1. Introduction

2. Understanding Psychotic Symptoms

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


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  Associated Disorders:

3. Causes of Psychotic Symptoms

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  Breakthrough Symptoms: These can occur even in individuals who are generally functional.


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  Causes:


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  Unmedicated State: By choice or due to forgetfulness.


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  Medication Non-compliance: Due to side effects or difficulty maintaining a regimen.


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  Stress: A major trigger for acute episodes.


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  Medication Imbalances: Can be caused by dehydration, heat, dietary changes, weight fluctuations, and drug interactions (e.g., antibiotics, caffeine, nicotine).


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  Other Factors: Conditions like hypoglycemia, severe sleep deprivation, and chronic stress can exacerbate symptoms.

4. Strategies for Support

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  Medication Management: Ensuring compliance and adjusting for lifestyle changes.


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  Stress Reduction:


• Identify stressors (physical, cognitive, emotional) and work to mitigate them.


• Develop emergency plans to address prodromal symptoms (early signs of relapse).


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  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.


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  Environmental Modifications: Adjusting surroundings to minimize stressors and support daily functioning.

5. Recognizing and Managing Prodromal Symptoms

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  Prodromal Symptoms:


• Chronic anxiety, mood swings, sleep disturbances, memory problems, social withdrawal, decline in hygiene, and inability to perform daily tasks.


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  Early Intervention: Recognizing these signs allows for early intervention to prevent full-blown episodes.

6. Addressing Hallucinations and Delusions

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  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.


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  Behavioral Strategies: Encourage comparison of their behavior to others, use of distraction techniques, and reinforcing positive behaviors.

7. Enhancing Functionality

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  Daily Living Support: Use lists, schedules, and guides to help individuals manage daily tasks.


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  Token Economies: Reward systems to encourage participation in therapeutic activities.


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  Environmental Prompts: Reminders and tools to support memory and task completion.

8. Cognitive and Executive Functioning

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  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.


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  Cognitive Behavioral Therapy (CBT): Applied during remission or prodromal phases to manage residual symptoms and improve quality of life.

9. Final Considerations

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  Relapse Prevention:


• Continuous monitoring of stress levels and medication effectiveness.


• Developing a strong support system and improving stress management skills.


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  Therapeutic Engagement: Ensuring clients feel safe and validated in discussing their symptoms.

10. Conclusion

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  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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