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Verbal De-Escalation Case Study

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Due to the impaired judgment, intense emotion and overt psychosis, there is an increased risk of violence in mentally ill patients during a relapse. Therefore, verbal de-escalation was crucial in eliminating the possible aggression during the first few home visits. Madam MA appeared frustrated the moment she saw the community team going to her house. She could not see the reason for the home visits. After the verbal de-escalation, she appeared calmer and was able to talk with the community team. Indeed, this was important in establishing the rapport and the therapeutic alliance. The doctor explained to her about the nature and the course of the illness, the importance to adhere to medications and the anticipated side effects of the medications. The relationship between non-adherence and re-emergence of the symptoms was emphasized multiple times. This was because she had a past history of multiple relapses secondary to treatment non-adherence. Besides, she had been advised to seek medical attentions if she encountered any side effect of medications. Lastly, the doctor advised her to practice healthy lifestyle, for instance having regular exercises and healthy diets. Supportive psychotherapy was crucial for this patient as well. Madam M was encouraged to have emotional ventilations. This was …show more content…

The depot preparation could ensure continuous drug delivery with a stable plasma drug concentration over long periods. Taking into account the high propensity of noncompliance to the oral medications, long-acting depot would likely be beneficial to Madam M. Therefore, the doctor initiated intramuscular fluphenazine decanoate 25mg monthly for her. As for oral antipsychotics, the doctor aimed to taper off tablet aripiprazole in the future. This was because a monotherapy (IM depot) was likely sufficient for Madam

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