Students want change on a daily basis. We assume that all these wants and needs are positive, however as much fun and stimulation as it all is, does it make learning happen or are we being blinded by the ME generation. Surely the role of the adults, teachers and administrators is to apply experience, wisdom and the braking system of reality. The cost of all these rapid changes may not balance with the benefits.
Just because kids can chat online and share their assignments, resources and references, do they do any better work, do they learn anything other than how to plaigirise? Has society progressed? Do we have global peace, care, equality etc?Certainly not
Have we assessed the social ramifications?
For example kids prefer to text each other than meet. Breaking off with a girlfriend is now a text that says 'your dumped'. Kids hide in their rooms and 'study' online. Most of the time they only have virtual connectedness, lack family time and for an increasing number of kids, the real/hyper-real and virtual have become very blurred. We have an explosion of mental illness and people with lack of connectivity shooting up schools. I think that we need to be cautious as adolescents lack the maturity to really know what they want and need.
We have an explosion of materialism and consumerism that is environmentally and economically unsustainable.
Whilst our political systems are held ransom to lobbyists where is the democratic debate about where our resources are to go. Is the latest fast broadband more important than emergency services, illegral migant housing, neo-natal health care- etc.
This is an interesting article that reviews outcomes for laptop programmes for schools to cross the digital divide(Hu 2007). Kids are using laptops and Internet access to cheat, download porn and play games. There is no measurable improvement on academic achievement given the technology availability. The cost is not giving any value for money. It won’t stop me using a laptop or accessing the Internet but I think that these are important issues for debate.
Hu, W (2007) Seeing no Progress, Some schools drop laptops New York Times May 4 retrieved 6/5/2007
http://www.nytimes.com/2007/05/04/education/04laptop.html?_r=2&hp=&oref=slogin&pagewanted=all&oref=slogin
Sunday, May 6, 2007
website
Welcome to this website. I hope you find what you are looking for. If not email me or send me links you have found useful. I am not writing a text-book here so these are potted summaries in words I can understand. I have included useful links when I can but you can’t always guarantee that they are still active.
Depression
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Varieties of depression.
Mood Disorder Major Depression
Chronic Dysthymia
Symptoms of depression
Funnily enough not many people are actually sad but some are and their mood swings a lot.
Irritable or anxious mood is more common
No energy, no interests, tired, no fun any more, difficult to get the basics things done
Sleep is no good or in fact can’t stop sleeping
Can’t eat and lose weight or for some, comfort eating and put on weight
Feelings of hopeless, helpless and pointless, with no future take over. Time seems to drag.
Chronic pain can sometimes be the only sign.
What causes Depression?
Genetics can make you vulnerable, so this is a commonly inherited illness. With 20 % of our society suffering depression at some stage in their lives, there is a huge gene pool obviously.
Stressful events can trigger a depression but not always. Some stress is good for you.
Medical problems often cause depression
Living with someone who is depressed can cause depression
Losing someone close to you can cause depression.
Alcohol and cannabis cause depression
Treatment
Get the right diagnosis first and make sure that there isn’t a medical problem that needs treatment first. So see your doctor.
Medications
Antidepressants work well. They all take about 10 days to start working and about 6 weeks to be working fully. If they havn’t got you back to normal again, you may need an increased dose. So see your doctor.
Side effects for most people are reduced with the new antidepressant so its easy to get well.
Hospital is sometimes needed. A psychiatric ward is a special place where you can do group therapy and get help while you are getting better. Sometimes people can attend as a day patient if they are a bit better.
Psychotherapy. Help to make your thoughts change your mood is very useful. It will take some time to achieve this but will stand you in good stead to prevent and lessen symptoms of depression in the future.
Simple things you can do. Keep doing things and meeting people, having fun as much as you can. Exercise and a healthy diet are good for you whether you are depressed or not.
Don’t drink alcohol.
Check with your doctor that you are still safe to drive your car.
Outcome
Most depression will get better. Treatment reduces the suffering, loss of friends, marriages, relationships, jobs, health etc that depression can cause, not to mention the suffering. There is no cure as yet and most depressions will come back at some stage in your life. So look out for depression. And have someone close to you also watch out for the signs. Get treatment early. With good management the outcome can be great.
More information
Try these useful links
The Royal Australian and New Zealand College of Psychiatrists , (RANZCP)website is fantastic.
http://www.ranzcp.org/publicarea/cpg.asp#consumer
The Royal College of Psychiatrists (UK)
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/depression.aspx
Men and Depression
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/depression/mendepression.aspx
Postnatal Mental Health RCP (UK)
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/postnatalmentalhealth.aspx
Find Free Clipart at School Clip Art
Children and depression form the American Academy of Child and Adolescent psychiatry
http://aacap.org/cs/root/resources_for_families/glossary_of_symptoms_and_illnesses/depression
Beyond Blue
http://www.beyondblue.org.au/
An interesting web-program that is free
http://moodgym.anu.edu.au/default.asp?lang=1
Postnatal Depression
http://www.beyondblue.org.au/index.aspx?link_id=94
Depression for rural people- especially important with the drought .
http://www.beyondblue.org.au/index.aspx?link_id=84
This site has good description of all the antidepressants and their side effects.
http://www.beyondblue.org.au/index.aspx?link_id=89.581
Bipolar Disorder
What Causes Bipolar Disorder
It is an inherited disorder, once called Manic Depression.
Many illnesses can cause Mania and antidepressants can cause mania as well. Some illegal drugs cause highs as well.
Symptoms
Symptoms of depressive moods as well as manic (highs) episodes occur in Bipolar disorder.
See depression for a summary about this part of the illness.
During a high, the person experiences everything going too fast, time speeds up, thoughts and speech and actions all speed up. People can overspend, become irritable, take on too many interests, projects or work and wear out their friends and family.
Bipolar I or Bipolar II
Sometimes psychiatrists distinguish between bipolar disorder and a milder form (II) because there have not been manic episodes severe enough to need hospital care or cause severe symptoms but there are obvious mood swings with one or more mild manic times and depressions. Bipolar II also needs treatment and can be a forerunner of Bipolar I disorder.
Treatment
Antidepressants are best avoided as they can cause a manic episode.
