Life Skills Program for

SchizophreniaChristina, Brianna, and Jacqueline

What is Schizophrenia? Schizophrenia is a serious mental illness that

affects 300,000 Canadians.

It is a chronic, complex biochemical brain disorder

that affects a persons ability on determining what

is real and what is not.

What is Schizophrenia? Shows up in males earlier than females

Males: late teens, early twenties

Females: late twenties, early thirties

Many people with schizophrenia have difficulty

holding a job or caring for themselves, so they rely

on family members or others for help.

People with the disorder may hear voices other

people don't hear.

Signs and Symptoms Delusions: False beliefs, peoples believe the delusion even when

others tell them it is not true or logical, have bizarre thoughts (believes people are controlling their life, believe they are a historical famous person, people are poisoning them)

Hallucinations: Things a person sees, hears, smells, or feels that no one else around them can.

“Voices” are the most common type of hallucinations

seeing people or objects that are not there

Thought Disorders: Unusual or dysfunctional ways of thinking

“disorganized thinking” : when a person has trouble organizing their thoughts and connecting them logically

Movement Disorders: agitated body movements.

certain movements over and over.

Signs and Symptoms Cognitive Symptoms: subtle symptoms. May be difficult to

recognize.

Poor ability to understand information and use it to make decisions

Trouble focusing or paying attention

Problems with "working memory" (the ability to use information immediately after learning it).

Positive Symptoms: psychotic behaviors not seen in healthy people.

people with these symptoms often “lose touch” with reality

Negative Symptoms: disruptions to normal emotions and behaviors. these symptoms can be mistaken for depression .

"Flat affect" (a person's face does not move or he or she talks in a dull or monotonous voice)

Lack of pleasure in everyday life

does not speak much

Causes Genes and Environment:

The illness occurs in 1%of the general population

It occurs in 10% of people who have a first-degree

relative with the disorder (mother, father, siblings)

People who have a second-degree relative (aunt, uncle, grandparent) with the disorder have a higher

percent chance of having schizophrenia more than

the general population.

The highest risk for schizophrenia is for an identical twin of a person with schizophrenia. They have a 40

to 65% chance of developing the disorder.

Causes Different brain chemistry and structure.

Scientists have found imbalance in the complex, interrelated chemical reactions of the brain play a role in schizophrenia.

imbalances in neurotransmitters dopamine and glutamate, and possibly others

brains of people with schizophrenia look different than those of healthy people

• Ventricles are

Larger

• Tends to have

Less gray matter

Treatment Treatment helps decrease and handle the many

symptoms of schizophrenia, but most people who

have the disorder cope with symptoms throughout

their lives. However, it is possible someone with

schizophrenia can lead a rewarding and meaningful

lives in their communities.

Antipsychotic Medications Chlorpromazine (Thorazine)

Haloperidol (Haldol)

Perphenazine (Etrafon, Trilafon)

Fluphenazine (Prolixin).

Risperidone (Risperdal)

Olanzapine (Zyprexa)

Quetiapine (Seroquel)

Ziprasidone (Geodon)

Aripiprazole (Abilify)

Paliperidone (Invega).

Exercise Benefits • In 2010 a review of exercise studies by University of

Toronto by researchers Paul Gorczyniski and Guy

Faulkner discovered “that regular, moderate aerobic

exercise could alleviate feelings of depression, social

isolation and low self-esteem in schizophrenics.”

• They also notices an increase in motivation, primarily

affecting eating habits, hygiene and willingness to

exercise, was the most significant benefit.

Exercise Benefits Exercise may also help with the reduction of:

perception of auditory hallucinations

promote healthier sleep patterns,

Improve behavior and help maintain healthy weight,

Doctors now recommend the same amount of exercise for schizophrenics as they do for the rest of the general population moderate exercise 30 minutes a day most days of the

week.

Recommended types of exercise include cycling, jogging, walking, weight training and yoga.

