PSY470 Grand Canyon Schizophrenia A Siblings Tale Article Discussion

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Article Critique 3 After reading Schizophrenia: A Sibling’s Tale, write a paper of 500-750 words in which you address the following questions: 1.What did you think of the article? 2.How did the article relate to topics presented in the textbook? 3.Whatinteresting questions did the article raise for you? 4.Identify the positive and negative symptoms of schizophrenia and give an example of each. 5.Describe the types of therapy discussed in Schizophrenia: A Sibling’s Tale. Use the GCU Library databases and include two to four scholarly sources from the GCU library to support your claims, in addition of the article you are critiquing. In addition to the scholarly resources from the library, you can include past classroom materials as well as your textbook as additional reference material. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Course Code PSY-470 Class Code PSY-470-O101 Criteria Content Percentage 70.0% What interesting questions did the article raise for you? How did the article relate to topics presented in the textbook? 20.0% Identify the positive and negative symptoms of schizophrenia and give an example of each. 20.0% Describe the types of therapy discussed in Schizophrenia: A Sibling?s Tale. 30.0% Organization and Effectiveness 20.0% Thesis Development and Purpose 7.0% Argument Logic and Construction 8.0% Mechanics of Writing (includes spelling, punctuation, grammar, language use) 5.0% Format 10.0% Paper Format (use of appropriate style for the major and assignment) 5.0% Research Citations (in-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment and style) 5.0% Total Weightage 100% Assignment Title Article Critique 3 Unsatisfactory (0.00%) Does not identify questions raised by article. Does not identify how the topics relate to the textbook. Does not identify the positive and negative symptoms of schizophrenia, nor are examples given. Description of types of therapy is missing. Paper lacks any discernible overall purpose or organizing claim. Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used. Template is not used appropriately, or documentation format is rarely followed correctly. No reference page is included. No citations are used. Total Points 50.0 Less than Satisfactory (65.00%) Questions raised by article and how the topics relate to the textbook are missing or vague. Identification of positive and negative symptoms of schizophrenia each example is vague or incomplete. Description of the types of therapy discussed in the article is vague or incomplete. Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) and/or word choice are present. Sentence structure is correct but not varied. Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent. Reference page is present. Citations are inconsistently used. Satisfactory (75.00%) Questions raised by article and how the topics relate to the textbook are appropriate and complete. Identification of the positive and negative symptoms of schizophrenia is present. An example of each symptom is appropriate. Description of the types of therapy discussed in the article is adequate and clear. Thesis and/or main claim are apparent and appropriate to purpose. Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. Appropriate template is used. Formatting is correct, although some minor errors may be present. Reference page is included and lists sources used in the paper. Sources are appropriately documented, although some errors may be present Good (85.00%) Questions raised by article are thoughtful. Provides relevant examples of how the topics relate to the textbook. Identification of the positive and negative symptoms of schizophrenia is insightful. An example of each symptom is appropriate and makes connections to readings. Description of the types of therapy discussed in the article is insightful and makes connections to topic reading. Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose. Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. Appropriate template is fully used. There are virtually no errors in formatting style. Reference page is present and fully inclusive of all cited sources. Documentation is appropriate and citation style is usually correct. Excellent (100.00%) Questions raised by article are thoughtful and insightful. Provides relevant, well-researched examples of how the topics relate to the textbook. Identification of the positive and negative symptoms of schizophrenia is thoughtful and well-researched. An example of each symptom provides relevant examples. Description of types of therapy discussed in the article is wellresearched and provides relevant examples. Thesis and/or main claim are comprehensive. The essence of the paper is contained within the thesis. Thesis statement makes the purpose of the paper clear. Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. Writer is clearly in command of standard, written, academic English. Comments All format elements are correct. In-text citations and a reference page are complete and correct. The documentation of cited sources is free of error. Points Earned Feature SCHIZOPHRENIA: a sibling’s tale A diagnosis of psychosis can have a devastating effect on close family members of the person concerned. Stephan Kirby introduces Leanne Bowman’s account of living with a brother who was diagnosed with schizophrenia five years ago Summary Stephan Kirby suggests that mental health professionals need a greater insight into the effects a diagnosis of serious mental illness has on family members. Leanne Bowman’s account explains how her brother’s diagnosis was received and how living with him since then has introduced new challenges to her life. Keywords Serious mental illness, schizophrenia, siblings, advocacy As an occasional user of mental health services, and a mental health nurse of many years’ standing, I have some insight into the needs, requirements and problems facing mental health professionals and the users and carers we come into contact with. But the one thing I have never given much thought to over the years, apart from as an academic or professional requirement, was how my own mental health issues were affecting and had affected loved ones around me. As professionals, we know it makes sense to foster relationships with service users, based on listening and understanding. But from political and common-sense points of view it is vital to remember to listen to our patients’ carers, their parents, siblings, children and other loved ones, and understand what the experience of mental illness is like for them, as well as for the patient in our care. I met Leanne, a mental health nursing student, when she was embarking on her final year of study. 