We use Mood Stabilisers for this illness with usually good results. You have to remember that these do not cure and you are looking at lifelong management of your illness. Monitoring you r mood, slowing yourself down, taking yourself somewhere quiet is recommended for people when they are a bit high. See you r doctor if these don’t work. Dealing with anxiety is important, as it is a common feature of Bipolar Disorder. Dealing with relationship issues, family support and stressful events are best managed with your doctor.
Medications-
Mood stablisers.
Lithium carbonate, Lithicarb, 250 mgs or the slow release medication, Quilonum 450 mgs. This medication, first discovered by an Australian, John Cade, works well to stabilise mood. It is dissolved in the eater of you body so can become too high in your body if you get dehydrates, If you get a temperature, need surgery or are sick, stop the medications for a day or two until you are well again. The blood level must be tested every 6 months. We also check your thyroid function every year as Lithium can affect your thyroid.
Signs of toxicity- slurred speech, staggering gait, unwell, seek emergency medical treatment and drink lots of fluid.
Do not use in pregnancy or breast -feeding.
Sodium Valproate, Epilim or Valpro. This medication was first used as an anticonvulsant or for epilepsy. It is also a good mood stabiliser with rapid action, low side effects and no need for blood tests usually.
Olanzepine or Zyprexa. This also comes as a wafer. Do not cut this medication in half as it will render it unusable. This medication is an extremely good mood stabiliser. It is also an antidepressant, stops anxiety, helps to slow you down and get a good night sleep. It will make you tired. It will also make you hungry and if you eat too much you will put on a lot of weight and get diabetes. So monitor your weight with this one.
Aripiprazole or Abilify has been used outside Australia as a mood stabiliser. It has less side effects than Olanzepine but is not available for use here as yet.
Psychotherapy is important to learn how to deal with anxiety, monitor your mood and deal with stressful events. Support for your family is important so that they understand the illness. The children also need to know about the inherited nature of this illness.
More information
Try these links
RANZCP consumers and carers site
http://www.ranzcp.org/publicarea/cpg.asp#consumer
The Royal College of Psychiatrists (UK)
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/manicdepressionbipolar.aspx
The black dog institute has a good website
http://www.blackdoginstitute.org.au/bipolar/explained/index.cfm
And this site has a self -test page.
http://www.blackdoginstitute.org.au/bipolar/howtotell/selftest.cfm
Beyond Blue
http://www.beyondblue.org.au/index.aspx?link_id=89.581
Detailed summary of Bipolar disorder from the National Institute of Mental Health, USA
http://www.nimh.nih.gov/publicat/bipolar.cfm
More information
http://www.emedicinehealth.com/bipolar_disorder/article_em.htm
Anxiety Disorder/ Panic Disorder and Agoraphobia
Anxiety disorder is very common and most people worry at sometime. Some people are born worriers and others not. Children often suffer anxiety disorder. Anxious mothers often have anxious children, which might be genetic but can also be learnt.
When the worry starts to interfere with running a normal life, you need help.
Through the action of adrenalin, you body experiences anxiety, not just your mind. You can experience
Poor sleep
Shortness of breath
Palpitations or heart pain
Nausea, diarrhoea, abdominal pain
Urinary frequency
Tingling in your fingers
Dizziness or faintness
Sweaty palms and hot and cold flushes
Terror and an overwhelming feeling that something bad is going to happen.
When this happens suddenly and severe it is called a panic attack and you know that this is so bad that you are going to die.
If you run away when you feel this happening you will become phobic or always want to avoid situations that seem to cause panic. It is an understandable response but can lead to agoraphobia, or not wanting to leave the safety of your home.
Treatment
Medications
Antidepressants work well
Sometimes a medication called an anxiolytic, (stops anxiety) can be used until the antidepressant is working. I try to avoid the benzodiazepines (like Valium, Serapax and Xanax), because they lose their ability to work (tolerance) quickly and people can become addicted to them.
Cut out your caffeine intake as this causes anxiety, palpitations and panic disorder. You can buy decaffeinated coffee, tea and cola.
Cognitive Behaviour therapy
This is an important therapy to use as it will save you form panic attacks very quickly and you can prevent anxiety and panic from taking over your life. Breathing techniques, relaxation, desensitisation and response prevention are some of the things you can do in CBT
Sometimes you can get anxiety and panic from bad things that might have happened to you in the past. Sometimes we call that Post Traumatic Stress Disorder. You might then need to do some other type of psychotherapy to address that bad thing and its impact on your life.
Need more information
Check out these sites
RANZCP website
http://www.ranzcp.org/publicarea/cpg.asp#consumer
The Royal College of Psychiatrists (UK)
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/anxietyphobias.aspx
Beyond Blue webpage
http://www.beyondblue.org.au/index.aspx?link_id=90
This is also a good website with some good resources.
http://www.panicanxietydisorder.org.au/
an interesting article
http://www.abc.net.au/health/library/anxietydisorders_ff.htm
More information
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Anxiety_treatment_options
This page is useful for men, women and young people
http://www.womhealth.org.au/factsheets/anxiety_disorders.htm
and this one
http://www.mydr.com.au/default.asp?article=2842
American Academy of Child and Adolescent Psychiatry
http://aacap.org/cs/root/resources_for_families/glossary_of_symptoms_and_illnesses/anxiety
Obsessive Compulsive Disorder
What is this?
Obsessive Compulsive Disorder (OCD) is usually inherited. People with OCD can also have
Tic Disorders or Gilles de la Tourette Disorder. This is a series of movements, noises that are habits, like winking, blinking, throat clearing.
And Trichotillomania. In this problem people twirl and pull their hair. Sometimes they look and feel the end of the hair and sometimes put it in their mouth. It is a common thing that people hide it from other people.
And other Habit Disorders, like biting your fingernails or scratching your skin.
It often starts when you are about 7 years of age and comes and goes throughout your life or when things get stressful. Sometimes, stressful problems makes OCD start.
OCD can be partners with depression or schizophrenia.
What are the symptoms?
OBSESSIONS are thoughts that are nasty and unwanted. You know that they are your own thoughts but you didn’t invite them and you find it hard to tell them to go away. They are commonly thoughts of bad accidents to yourself o your family, people you love dying or being caught by the police for something you didn’t do. They may be thoughts about saying rude things by accident. Sometimes people get pictures in their head of the bad things happening. These thoughts tend to take up all your mind-space so it is hard to concentrate on other people, work or school.
