medical condition.

Paraphrenia

Paraphrenia is schizophrenia in elderly patients.

Who Can Get a Psychotic Disorder?

Approximately 1 percent of the population suffers from a psychotic disorder. These conditions are most commonly found in people in their late teens to early thirties and effects men and women equally. Like many other mental disorders, psychotic disorders are often genetic. People who have a family member with this type of disorder are more likely to develop it than those who do not have a family history of it. It is also believed that these disorders are related to the hyper activity of chemicals in the brain that are vital to normal functioning. Additionally, those who experienced brain injury during fetal development or childhood are at a higher risk of developing the condition.

How Are Psychotic Disorders Diagnosed?

If the symptoms of a psychotic disorder appear in an individual, the doctor will conduct a physical exam as well as gather medical history. Once physical reasons for the abnormal behaviors are ruled out, the doctor will then refer the patient to a psychiatrist. Psychiatrists have a specific set of tools to properly diagnose a psychotic disorder.

How are Psychotic Disorders Treated?

The two main forms of treatment for psychotic disorders are medication and psychotherapy. The signature medications to treat psychotic disorders are antipsychotics. These medications aid in managing the symptoms of the disease like the hallucinations and delusions. Some examples of antipsychotics are pimozide, haloperidol, chlorpromazine and amisulpride. Depending on how each individual is affected by the medications, it may be necessary for the doctor to prescribe more than one consecutively until the proper medication is found that meets the required results.

Psychotherapy for psychotic disorders may include individual sessions, family sessions and support groups. While most patients are treated as outpatients, in severe cases, such as when the physical well-being is in danger, hospitalization may be necessary to stabilize the patient's condition.

In addition to medication and psychotherapy, self-help can also aid in successfully managing living with psychotic disorders. It is important that the patient learn how to cope when these episodes occur and learn how to find help on treating someone with psychosis. Studying and learning as much as possible about the specific disorder is vital to managing a healthy, happy, fulfilling life.

What Is the Prognosis for Those with Psychotic Disorders?

Many people who have been diagnosed with a psychotic disorder tend to lead productive lives and function normally with the proper treatment. The prognosis for those with psychotic disorders varies from person to person. For example, women tend to respond better to medication than men. Those with a family history of illness have a lower prognosis than those without. The number of negative symptoms also determines the individual prognosis as well as age; the older the patient, the more promising prognosis. Another important factor in determining prognosis is the individual's support system. Most will never fully recover from or be cured of psychotic disorders and will need to continue treatment for the duration of their lives. To maintain mental and physical stability with the condition, it is important for patients to strictly follow the treatment of psychotic disorders recommended by their healthcare providers.

For more on the topic of Psychotic Disorders, we've included the following expert consensus documents as reference materials:

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What Are Psychotic Disorders? Psychotic disorders are mental disorders in which a person's personality is severely confused and that person loses touch with reality. When a psychotic episode occurs, a person becomes unsure about what is real and what isn't real and usually experiences hallucinations, delusions, off-the-wall behavior, chaotic speech and incoherency.

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What is Obsessive Compulsive Disorder? How do I help students who may have OCD?

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What is Obsessive Compulsive Disorder? How do I help students who may have OCD?

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Suffering in Silence- Examining OCD in School Setting

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Oppositional Defiant Disorder

No. 72; Reviewed January 2019

All children are oppositional from time to time, particularly when tired, hungry, stressed, or upset. They may argue, talk back, disobey, and defy parents, teachers, and other adults. Oppositional behavior is a normal part of development for two to three year olds and early adolescents. However, openly uncooperative and hostile behavior becomes a serious concern when it is so frequent and consistent that it stands out when compared with other children of the same age and developmental level and when it affects the child's social, family, and academic life.

In children with Oppositional Defiant Disorder (ODD), there is an ongoing pattern of uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with the child's day to day functioning.

Symptoms of ODD may include:

Frequent temper tantrums

Excessive arguing with adults

Often questioning rules

Active defiance and refusal to comply with adult requests and rules

Deliberate attempts to annoy or upset people

Blaming others for his or her mistakes or misbehavior

Often being touchy or easily annoyed by others

Frequent anger and resentment

Mean and hateful talking when upset

Spiteful attitude and revenge seeking

The symptoms are usually seen in multiple settings but may be more noticeable at home or at school. One to sixteen percent of all school-age children and adolescents have ODD. The causes of ODD are unknown, but many parents report that their child with ODD was more rigid and demanding than the child's siblings from an early age. Biological, psychological, and social factors may have a role.

A child presenting with ODD symptoms should have a comprehensive evaluation. It is important to look for other disorders which may be present, such as attention-deficit hyperactivity disorder (ADHD), learning disabilities, mood disorders (depression, bipolar disorder), and anxiety disorders. It may be difficult to improve the symptoms of ODD without treating the coexisting disorder. Some children with ODD may go on to develop conduct disorder.

Treatment of ODD may include:

Parent Management Training to help parents and others manage the child's behavior

Individual Psychotherapy to develop more effective anger management

Family Psychotherapy to improve communication and mutual understanding

Cognitive Problem-Solving Skills Training and Therapies to decrease negativity

Social Skills Training to increase flexibility and improve social skills and frustration tolerance with peers

Medications may be helpful in controlling some of the more distressing symptoms of ODD as well as the symptoms related to coexistent conditions such as ADHD, anxiety, and mood disorders.

A child with ODD can be very difficult for parents. These parents need support and understanding. Parents can help their child with ODD in the following ways:

Always build on the positives, give the child praise and positive reinforcement when s/he shows flexibility or cooperation.

Take a time-out or break if you are about to make the conflict with your child worse, not better. This is good modeling for your child. Support your child if s/he decides to take a time-out to prevent overreacting.

Pick your battles. Since the child with ODD has trouble avoiding power struggles, prioritize the things you want your child to do. If you give your child a time-out in his room for misbehavior, don't add time for arguing. Say "your time will start when you go to your room."

Set reasonable, age appropriate limits with consequences that can be enforced consistently.

Maintain interests other than your child with ODD, so that managing your child doesn't take all your time and energy. Try to work with and obtain support from the other adults (teachers, coaches, and spouse) dealing with your child.

Manage your own stress with healthy life choices such as exercise and relaxation. Use respite care and other breaks as needed.

Many children with ODD will respond to the positive parenting techniques. Parents may ask their pediatrician or family physician to refer them to a child and adolescent psychiatrist or other qualified mental health professional who can help diagnose and treat ODD and any coexisting psychiatric condition.

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Oppositional Defiant Disorder No. 72; Reviewed January 2019 All children are oppositional from time to time, particularly when tired, hungry, stressed, or upset. They may argue, talk back, disobey, and defy parents, teachers, and other adults. Oppositional behavior is a normal part of development for two to three year olds and early adolescents.

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Attention Deficit Hyperactivity Disorder Fact Sheet

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Attention Deficit Hyperactivity Disorder Fact Sheet

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Definition of Disorder
Symptoms
How to Help

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Definition of Disorder
Symptoms
How to Help

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1. Oppositional Defiance Disorder
2. Conduct Disorder
3. Attention Deficit Hyperactivity Disorder

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Bipolar Disorder and How to Help Students

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Bipolar Disorder and How to Help Students

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Different Types of Eating Disorders Defined and How School Counselors Can Help

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Different Types of Eating Disorders Defined and How School Counselors Can Help

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Module 3 - Educating Others on Eating Disorders

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1. Anorexia Nervosa
2. Bulimia Nervosa
3. Binge Eating Disorder
4. Other Eating Problems