Our Client Name: Kayla Smith

Age: 27

Diagnoses: Schizophrenia

The Story: Kayla works as a secretary in an office and thinks her boss and coworkers are “out to get her”, and is convinced her boss is watching her through surveillance cameras that secretly hooked into the computers and phones. She ended up hitting a breaking point and smashed all computers and phones are her work because “the voices” told her to get the cameras out. Since then Kayla stopped caring about her appearance and barely showered. She claimed that voices are telling her that someone is reading her mind and are plotting to harm her. Kayla was brought to our attention after her former boss pressed charges and was finally diagnosed with Schizophrenia from a psychiatrist.

Assessment of KaylaThrough Observation

Functional Ability: Satisfactory

Recognition: Good

Attention: Poor – is distracted with voices in her head

Short term memory: Poor – cannot retain much info because voices in her head distract her

Long term memory: Good – can remember things from past

Judgment: Poor – Delusional

Language: Poor English – does not make sense sometimes

Academic skills: Very good writing skills, satisfactory calculating and counting skills (needs improving with money management)

Assessment of Kayla Cognitive Behavior: Thought process is interrupted by

voices, has little control over thoughts

Social Behaviors: Needs personal space, does not communicate well with others, has good manners

Physical Behaviors: Agitation, outbursts of thrashing in anger due to delusions. She has overall good balance and motor skills.

Psychological Behavior: Poor anger management, coping-emotional control and expression, frustration and tolerance levels, and experiences hallucinations, Kayla is overall very unstable.

Kayla’s Symptoms Kayla goes through periods of time which she cannot tell the

deference from what was real and what was not.

Kayla believes people are reading her mind and plotting to harm her.

She is showing feelings of agitation and fear that “someone” is going to hurt her.

During the assessment the team noticed Kayla sometimes she does not make sense when she talks and will sit there without moving or talking for several minutes.

Kayla has shown signs of hallucinations: voices criticizing her behavior, and order her to do things she does not want to do (stealing, hitting herself, and screaming, etc.)

Planning Life skills program consisting of: an Etiquette class,

Money management class, Problem solving class, Educating / Coping class , and Creative writing class, Exercise class. A minimum of 2 months until Kayla is ready for discharge.

Overall Objective: To decrease the incidence of hallucinations, delusions, and aggressive outbursts, as well as educate Kayla on schizophrenia in hopes that she can cope with her illness.

Anticipation: We anticipate that Kayla will be difficult when joining activities. We think she will strive in the creative writing activity and will have the hardest time with the money management class.

Goals Develop Healthy coping strategies

Improvement of fine and gross motor skills

Help the clients ability to think on their own

Find positive ways to express their emotions

Improve communication skills

Improve clients ability to work with others in a group

Patient will participate in one complete group or activity per day

Patient to set short term goals for themselves

Help the client find suitable recreation activities that he can enjoy

PlanningThe Life Skills Program Schedule

This comprehensive program tackles all aspects of a schizophrenic’s life that

need improving.

Planning Etiquette Class: Will take place in the “classroom” of our

rehabilitation center. Will be run by a TR specialist

Money Management Class: Will take place in the “classroom” of our rehabilitation center. Will be run by a TR specialist with a background in accounting.

Problem Solving Class: Will take place in the “classroom” of our rehabilitation center. Will be run by a TR specialist with a background in accounting.

Educating and Coping Class: Will take place in the “classroom” of our rehabilitation center. Will be run by a TR specialist who specializes in schizophrenia.

Creative Writing Class: Will take place in our library. Will be run by TR specialist.

Exercise Class: Will take place in our “recreation room.” Will be run by a TR specialist.

Leisure Ability Model Functional Intervention: to improve our clients overall

functionality, and to help them cope with their disorder. In this stage as a rec therapist we are trying to stage our programs with the purpose of helping our client function better for an end result.

Activities Include: Educating and Coping Class, and Problem Solving Class

Leisure Education: In this stage the rec therapist acts as a counsellor to the client and gives the client knowledge and skills. In this stage we are trying to educate the client on their illness, which is schizophrenia in our case, and teaching our client coping and life skills on how to manage living with schizophrenia.