COMPULSIONS are the actions that people take to stop the bad things happening or keep the bad thoughts away. The actions are things like counting your steps and making sure that you reach a magic number of steps. Checking light switches, windows and door and washing your hands to get rid of germs are common compulsions. Saying prayers a set number of times or touching religious pictures, lining up your shoes, books, straightening things in perfect alignment., hoarding things are all common actions. Unfortunately they can take up a lot of your time and energy and are difficult to hide from other people.
How do we treat it?
Medications
Antidepressants
Most antidepressants will work well for OCD. For children Luvox is well tested with few side effects. Anafranil (Clomipramine) is the best antidepressant to use in OCD but has a lot of side effects so psychiatrists usually use SSRI medications first.
Tranquillisers
The anxiety and distress of OCD can often settle quickly with these medications so they are useful particularly until the antidepressant starts to work.
Cognitive Behaviour Therapy
Once you analyse all the obsessions and compulsions you can plan their attack. It is easier to deal with compulsions first. With CBT you learn to control anxiety. Then you can use RESPONSE PREVENTION. This means that you stop the OCD from making you do the compulsions. As your anxiety increases, the OCD is trying to win and force you to do the compulsion, you can use the CBT to reduce your anxiety. You win, OCD loses. Once you have controlled one compulsion you are then in a better position to tackle the others and then the obsessions.
Psychoanalysis
There has been a lot of good therapy for OCD using psychoanalysis. Your psychiatrist can help you make a decision of this is useful for your sort of OCD.
Useful links
The Royal College of Psychiatrists website ( UK) is comprehensive
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/obsessivecompulsivedisorder/obsessivecomplusivedisorder.aspx
This is a self- assessment site
http://psychcentral.com/ocdquiz.htm
American Academy of Child and Adolescent Psychiatry on Tourette’s Disorder
http://aacap.org/page.ww?section=Glossary+of+Symptoms+and+Illnesses&name=Tourette%27s+Syndrome
and for OCD
http://aacap.org/cs/root/resources_for_families/glossary_of_symptoms_and_illnesses/obsessivecompulsive_disorder_ocd
Attention Deficit Hyperactivity Disorder ADHD, Attention Deficit Disorder ADD
Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) have no reliable diagnostic tests. There is a spectrum of activity and children always have more energy than adults. So we have to keep in mind the correct developmental level for children when making this diagnosis. So if your child is more active than other kids and cannot sit still, pay attention , wait their turn, is impulsive more than other kids their age , they may have an ADD that is interfering with their ability to learn and to cope with family rules.
Children with ADHD and ADD are often depressed because of they are in trouble and not learning and their ability to make friends is effected. They may also be depressed because this is the same area of the brain as the ADHD and ADD. Sometimes kids with an ADHD picture have a childhood form of Bipolar Disorder.
ADHD and ADD may lead to behaviour problems and Oppositional Defiant Disorder and Conduct Disorder.
Boys are more likely to have ADHD and girls have ADD. ADD is more likely to be missed as these people sit quietly and don’t draw attention to themselves.
Children with these disorders are most likely to have a Communication Disorder which requires diagnosis and treatment by a Speech Therapist
ADHD and ADD is inherited and children are born with this problem. Most children outgrow this problem in adolescence although a small number continue to suffer all their lives.
Treatment
We treat ADHD and ADD because we want to limit the behavioural, educational, self-esteem and social skills problems that can occur for these children.
There is good evidence that 50% of children with ADHD has food sensitivities and an elimination diet is good to try.
See this site http://members.ozemail.com.au/~breakey/
Behaviour treatment is very necessary and these children need a much more controlled environment than other kids. As heir attention span is short, tasks need to be divided into small chunks, simple commands given, one at a time and rewards for completion of tasks immediate. They need time to get the ‘jumping beans’ out of them.
Medications are highly contested as people see that ADHD can be a societies intolerance to children rather than an illness. Some of the medications have side effects that are not nice for young children. If he child is suffering and their development is hampered and all the above has not worked, I think that the issue of medications needs to be discussed with the child’s needs in mind. Medications include
Antidepressants
The SSRI are stimulant but without the side effects of the other medications. They are not as strong and I think that they are a good place to start. They will also treat the depression component of ADHD/ADD.
Stimulants
Dexamphetamine, Methylphenindate(Ritalin, Concerta) , Atomexetine (Strattera) are used. Some are now in long acting formulae.
They are active within 20 minutes of taking them and last 4 to 8 hours.
They may reduce appetite, interfere with sleep, cause a rebound hyperactivity when they wear off , depression and delirium ( rarely). We try to keep the lowest dose needed and sometimes give drug holidays so that we only use the medications on school days.
Some kids need it every day because of the disruption to their home as well.
Useful links
Australian Government website with lots of papers and links
http://www.healthinsite.gov.au/topics/Attention_Deficit_Disorder__ADD_or_ADHD_\
Lots of information in this place
http://www.nimh.nih.gov/publicat/adhd.cfm
This website is easy to read and very useful for parents and teachers
http://www.kidshealth.org/parent/medical/learning/adhd.html
Diagnosis
http://www.cdc.gov/ncbddd/adhd/symptom.htm
a newsletter
http://familydoctor.org/118.xml
A symptom checklist
http://pediatrics.about.com/cs/adhd/l/bl_adhd_quiz.htm
Treatment information
http://www.keepkidshealthy.com/medicine_cabinet/adhd_medications.html
American Academy of Child and Adolescent Psychiatry
http://aacap.org/page.ww?section=Facts+for+Families&name=Children+Who+Can't+Pay+Attention%2FADHD
Post traumatic Stress Disorder
Symptoms
Flashbacks or bad memories
Triggers or things that bring back the memories
Avoiding things that remind you of the trauma
Withdrawal from people and life
Depression
Anxiety and Panic Attacks
Irritability
Increased arousal and startle reponses
Nightmares
Treatment
Medications
Antidepressants work well for the anxiety and depression symptoms of PTSD.
Tranquillisers are useful to help with sleep problems and reduce anxiety.
Psychotherapies
Cognitive Behaviour Therapy
Narrative Therapy
Psychodynamic Psychotherapy
These are some of the types of therapy used. You need a professional psychiatrist or psychologist for this sort of work. Psychotherapy is an important part of treatment Sometimes you need medications to feel well enough to be abele to cope with psychotherapy.
