diveshark's Journal

2:59am: girlfriend
Im the luckest bastard alive. My girlfriend is the greatest.

12:18pm: moon monkey
Today Lily said that she either wants to be a princess or an astronaut when she grows up. I suggested that she be the queen or princess of the astronauts, to this she replied, "dad that's just stupid"

12:14pm: of castles and fairy princesses
Today I bought Lily a wand for her fairy princess costume. she is so excited to do Halloween this year. she also found the catalog for the Papo toys and was very excited to see the toy princesses and the fairy and the knights. Now I need to get a castle for it. I can't wait to play with her this Christmas.

11:46pm: James Tod Hawkins
due date: 9-17-03
Name: Mr. Simpson
Date: 9-17-03
Type of session: Intake
Identifying information: 44 year old male, single, unemployed, White
1. Presenting Problem: Client was brought into the emergency room by the police for assault against an elderly woman in client's apartment building. Client had stated, "That damn bitch, she and the rest of them deserved more than that for what they put me through". Client complains of a "Large network" that monitor all his activities. This "network" involves three major television networks, hidden cameras, and hundreds of "actors" who live in his neighborhood. He complains of hearing voices, he claims that his neighbors operate two different "machines" through which they operate the voices, except for one he calls the "joker". One machine controls the voices that tell him which stocks to buy when he is going over his investments. He believes that the woman he attacked controlled one such device. The "Joker" voice doesn't come out very much but when he hears it he says that it is very funny and it is not controlled by a machine. The other machine he calls, "the dream machine" which puts erotic dreams into his head, usually of "black women". He thinks that the reason he is under surveillance is due to his superior intelligence, someone wants to find out the why he is as smart as he is.
2. Medical History: Client has had multiple hospital placements beginning when he was 22 years old. He was hospitalized at the age of 24 following being fired from a bank at which he was working due to his perception that his co-workers were talking about him. He complained that they gave him "signals". It was then that he first reported hearing voices. He has not worked since. The total number of times he has been hospitalized is twelve. The longest stay was eight months. In the last five years he has only been hospitalized for once for three weeks. During the hospitalizations he has received various anti-psychotic drugs. Although outpatient medication has been prescribed, he will often stop taking it shortly after he leaves the hospital setting. Recently he expressed feelings of anger during this interview for having been brought in by the police and being made to take an anti-psychotic drug. After several weeks, the drug failed to control his psychotic features. He was then transferred to a long-stay facility with a plan to arrange a structured living situation for him.
3. Psychiatric counseling history: First entered into treatment when he was 22 and in college. Has had multiple hospital placements, twelve altogether, first time when he was 24 years old. He will often begin to take medications but will go off them after he leaves the hospital setting.
4. Substance Abuse: None reported.
5. Family and Martial History: The client has never been married. He visits his uncle on a biyearly basis (lunch meetings). Little information was provided in regards to early childhood or teen years
6. Educational and Employment History: He was convinced that his classmates in college were making fun of him. He stated that he noticed that they "snorted and sneezed" when ever he would walk into the classroom. At that time he believed that after a girl whom he had been dating had broken off a relationship with him, she had been "replaced" by a look alike. His performance in school declined and he was asked to leave school to seek psychiatric care. He worked as an investment counselor at a bank for seven months until he was fired. He has not worked since that time. He has a large inheritance, and it supplies his needs financially.
7. Personal and social history: Client often isolates himself and only makes contact with his uncle once a month and his mental health workers on scheduled visits. Client is not married and has no children.
8. Problems-Tasks: Stabilize client on his medications. Refer client to individual therapy, case management, attendant care, and a support group.
9 Treatment goals and objectives:
Goal A: Set up community supports for client
Objective 1: Refer client to medication management, individual therapy, case management, attendant care, and schizophrenia support group.
Objective 2:
B:
1:
2:
C:
1:
2:
10. Tentative Diagnosis: Axis I: 295.30 Schizophrenia, paranoid type
Rationale for diagnosis:
Clients behaviors are due to delusions, and hallucinations, therefore meeting criterion A. He has not been able to hold a job for very long and has had difficulty completing his college education which meets criterion B. His condition has lasted for more than a period of 6 months and meets criterion C. Both Schizoaffective and mood disorder are ruled out due to his not having a major depressive, manic, or mixed episode during his active phase. This meets the exclusion requirements for criterion D. His delusions and hallucinations are not due to drug abuse, a medical condition, or as the result of a prescription drug meeting criterion E. He does not meet the criteria for criterion F.
He meets the features for the subtype of the Paranoid type due to having non-bizarre delusions, and auditory hallucinations. This meets requirements for criterion A for the sub-type. There is also no mention of catatonic behaviors or disorganized speech meeting sub-type criterion B. His delusions are typically persecutor and grandiose.

11. Prognosis: Good with treatment and after care supports
12. Treatment plan:

10:11am: feeling tired
Man I had quite a weekend.......Im feeling very tired though, and going to work after going on a trip is hell. I fell asleep during an all staff meeting, very embarrassing. But it was worth seeing Amy and her family again.

11:54pm: lonely
it's not been easy having a relationship with someone and living so far apart