18 September 2009 | Volume 13 | Number 1 When preparing some work for me, Leanne was open and honest when discussing her brother’s major mental illness and the effect it had and was having on her family life and her training. We hope this paper offers readers an insight into the trials and tribulations faced when a close family member has a serious mental illness. We hope readers will gain an understanding of what it is like to have a sibling diagnosed with schizophrenia. In what follows there is a discussion about the feelings, isolation and stigma encountered by Leanne when she learnt that her brother ‘was schizophrenic’, a term we accept is not politically correct. It shows the importance of appropriate support from mental health services and professionals to enable families to cope effectively with the situation. Leanne Bowman’s story ‘I am a third-year mental health nursing student and by no means an expert on schizophrenia. But I can explain how the condition affects the family because my brother Jamie (not his real name) was diagnosed with this severe and enduring mental illness when he was 18 years old. Our mother is his primary caregiver and I am the secondary, but no less involved, carer. ‘When Jamie was diagnosed in 2003 I experienced a mixture of feelings and emotions. First, I felt a great sense of loss, almost like a bereavement. In a sense it was a bereavement because, while Jamie looked the same, he acted very differently from the brother I knew. This process is described by Kuipers et al (2002) who identify two types of loss: the loss MENTAL HEALTH PRACTICE Jim Varney Feature ‘I felt that because I was the older sibling I had the responsibility to protect my brother from suffering, but I had somehow failed him’ Leanne Bowman MENTAL HEALTH PRACTICE September 2009 | Volume 13 | Number 1 19 Feature of the person we knew and the loss of the hopes and aspirations we had for them. I also experienced “survivor’s guilt” (Kuipers et al 2002) because I was the “normal one” and had managed to escape the suffering of being mentally ill. I felt that because I was the older sibling I had a responsibility to protect my brother from suffering, but I had somehow failed him. I also felt frustrated because my mother and I seemed to be doing everything we possibly could to help Jamie, but it was never enough.’ Stigmatisation ‘I had a basic understanding of the term schizophrenia, but probably like many others I had misconceptions and was even scared of the term and its connotations. In society in general there is a stereotyped view of people with mental health problems, especially in the case of schizophrenia. The common misperception is that these people are violent, exhibit sexually inappropriate behaviour and have a split personality (Kuipers et al 2002). Corrigan and Watson (2002) refer to this stigmatisation as “the double misfortune of the mentally ill”. It occurs because of discrimination in areas such as work and independent living and, second, due to the effect of a culture steeped in stigmatising images that are exacerbated by headlines in the national media, such as “Schizophrenic man chops off his mother’s head” (Anon 2004) or “Schizo cabbie knifed six” (Moult 2005). ‘In the five years since my brother was diagnosed we have encountered our share of stigmatisation and isolation. When Jamie first came out of hospital the positive symptoms of his illness (Box 1) appeared to be under control but he was suffering with the negative symptoms and often stated that he felt depressed. As a result, he would often use socially inappropriate coping strategies to lift his depressive state, which more often than not involved taking illicit substances. ‘When Jamie was taking them he became violent and aggressive towards our mother, towards me and his friends. At first, we turned a blind eye and tried to deal with it ourselves because we wanted to protect him and did not want him to get into trouble. Box 1 Positive and negative symptoms As a general rule, positive symptoms are an additional experience, whereas negative symptoms are a reduction in normal experiences: Positive symptoms ■■ Hallucinations. ■■ Delusions. ■■ Thought disorder. ■■ Catatonia. (Brennan G (2009)) 20 September 2009 | Volume 13 | Number 1 Negative symptoms ■■ Lack of volition. ■■ Lack of excitement. ■■ Poverty of thought. ■■ Poverty of speech. But the violence and aggression escalated until it reached the point where we had to call outside help every week to have him removed from the house. ‘This sort of behaviour does nothing to promote a positive image of people with schizophrenia, but I understand that Jamie acted this way because of the substances he was taking. When he is not taking anything, he is a gentle and loving human being, but I do not think our neighbours understood that. ‘Schizophrenia can be devastating not only for the person who is ill, but also the entire family. Among the most vulnerable and most affected are siblings (Friedrich et al 2008), as the unremitting stress affects many aspects of their lives, including relationships, roles and health. I can relate to this because my life has changed dramatically since Jamie’s diagnosis. As a result of his changeable moods and unpredictable behaviour, I stopped inviting friends over because I often felt embarrassed because I did not know what sort of mood he would be in from one minute to the next. ‘I was lucky because my friends understood when I had to cancel plans or if I was late. They knew it was because Jamie’s needs had to come first. On the rare occasions when I managed to meet friends it was hard to focus on the conversation because I was worried something might be happening at home. At times my friends’ problems, such as boyfriend troubles, seemed unimportant compared with what was happening to our family. Chapman (2004), a carer herself, says she was reluctant to mix socially because her son’s illness was always uppermost in her mind.’ Carer experience ‘The relationship with my mother also changed. We had always been close and in some ways we became even closer. But there were times when we would disagree about the best way to deal with a situation. For example, if my mother and I had arranged to go shopping, but Jamie wanted to go somewhere different, his needs came first. If I disagreed with my mother and said we should do as we had planned, neither of us would have been able to enjoy the shopping because we would have worried about how Jamie had reacted to taking second place, so we would cancel our arrangements. ‘The National Service Framework (NSF) for Mental Health Standard 6 states that “carers play a vital role in helping to look after service users of mental health services particularly those with severe mental illness” (Department of Health (DH) 1999). ‘The National Institute for Health and Clinical Excellence (NICE) (2002) also acknowledges that “carers of someone suffering with schizophrenia have an integral role in community mental health care”. Their experiences need to be taken into MENTAL HEALTH PRACTICE Feature account for their own wellbeing and to ensure they can give their loved ones relevant community support. NICE makes it clear that intelligible information about schizophrenia and the possible role families can have in promoting recovery and preventing relapse should be made available to service users and their families. ‘But as a carer I feel let down by mental health services. After Jamie was first admitted to a psychiatric unit under the Mental Health Act 1983, where he spent 28 days, I kept asking to speak to the mental health nurses on the ward to find out how he had been or if they were any closer to a diagnosis, but they always seemed to be too busy to talk to us. On the last day of Jamie’s detention, my mother and I were to our surprise invited to the ward to discuss Jamie’s progress and plans. But the mental health professionals seemed to be talking among themselves and the only time they made eye contact or paid us any attention was when they told us that Jamie’s diagnosis was schizophrenia, that we could take him home and that we would get some support from a mental health team specialising in psychosis. ‘I wanted to shout: “What does that mean?”, “Why did this happen?”, “What can we do to help?” But we were not given the opportunity to ask any questions. ‘The Mental Health Policy and Implementation Guide (DH 2001) states that early intervention in psychosis teams (EIP) are there to support people aged 14-35 years with a first presentation of psychosis and to offer support for the first three years. The guidelines also state that EIP teams should involve families and carers in the assessment and treatment process, as well as offering family therapy and maintaining regular contact with carers. ‘The EIP team did give us some useful information about schizophrenia and had regular contact with Jamie. But I felt that I was disregarded as a carer because I was not the parent or the primary carer. It is important to recognise that the bond between siblings is distinct and can be the longest lasting relationship in some families (Barnable et al 2006). Even if they are not involved in care, siblings can still experience stress by being part of the same household and because of the chronicity of the illness.’ Expressed emotion ‘Despite initial promises, my mother and I were not offered any family therapy. There were times when my brother and I were constantly arguing and being hostile towards one another, due to his unpredictable behaviour. At these points, it would have been useful to have had some knowledge of the stress-vulnerability model (Zubin and Spring 1977), which the EIP teams use to underpin care. But I had not heard of it – or the MENTAL HEALTH PRACTICE I wanted to shout: ‘What does that mean?’, ‘What can we do to help?’ But we were not given the opportunity to ask any questions concept of expressed emotion (EE) (Brewin et al 1991) – until I started nurse training. ‘The theory of EE (Thomas et al 2004) correlates certain family communication patterns with an increase in symptoms and relapse in patients with schizophrenia. I support the idea of EE, but in practice, it is difficult not to make negative comments and to be critical when your sibling is constantly being demanding, and is hostile and aggressive towards you, especially when there has been no offer of support or family interventions to help deal with the situation more positively. ‘My brother too received little help, and was offered only antipsychotic medication. We were told by the mental health professionals that as long as he continued to take his medication he would be “under control”. The drug Jamie was prescribed, amisulpride, is an atypical antipsychotic drug that is a first-line treatment in people newly diagnosed with schizophrenia (NICE 2002). I do not dispute its effectiveness in alleviating some of the positive symptoms of his illness, but he still has auditory hallucinations – even though he will deny this to his mental health worker – and he continues to suffer with the negative symptoms of schizophrenia, particularly a lack of motivation. ‘Jamie’s lack of motivation has a maj ...
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Running head: SCHIZOPHRENIA CASE STUDY

Schizophrenia Case Study
Student’s Name
Institutional Affiliation

1

SCHIZOPHRENIA CASE STUDY

2

Schizophrenia Case Study
Question 1
The article discusses the devastating effects that a diagnosis of psychosis may have on the
family members and immediate colleagues of the person concerned. After reading the article, I
thought it was a very thoughtful piece that allows people to understand the impacts of
Schizophrenia. When this happens, individuals at the societal level can learn of the impacts of
the ailment so that they can help their loved ones and friends who are diagnosed with the
condition. For a long time, the carers, siblings, and members of the family of the patient have not
been looked into and very little research has been conducted on the various experiences that they
go through due to mental illnesses of one of them. By discussing the topic, the article sheds light
on an issue that has been ignored for a long time.
Question 2
The article related topics presented in the textbook in several ways. The first was through
addressing the feelings, stigma, and isolation that affects members of the family when their
sibling is diagnosed with a mental illness. Addressing the concerns of these individuals helps fill
a healthcare gap that has for a long time not been looked into. On many occasions, healthcare
services concentrate on the patient without necessarily assessing how the family is aff...

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