Some Useful Links
The Royal College of Psychiatrists
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/posttraumaticstressdisorder.aspx
for children and adolescents, American Academy of Child and Adolescent Psychiatry
http://aacap.org/cs/root/resources_for_families/glossary_of_symptoms_and_illnesses/posttraumatic_stress_disorder_ptsd
and another website about PTSD and children
http://www.kidshealth.org/parent/emotions/feelings/ptsd.html
Comprehensive website Mayo Clinic
http://www.mayoclinic.com/health/post-traumatic-stress-disorder/DS00246
This is a good website for Vietnam Veterans
http://www.dva.gov.au/health/vvcs/family.htm
more information
http://www.ncptsd.va.gov/ncmain/index.jsp
Secondary to cancer
http://www.cancer.gov/cancertopics/pdq/supportivecare/post-traumatic-stress/patient
Simple information
http://familydoctor.org/624.xml
Asperger’s syndrome
Asperger’s Syndrome is a Pervasive Developmental Disorder related to Autism.
This syndrome has become somewhat over-diagnosed of recent times because it attracts funding. It has also been levelled in an unkind way against men who don’t communicate their emotions well.
Symptoms
There is always a delay in language and communication skills for these people
This creates social skills problems and autistic behaviour (withdrawal form [people).
People with Asperger’s syndrome have a restricted areas of interested but become obsessional about them They also become obsessional about ritual and objects and have separation anxiety, panic and behavioural problems if you change things around.
People with Asperger’s syndrome have little understanding of emotions for themselves or other people so they lack empathy or emotional attachment to people. They don’t like cuddles and prefer to be alone.
There is often unusual and eccentric behaviour and language.
Children do not have ability for fantasy or play but may be drawn to spinning objects.
Co-Morbid Problems
People with Asperger’s Syndrome often have other psychiatric disorders that need diagnosis and treatment. These include
Depression
Schizophrenia
ADHD
OCD
Learning Disorders
Treatment
Children with Asperger’s Syndrome need Special Education
A Speech Therapist is important to help these people with their language, communication and social skills
Behaviour therapy is important but the usual interventions may not work well and help is needed to devise a good behaviour management plan. See your GP, child psychiatrist, child psychologist, special education teacher and Guidance officer at school or get help form the Autistic Association
Local support groups are useful for the carers of children with Asperger’s Syndrome
Some children respond well to Rispiridone or other tranquillisers although this is not a cure.
Some useful links
American Academy of Child and Adolescent Psychiatry
http://aacap.org/page.ww?section=Facts+for+Families&name=Aspergers+Disorder
This is a good summary and management plan from a teacher’s perspective
http://www.behavioradvisor.com/AspergersSyndrome.html
More information
http://www.aspergers.com/
Another useful link
http://www.disability.vic.gov.au/dsonline/dsarticles.nsf/pages/Asperger's_syndrome
Kid’s site
http://www.cyh.com/HealthTopics/HealthTopicDetailsKids.aspx?p=335&np=287&id=2339
Asperger’s Association
http://www.asperger.asn.au/Contact+Us
Autism Association
http://www.autismqld.com.au/
Schizophrenia
Symptoms
Sometimes before the following symptoms occur, the person suffers prodromal symptoms of depression, anxiety, OCD, difficulty organising themselves, thinking, and withdrawal from school, friends, work and family.
Delusions. There are thoughts and convictions that are based on faulty reasoning and are untrue. They may make people act in unsafe, self-b harmful or dangerous ways.
Hallucinations are voices, noises or visions that are not real but seem real to the person suffering them.
Thought disorder means that thoughts do not go in straight lines and become confused.
It is uncommon to see children with schizophrenia although it is possible. Most symptoms start in puberty or early adolescence although some forms of schizophrenia do not have symptoms until mid-life,
Causes
Most schizophrenia has no known causes although there is a lot of research to find the cause. Genetics has an important role as there are some people who have inherited an increased risk of developing schizophrenia
Drugs cause schizophrenia
Head Injuries can cause schizophrenia
Schizophrenia is more common in people who have epilepsy orAsperger’s syndrome
Treatment
Medications
Antipsychotic medications
Older medications
Neulactil
Chlorpromazine (Thorazine)
Haloperidol (Haldol)
Flupenthixol
Trifluperazine ( Stelazine)
Newer medications have fewer side effects
This article summaries the issues although it is a little dated.
http://www.australianprescriber.com/magazine/22/4/81/3/
Risperidone ( Risperdal)
Quetiapine (Seroquel)
Olanzepine (Zyprexa)
Amisulpride (Solian)
Clozapine(Clozaril)
Aripiprazole (Abilify)
See these websites
http://www.sane.org/information/factsheets/antipsychotic_medication.html
http://support4hope.com/medications/antipsychotic/index.htm
http://support4hope.com/medications/antipsychotic/aripiprazole_abilify.htm#1
http://support4hope.com/medications/antipsychotic/chlorpromazine_thorazine.htm#1
http://support4hope.com/medications/antipsychotic/clozapine_clozaril.htm#1
http://support4hope.com/medications/antipsychotic/flupenthixol_fluanxol.htm#1
http://support4hope.com/medications/antipsychotic/olanzapine_zyprexa.htm#1
http://support4hope.com/medications/anti_anxiety/trifluoperazine_stelazine.htm#1
http://support4hope.com/medications/antipsychotic/quetiapine_seroquel.htm#1
http://support4hope.com/medications/antipsychotic/risperidone_risperdal.htm#1
Antidepressants are often used to treat the depression that often accompanies schizophrenia.
Support is important and includes your doctor, psychiatrist, family and community services.
Home life is often disrupted when someone suffers schizophrenia and there are supports for the family as well.
Work may need to understand the limitations that schizophrenia applies and the difficulties the person may have with some aspects of work. Supported work and occupational therapy are useful. In Toowoomba Clubhouse helps with this, CRS offers supported retraining and employment as well as the employment agencies that specialise in areas of need and people who have disabilities.
Friends
Accommodation is important and many people ill with schizophrenia lack basic resources. Centrelink and the Housing Department can help with these needs.
Find Free Clipart at School Clip Art
Finances can be assisted by Centrelink and managed by the Public Trustee if needed.
CBT can help deal with voices that are interfering.