Activities Include: Money Management Class, and Etiquette Class

Leisure Ability Model Recreation Participation: After helping our client

gain new leisure knowledge and skills as a team we

can step back and become more of a leisure

resource. Our client will be able to pretty self-

sufficient when it comes to their recreation choices

but will occasionally need help from a TR

specialist. Our client will be engaging in organized

participation opportunities.

Activities Include: Exercise Class and Creative Writing

Implementation Kayla was hesitant in starting the program, as she

believed we were conspiring against her

Her favorite program is the creative writing

program

After a lot of effort and encouragement, we have

formed a helping relationship with Kayla

She has some form of trust in us

She does not like being with others still

Evaluation Kayla is still not 100% on her common courtesy and

problem solving and it seems to be taking a little bit longer then we have planned for her. Some days she

seems like she understands what is going on and other

days she seems lost. When she is getting taught proper etiquette she feels the teacher is out to get her at times

and Kayla’s state of mind changes instantly. During our

problem solving class Kayla seems to still be getting distracted and gets paranoid when other are trying to

help her as she feels they are out to get them. There has

been some improvement but there definitely is room for so much more.

Evaluation When it comes to money management, Exercise

and Creative writing class Kayla seems to being

doing excessively well. Personally I feel this has to

do with her self-fulfillment from it, when watching

her do different activities for each class you can see

she deeply enjoys it and it tends to keep her mind

active. We feel she is doing well in these classes

because these sorts of activities don’t require for

her to communicate and work with others and she

can just have her personal space doing it.

Evaluation The program that needs the most improving is

Educating and Coping Class. Every time Kayla is in

this class things just don’t seem to go right. She

tends to have a lot of outbursts when we talk about

the illness schizophrenia and gets overly frustrated.

She doesn’t like to hear what she was diagnosed

with and when it comes to educating her on it she

seems to get distracted by the “voices” in her head.

Evaluation Since Kayla has started taking our program we feel her

behaviour has changed rapidly over the period of time we have had to work with her. All of her goals but one have been achieved which is improving the clients ability to work with others in a group.

We seem to be having a difficult time achieving this goal as Kayla likes to have her personal space and can’t communicate well with others. It is a working progress but we will overcome this and achieve this goal. Kayla tends to be more independent based now and is able to find recreational activities that are best suitable for her needs and wants. Overall from our program we do see a big difference in Kayla’s behaviour and it’s hard dealing with schizophrenia but she is managing and challenging this stage in her life excellently.

Final Evaluation We have collected this data from 2 months of Kayla

participating in our Life Skills Program.

We are going to keep her in this program until she has reached all of her goals

She still has little outbursts and but she has learned how to control her impulses

The voices are still there but with our Educating and Coping class she has learned how to deal with them

Our estimation is that she will be apart of our program for approximately the next 2 months

Task Try to write down positive things about yourself and

you life while listening to this voice clip.

Its important to listen and to not block out the

voices (individuals with schizophrenia don’t have

the choice to block them out)

https://www.youtube.com/watch?v=0vvU-Ajwbok

References "Exercise & Schizophrenia." LIVESTRONG.COM. LIVESTRONG.COM, 28

Jan. 2014. Web. 25 Nov. 2014. http://www.livestrong.com/article/417782-exercise-schizophrenia/.

"Schizophrenia." NIMH RSS. National Institutes of Health, n.d. Web. 23 Nov. 2014. http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml

"Schizophrenia - Canadian Mental Health Association." Canadian Mental Health Association. Canadian Mental Health Association, n.d. Web. 25 Nov. 2014. http://www.cmha.ca/mental-health/understanding-mental-illness/schizophrenia/.

"Learn More About Schizophrenia." Learn about What Is Schizophrenia and Schizophrenia Treatment Options. N.p., n.d. Web. 25 Nov. 2014. <http://www.schizophrenia.ca/learn_more_about_schizophrenia.php#4>.