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  • in reply to: How reintegration can look so different for our clients #11380

    Hi Breanne,

    I appreciate your comment about providing education on the phases of recovery. It makes sense that clients would be eager to get back to their day-to-day activities as soon possible after experiencing a psychotic episode. However, clients may not always be aware of the potential consequences of integrating back into life too quickly. I find youth in particular might need extra support in building insight about how stressors can impact their recovery. I think talking about the phases of recovery and helping the youth identify the stage they are is a good starting point to creating a plan for re-integration.

    in reply to: Medication Adherence #11329

    Hi Victoria and Grace,

    I am also new to EPI, so I am in a similar position as Victoria. I am just starting to encounter clients who struggle to take their medication. Currently, I have a client who does not want to take medication because they are concerned about their weight and appearance. This client has been bullied in the past, so it makes sense appearing a certain way is important to them. Grace, I found your suggestion to offer continuous/ongoing psycho-ed helpful. This client was not provided much information on why the medication changes their weight, and they might feel like they have more agency in responding to the side effects if they know why their body is changing in the first place. I also reviewed the suggestions for managing side effects that were provided in this module, and found a youth worker who would be able to help the client participate in regular exercise. Instead of trying to help this client not worry about weight, I want to support them in feeling like they have tools to know how to navigate side effects. I am happy to hear more suggestions on how to navigate medication non-compliance related to weight gain.

    in reply to: Overcoming friction with Families and Care Teams #11169

    Hi all,

    It is so hard to work with families when there is an underlying sense of “us versus them” when it comes to treatment for their loved one, or when the family views the service providers as getting in the way of what they believe would be helpful. I had similar thoughts as Grace surrounding common goals. I really appreciated the exploratory questions surrounding the impact psychosis has had on the family system. These questions made me curious if inquiring about who is shouldering the burden and taking responsibility for decision making, and validating the frustration of having different perspectives of the service provides, would be an avenue to develop shared goals with that family member. If there is some way to get on the same page of the person who is carrying the family stress, I wonder if that would shift the family’s reluctance and hesitancy to listening to psychoeducation and suggestions. That being said, I recognize it is not easy to work with so many moving parts of a system and sometimes families continue to feel resistant despite best efforts.

    in reply to: Challenges of Care with COVID-19 #10898

    Hi Robert, I had similar thoughts (unrelated to the pandemic pieces). As a new mental health clinician, I find it challenging to tease apart what a severe presentation of psychotic symptoms looks like, versus what an ’at-risk’ presentation looks like. At this stage in my understanding, I think relying on assessments provides a helpful foundation to understand my client’s symptoms more fully. For example, I have found that familiarizing myself with the domains on the CAARMS has helped me start to identify and categorize clients’ symptoms more accurately. Further, familiarity with this assessment has helped me shape my questions in sessions to elicit more relevant information surrounding the severity, frequency, and duration of a client’s symptoms.
    I think using a tool like the 2-COM could serve a similar function – to help structure a session and draw out relevant information from the client’s experience, like you mentioned. This could be particularly helpful when a client is unsure of what information is necessary to share, with the added function of helping a clinician shape the goal of their session. It is nice to hear about how other clinicians new to EPI are processing the material.

    in reply to: Family Involvement #10610

    Hi Christina and Jacob,

    Thanks for sharing. I have had similar experiences when a family’s explanatory model of psychotic symptoms does not align with an accurate understanding of psychosis. Like Jacob mentioned, it is challenging when family members will interpret symptoms as disrespectful behavior or as having a spiritual component instead of labelling the client’s concerns as a mental health difficulty. I have found that attempting to understand the family’s potential fear around labelling their loved one with a psychotic disorder, while also identifying the family’s care underneath their beliefs, has been helpful for me in this process. I wonder if offering validation of a family’s concern/fear/overwhelm may build a bridge or pathway to the family feeling more receptive of psycho-educational language surrounding the theoretical causes/triggers of psychotic symptoms. I find families are more receptive to education if they feel heard, validated, and understood, like Christina mentioned. That being said, I also recognize that every family is different and some simply do not want to engage.

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