RANZCP website
http://www.ranzcp.org/publicarea/cpg.asp#consumer
American Academy of Child and Adolescent Psychiatry
http://aacap.org/page.ww?section=Facts+for+Families&name=Schizophrenia+In+Children\
SANE
http://www.sane.org/information/factsheets/schizophrenia.html
Eating disorders
Anorexia nervosa
Bulimia nervosa
Obesity
These are the three main sorts of eating disorder and they can co-exist or move from one variety to another over time. These disorders are mostly suffered by girls but boys can get this too.
Symptoms
Not eating and the compulsion to avoid fatty, sugary, carbohydrate foods, or water constitutes a restrictive eating plan with the aim of losing significant amounts of weight. People will often not eat with other people to avoid conflict about their diet and because they feel guilty for eating what they do.
Exercise, usually compulsive and past the point of healthy can take up a significant part of the day.,
Bulimia is ‘ox appetite’. People binge or overeat. Sometimes they feel guilty and then induce vomiting or regurgitation. Sometimes they take laxatives or emetics.
People become obsessed with the eating part of their lives and weight themselves, talk about food, diet, exercise, weight a lot.
Medical symptoms include dizzy spells, fainting, feeling cold especially hands and feet, weight loss, hiding the weight loss.
People become irritable, moody, angry., secretive, withdrawn, suicidal and at times psychotic.
Treatment
Stage 1 Re-feed and save this person’s life
This sometimes needs hospitalisation and naso-gastric feeding. Corrections of electrolytes, glucose levels and protein intake, fluid levels become a medical emergency.
Stage 2 Regain normal weight
Your doctor will tell you your normal weight. A healthy diet is needed and dietary advice.
Stage 3 Maintain normal weight
This is the most difficult one and you need to be monitored and weighed weekly.
Stage 4 Deal with the underlying problems.
This can happen at any time but your brain needs to be working before you can think at this level. There are many problems that cause eating disorders so correct diagnosis sand treatment is needed. Antidepressants are often needed to treat underlying or secondary depression.
Stage 5 Long- term treatment, management and prevention
On average it take about 2 years of treatment and maintaining your weight for the problem to go away. It may return for a number of different reasons so learning how to monitor your illness and having your doctor monitor you especially at times of stress is important for the rest of your life.
Families need support and help to manage. Family therapy is often used.
Complications
There are medical complications of eating disorders
Heart muscles may not be able to work properly due to lack of potassium , protein and sugar. A slow pulse rate is the first sign , but the heart can stop suddenly as well.
Bone leaches calcium so that osteoporosis ( brittle bones) with spinal crush fractures and ‘dowager’s hump’ can occur in later life.
Brain
Dehydration
Hormones can be disrupted with loss of periods or ovulation for up to a year after recovery. Often girls get downy hair on their face due to the changes of hormones.
Infection and illnesses can occur secondary to immune suppression.
There are psychiatric complications
Depression
Anxiety
Schizophrenia/psychosis
OCD
There can be interference with school, work, relationships and friends.
Some useful information.
The RANZCP
http://www.ranzcp.org/publicarea/cpg.asp#consumer
The Royal College of Psychiatrists (UK)
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/eatingdisorders.aspx
American Academy of Child and Adolescent Psychiatry
http://aacap.org/cs/root/resources_for_families/glossary_of_symptoms_and_illnesses/anorexia_nervosa
This is a good and comprehensive article, well referenced
http://www.mja.com.au/public/mentalhealth/articles/wilhelm/wilhelm.html
Government information
http://www.healthinsite.gov.au/topics/Eating_Disorders
another useful site
http://www.nimh.nih.gov/publicat/eatingdisorders.cfm
try this one
http://www.medicinenet.com/anorexia_nervosa/article.htm
lots of information here.
http://www.mayoclinic.com/health/eating-disorders/DS00294/DSECTION=2
Behaviour management
Here are some useful guidelines.
STEP 1
Analyse the behaviour. When and where does it happen- are there any clues here or use?
How often?
Is there a pattern?
Am I expecting too much given the independent developmental level of my child?
STEP 2
Set the RULES- in a positive frame- ie Do xxxxxxxx ( don’t do xxxxxxxxx is to too hard to follow). Have a family meeting once a week to set 5 rules each time as you update the past ones. Written rules are much easier to remember..
STEP 3
Set the goals- start with small achievable goals first.
STEP 4
The most powerful thing you can do is the POSITIVE REINFORCER.
The second most powerful thing you can do is the NEGATIVE REINFORCER.. That means that if you may lots of attention to unwanted behaviour, even in an angry way, it will increase!
The best way to stop behaviour you don’t want is to IGNORE it. Of course some behaviours are dangerous so they can’t be ignored. Ah the wisdom to know which is what. Take heart- we all get there by trial and error. There is no foolproof way for anything because humans are so complex.
Once you have established a behaviour you want, INTERMITTANTLY REINFORCE it
STEP 5.
Relax and enjoy life as you deserve it. Have fun and let your kids know that you much prefer each other’s company when you are having FUN.
What else.
A star chart is useful.
You get a star, positive reinforcer, for every time you do the required behaviour. There are no negative reinforcers on a star chart. That means no black marks or stars taken off etc.
It won’t work if the reinforcers are not valued by the person or they do not have a stake in the programme.
So sometimes we have to use CONSEQUENCES to behaviour. These are not punishment, they are about teaching your child to make choices, hopefully the right choice, and how to cope with the real world of choices and consequences.
The good news is that you don’t have to do too much here. Life offers lots of NATURAL CONSEQUENCES.
If you luck out and have to come up with your own consequences, give the offer only once then act. Don’t threaten consequences you can’t carry out. Use consequences as symbols rather than punishments. Use LOGICAL CONSEQUENCES as they make more sense to everyone.
AND
Children learn from others so you can model the right behaviour.
Need more information?
