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Diagnostic and Statistical Manual of Mental Disorder, Psychoses -- Treatment, Psychoses -- Diagnosis, Counseling psychology -- Study and teaching, Mental illness -- Prevention


Psychosis in general, and schizophrenia specifically, are among the most debilitating and difficult to treat disorders in mental health (Correll, Hauser, Auther, & Cornblatt, 2010). Identifying a patient with at-risk symptoms before the first episode of schizophrenia can be invaluable to the patient, clinician, and the community because the patient is treated early in the course of the disease where treatment is highly effective. After years of research it has been confirmed that at-risk symptoms for schizophrenia generally precede the first episode of psychosis, which results in the diagnosis of schizophrenia (Correll et al., 2010). At present however, the assessment and recognition of these symptoms for schizophrenia or APS remain under debate (Carpenter, 2009). Research has shown that utilizing low dose antipsychotic medication, cognitive behavioral therapy, and having a supportive family and social environment are essential resources to recovery and reduction of trauma for a patient experiencing symptoms of APS (Lencz, Smith, Auther, Correll, & Cornblatt, 2003; McGlashan, Walsh, & Woods, 2010; Olsen & Rosenbaum, 2006; Portland Identification and Early Referral Program, 2009; S.Trevino, personal communication, November 18, 2010). At this time research shows that early detection of APS symptoms can achieve secondary and tertiary prevention, such as delaying the onset of psychosis and reducing suicide, but does not prevent schizophrenia from occurring (McGlashan, et al., 2010.) There are various ways in which counselors can receive referrals to assess a patient for APS. The patient can be referred by a family member, a health care provider, a school administrator, a court order, another clinician, or by the patient directly. A clinical assessment encounter with the patient is then needed. The encounter should use a multi-method approach of clinical interviewing and assessment tests to diagnose and help place the patient in the appropriate treatment algorithm. At first referral to a clinician, the patient may not present with a need to assess for APS. Recognizing a broad marker for instability, such as multiple AXIS I diagnoses without clear criteria, may be an effective first clue that a patient may be exhibiting APS symptoms and warrant a diagnostic assessment. One goal of this paper is to describe the current diagnostic tools for APS, especially the Structured Interview for Psychosis-Risk Syndrome, SIPS, (McGlashan, et al., 2010). The SIPS assessment tool is a comprehensive assessment tool that can be used in the field to diagnose early detection for schizophrenia and monitor symptom severity.


Reprinted with permission from VISTAS Online, Vol. 2, Article 86 © 2012 - The American Counseling Association. No further reproduction authorized without written permission from the American Counseling Association

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