Triple P Parenting
http://www10.triplep.net/?pid=58
The Royal College of Psychiatrists (UK)
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthandgrowingup/2goodparenting.aspx
A nice website, based on education and behaviour management
http://www.ext.vt.edu/pubs/family/350-052/350-052.html
this is interesting
http://www.ext.vt.edu/pubs/family/350-052/350-052.html
This one is for FUN and lets you know that you are nor alone
http://www.behavioradvisor.com/
About Conduct Disorder
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Conduct_disorder?OpenDocument=
About ADHD
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Attention_deficit_hyperactivity_disorder?OpenDocument
Behaviour disorders in children
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Behavioural_disorders_in_children?OpenDocument
Discipline
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/discipline_children?OpenDocument
Bullying
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Bullying?OpenDocument
Children with disabilities
A heavy read but worth it
http://www.aihw.gov.au/publications/index.cfm/title/10086
I think this is the best part to read
http://www.aihw.gov.au/publications/dis/cda/cda-c02.pdf
Anger management
Do you find yourself blowing up like a volcano?
roaring like a lion?
Well we all are likely to blow up at times. But some people have shorter fuses than others.
So Step 1
STOP
When you notice the anger rising, stop and take your self away from the conflict zone
Step 2
THINK
This is the hardest bit. Why is there conflict? What was the miscommunication, misinformation? How can you handle this better.
BRAINSTORM some ideas.
ANALYSE them so you are anticipating the outcomes of your actions and prepared for the outcomes.
Step 3
TRY out your plan and analyse the result
LEARN from your mistakes and don’t make them again.
If you are a repeated hothead, blow off some steam with exercise, hard work and some creative arts.
Be a cool cat.
Kidzone
Kids Helpline call 1800551800
http://www.kidshelpline.com.au/home_KHL.aspx?s=6
OCD/ for kids
http://www.kidshealth.org/kid/health_problems/learning_problem/ocd.html
Asperger’s Syndrome
http://www.cyh.com/HealthTopics/HealthTopicDetailsKids.aspx?p=335&np=287&id=2339
Depression / for kids
http://www.cyh.com/HealthTopics/HealthTopicDetailsKids.aspx?p=335&np=287&id=2369
About eating disorders
http://www.kidshealth.org/kid/health_problems/learning_problem/eatdisorder.html
Help
Call 000 for all emergencies.
Toowoomba Ambulance
Toowoomba Police
Tooowoomba Fire Department
See your general practitioner
Kids Helpline freecall 1800551800
http://www.kidshelpline.com.au/home_KHL.aspx?s=6
Commonwealth Carelink
Toowoomba office, 10 Russell Street
http://www9.health.gov.au/ccsd/usr_general/find_centre_04.cfm?section=centre&state=6®ion=7073&shopfront=30&postcode=4350
.
There are emergency centres at
St Vincent’s Hospital Toowoomba
http://www.stvincents.org.au/index.asp
Toowoomba Health Services
http://www.health.qld.gov.au/wwwprofiles/twmba_twmba_hosp.asp
Psychiatric Hospitals
You will need a referral from a psychiatrist or your general practitioner will arrange admission for you if you are going to a private hospital.
Toowoomba
St Andrew’s Hospital has the only private hospital psychiatric ward
http://www.sath.org.au/
Toowoomba Health Services – a public hospital
http://www.health.qld.gov.au/wwwprofiles/twmba_twmba_hosp.asp
Brisbane
Toowong Private Hospital
http://www.toowongprivatehospital.com.au/
Belmont Private Hospital
http://www.apha.org.au/details/Belmont+Private+Hospital.html
New Farm Private Hospital
http://www.ramsayhealth.com.au/nfc/default.htm
Results of the Survey March 2007
Thank you for all your help getting some background information to help me put this site together. Here are the results.
Do you own a computer in your home yes 50 no 3
Do you use a computer outside your home yes 20 no 32
Do you research on the Internet ? yes 44 no 9
Would you visit a Web-page designed for education concerning psychiatric illness?
yes 45 no 7
Would you like links to information from this web-page?
yes 43 no 3
What information would you like on such a web-page?
The responses can be summarised as – signs and symptoms for Depression, Schizophrenia, Asperger’s syndrome, adolescent social problems, Children’s behaviour problems, Bipolar disorder
Treatments- medications and their side effects
Group therapy, hospitals and clinics available
Self help groups and chat rooms
Help for carers and parents
How to handle difficult behaviour
Where to find help.
Support for staff
Anger management
RESOURCES
Useful links
RANZCP have a patient portal for patients and carers with lots of wonderful information
http://www.ranzcp.org/publicarea/public.asp
and their website for resources
http://www.ranzcp.org/publicarea/resources.asp#aus
The Australian Government has a useful website that covers all sorts of things.
http://www.healthinsite.gov.au/
The Queensland Government .Queensland Health website
http://www.health.qld.gov.au/
The Royal College of Psychiatrists has a comprehensive website
http://www.rcpsych.ac.uk/mentalhealthinformation.aspx
and RCP (UK)website on treatment is very good
http://www.rcpsych.ac.uk/mentalhealthinformation/therapies.aspx\
This carers webpage is also excellent
http://www.rcpsych.ac.uk/campaigns/partnersincare.aspx
Beyond Blue for depression management
http://www.beyondblue.org.au/
Kids Helpline
http://www.kidshelpline.com.au/home_KHL.aspx?s=6
SANE Australia- useful information particularly for carers.
http://www.sane.org/
Some good information on this site- Auseinet
http://auseinet.flinders.edu.au/
ARAFMI Association of relatives and friends of the mentally ill.- Support services- Queensland branch
http://www.arafmiaustralia.asn.au/
Toowoomba Clubhouse
http://www.toowoombaclubhouse.org.au/access.html
Commonwealth Rehabilitation Services
Lots of information
http://psychcentral.com/
Depression
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Varieties of depression.
Mood Disorder Major Depression
Chronic Dysthymia
Symptoms of depression
Funnily enough not many people are actually sad but some are and their mood swings a lot.
Irritable or anxious mood is more common
No energy, no interests, tired, no fun any more, difficult to get the basics things done
Sleep is no good or in fact can’t stop sleeping
Can’t eat and lose weight or for some, comfort eating and put on weight
Feelings of hopeless, helpless and pointless, with no future take over. Time seems to drag.
Chronic pain can sometimes be the only sign.
What causes Depression?
Genetics can make you vulnerable, so this is a commonly inherited illness. With 20 % of our society suffering depression at some stage in their lives, there is a huge gene pool obviously.
Stressful events can trigger a depression but not always. Some stress is good for you.
Medical problems often cause depression
Living with someone who is depressed can cause depression
Losing someone close to you can cause depression.
Alcohol and cannabis cause depression
Treatment
Get the right diagnosis first and make sure that there isn’t a medical problem that needs treatment first. So see your doctor.
Medications
Antidepressants work well. They all take about 10 days to start working and about 6 weeks to be working fully. If they havn’t got you back to normal again, you may need an increased dose. So see your doctor.
Side effects for most people are reduced with the new antidepressant so its easy to get well.
Hospital is sometimes needed. A psychiatric ward is a special place where you can do group therapy and get help while you are getting better. Sometimes people can attend as a day patient if they are a bit better.
Psychotherapy. Help to make your thoughts change your mood is very useful. It will take some time to achieve this but will stand you in good stead to prevent and lessen symptoms of depression in the future.
Simple things you can do. Keep doing things and meeting people, having fun as much as you can. Exercise and a healthy diet are good for you whether you are depressed or not.
Don’t drink alcohol.
Check with your doctor that you are still safe to drive your car.
Outcome
Most depression will get better. Treatment reduces the suffering, loss of friends, marriages, relationships, jobs, health etc that depression can cause, not to mention the suffering. There is no cure as yet and most depressions will come back at some stage in your life. So look out for depression. And have someone close to you also watch out for the signs. Get treatment early. With good management the outcome can be great.
More information
Try these useful links
The Royal Australian and New Zealand College of Psychiatrists , (RANZCP)website is fantastic.
http://www.ranzcp.org/publicarea/cpg.asp#consumer
The Royal College of Psychiatrists (UK)
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/depression.aspx
Men and Depression
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/depression/mendepression.aspx
Postnatal Mental Health RCP (UK)
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/postnatalmentalhealth.aspx
Find Free Clipart at School Clip Art
Children and depression form the American Academy of Child and Adolescent psychiatry
http://aacap.org/cs/root/resources_for_families/glossary_of_symptoms_and_illnesses/depression
Beyond Blue
http://www.beyondblue.org.au/
An interesting web-program that is free
http://moodgym.anu.edu.au/default.asp?lang=1
Postnatal Depression
http://www.beyondblue.org.au/index.aspx?link_id=94
Depression for rural people- especially important with the drought .
http://www.beyondblue.org.au/index.aspx?link_id=84
This site has good description of all the antidepressants and their side effects.
http://www.beyondblue.org.au/index.aspx?link_id=89.581
Bipolar Disorder
What Causes Bipolar Disorder
It is an inherited disorder, once called Manic Depression.
Many illnesses can cause Mania and antidepressants can cause mania as well. Some illegal drugs cause highs as well.
Symptoms
Symptoms of depressive moods as well as manic (highs) episodes occur in Bipolar disorder.
See depression for a summary about this part of the illness.
During a high, the person experiences everything going too fast, time speeds up, thoughts and speech and actions all speed up. People can overspend, become irritable, take on too many interests, projects or work and wear out their friends and family.
Bipolar I or Bipolar II
Sometimes psychiatrists distinguish between bipolar disorder and a milder form (II) because there have not been manic episodes severe enough to need hospital care or cause severe symptoms but there are obvious mood swings with one or more mild manic times and depressions. Bipolar II also needs treatment and can be a forerunner of Bipolar I disorder.
Treatment
Antidepressants are best avoided as they can cause a manic episode.
We use Mood Stabilisers for this illness with usually good results. You have to remember that these do not cure and you are looking at lifelong management of your illness. Monitoring you r mood, slowing yourself down, taking yourself somewhere quiet is recommended for people when they are a bit high. See you r doctor if these don’t work. Dealing with anxiety is important, as it is a common feature of Bipolar Disorder. Dealing with relationship issues, family support and stressful events are best managed with your doctor.
Medications-
Mood stablisers.
Lithium carbonate, Lithicarb, 250 mgs or the slow release medication, Quilonum 450 mgs. This medication, first discovered by an Australian, John Cade, works well to stabilise mood. It is dissolved in the eater of you body so can become too high in your body if you get dehydrates, If you get a temperature, need surgery or are sick, stop the medications for a day or two until you are well again. The blood level must be tested every 6 months. We also check your thyroid function every year as Lithium can affect your thyroid.
Signs of toxicity- slurred speech, staggering gait, unwell, seek emergency medical treatment and drink lots of fluid.
Do not use in pregnancy or breast -feeding.
Sodium Valproate, Epilim or Valpro. This medication was first used as an anticonvulsant or for epilepsy. It is also a good mood stabiliser with rapid action, low side effects and no need for blood tests usually.
Olanzepine or Zyprexa. This also comes as a wafer. Do not cut this medication in half as it will render it unusable. This medication is an extremely good mood stabiliser. It is also an antidepressant, stops anxiety, helps to slow you down and get a good night sleep. It will make you tired. It will also make you hungry and if you eat too much you will put on a lot of weight and get diabetes. So monitor your weight with this one.
Aripiprazole or Abilify has been used outside Australia as a mood stabiliser. It has less side effects than Olanzepine but is not available for use here as yet.
Psychotherapy is important to learn how to deal with anxiety, monitor your mood and deal with stressful events. Support for your family is important so that they understand the illness. The children also need to know about the inherited nature of this illness.
More information
Try these links
RANZCP consumers and carers site
http://www.ranzcp.org/publicarea/cpg.asp#consumer
The Royal College of Psychiatrists (UK)
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/manicdepressionbipolar.aspx
The black dog institute has a good website
http://www.blackdoginstitute.org.au/bipolar/explained/index.cfm
And this site has a self -test page.
http://www.blackdoginstitute.org.au/bipolar/howtotell/selftest.cfm
Beyond Blue
http://www.beyondblue.org.au/index.aspx?link_id=89.581
Detailed summary of Bipolar disorder from the National Institute of Mental Health, USA
http://www.nimh.nih.gov/publicat/bipolar.cfm
More information
http://www.emedicinehealth.com/bipolar_disorder/article_em.htm
Anxiety Disorder/ Panic Disorder and Agoraphobia
Anxiety disorder is very common and most people worry at sometime. Some people are born worriers and others not. Children often suffer anxiety disorder. Anxious mothers often have anxious children, which might be genetic but can also be learnt.
When the worry starts to interfere with running a normal life, you need help.
Through the action of adrenalin, you body experiences anxiety, not just your mind. You can experience
Poor sleep
Shortness of breath
Palpitations or heart pain
Nausea, diarrhoea, abdominal pain
Urinary frequency
Tingling in your fingers
Dizziness or faintness
Sweaty palms and hot and cold flushes
Terror and an overwhelming feeling that something bad is going to happen.
When this happens suddenly and severe it is called a panic attack and you know that this is so bad that you are going to die.
If you run away when you feel this happening you will become phobic or always want to avoid situations that seem to cause panic. It is an understandable response but can lead to agoraphobia, or not wanting to leave the safety of your home.
Treatment
Medications
Antidepressants work well
Sometimes a medication called an anxiolytic, (stops anxiety) can be used until the antidepressant is working. I try to avoid the benzodiazepines (like Valium, Serapax and Xanax), because they lose their ability to work (tolerance) quickly and people can become addicted to them.
Cut out your caffeine intake as this causes anxiety, palpitations and panic disorder. You can buy decaffeinated coffee, tea and cola.
Cognitive Behaviour therapy
This is an important therapy to use as it will save you form panic attacks very quickly and you can prevent anxiety and panic from taking over your life. Breathing techniques, relaxation, desensitisation and response prevention are some of the things you can do in CBT
Sometimes you can get anxiety and panic from bad things that might have happened to you in the past. Sometimes we call that Post Traumatic Stress Disorder. You might then need to do some other type of psychotherapy to address that bad thing and its impact on your life.
Need more information
Check out these sites
RANZCP website
http://www.ranzcp.org/publicarea/cpg.asp#consumer
The Royal College of Psychiatrists (UK)
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/anxietyphobias.aspx
Beyond Blue webpage
http://www.beyondblue.org.au/index.aspx?link_id=90
This is also a good website with some good resources.
http://www.panicanxietydisorder.org.au/
an interesting article
http://www.abc.net.au/health/library/anxietydisorders_ff.htm
More information
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Anxiety_treatment_options
This page is useful for men, women and young people
http://www.womhealth.org.au/factsheets/anxiety_disorders.htm
and this one
http://www.mydr.com.au/default.asp?article=2842
American Academy of Child and Adolescent Psychiatry
http://aacap.org/cs/root/resources_for_families/glossary_of_symptoms_and_illnesses/anxiety
Obsessive Compulsive Disorder
What is this?
Obsessive Compulsive Disorder (OCD) is usually inherited. People with OCD can also have
Tic Disorders or Gilles de la Tourette Disorder. This is a series of movements, noises that are habits, like winking, blinking, throat clearing.
And Trichotillomania. In this problem people twirl and pull their hair. Sometimes they look and feel the end of the hair and sometimes put it in their mouth. It is a common thing that people hide it from other people.
And other Habit Disorders, like biting your fingernails or scratching your skin.
It often starts when you are about 7 years of age and comes and goes throughout your life or when things get stressful. Sometimes, stressful problems makes OCD start.
OCD can be partners with depression or schizophrenia.
What are the symptoms?
OBSESSIONS are thoughts that are nasty and unwanted. You know that they are your own thoughts but you didn’t invite them and you find it hard to tell them to go away. They are commonly thoughts of bad accidents to yourself o your family, people you love dying or being caught by the police for something you didn’t do. They may be thoughts about saying rude things by accident. Sometimes people get pictures in their head of the bad things happening. These thoughts tend to take up all your mind-space so it is hard to concentrate on other people, work or school.
COMPULSIONS are the actions that people take to stop the bad things happening or keep the bad thoughts away. The actions are things like counting your steps and making sure that you reach a magic number of steps. Checking light switches, windows and door and washing your hands to get rid of germs are common compulsions. Saying prayers a set number of times or touching religious pictures, lining up your shoes, books, straightening things in perfect alignment., hoarding things are all common actions. Unfortunately they can take up a lot of your time and energy and are difficult to hide from other people.
How do we treat it?
Medications
Antidepressants
Most antidepressants will work well for OCD. For children Luvox is well tested with few side effects. Anafranil (Clomipramine) is the best antidepressant to use in OCD but has a lot of side effects so psychiatrists usually use SSRI medications first.
Tranquillisers
The anxiety and distress of OCD can often settle quickly with these medications so they are useful particularly until the antidepressant starts to work.
Cognitive Behaviour Therapy
Once you analyse all the obsessions and compulsions you can plan their attack. It is easier to deal with compulsions first. With CBT you learn to control anxiety. Then you can use RESPONSE PREVENTION. This means that you stop the OCD from making you do the compulsions. As your anxiety increases, the OCD is trying to win and force you to do the compulsion, you can use the CBT to reduce your anxiety. You win, OCD loses. Once you have controlled one compulsion you are then in a better position to tackle the others and then the obsessions.
Psychoanalysis
There has been a lot of good therapy for OCD using psychoanalysis. Your psychiatrist can help you make a decision of this is useful for your sort of OCD.
Useful links
The Royal College of Psychiatrists website ( UK) is comprehensive
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/obsessivecompulsivedisorder/obsessivecomplusivedisorder.aspx
This is a self- assessment site
http://psychcentral.com/ocdquiz.htm
American Academy of Child and Adolescent Psychiatry on Tourette’s Disorder
http://aacap.org/page.ww?section=Glossary+of+Symptoms+and+Illnesses&name=Tourette%27s+Syndrome
and for OCD
http://aacap.org/cs/root/resources_for_families/glossary_of_symptoms_and_illnesses/obsessivecompulsive_disorder_ocd
Attention Deficit Hyperactivity Disorder ADHD, Attention Deficit Disorder ADD
Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) have no reliable diagnostic tests. There is a spectrum of activity and children always have more energy than adults. So we have to keep in mind the correct developmental level for children when making this diagnosis. So if your child is more active than other kids and cannot sit still, pay attention , wait their turn, is impulsive more than other kids their age , they may have an ADD that is interfering with their ability to learn and to cope with family rules.
Children with ADHD and ADD are often depressed because of they are in trouble and not learning and their ability to make friends is effected. They may also be depressed because this is the same area of the brain as the ADHD and ADD. Sometimes kids with an ADHD picture have a childhood form of Bipolar Disorder.
ADHD and ADD may lead to behaviour problems and Oppositional Defiant Disorder and Conduct Disorder.
Boys are more likely to have ADHD and girls have ADD. ADD is more likely to be missed as these people sit quietly and don’t draw attention to themselves.
Children with these disorders are most likely to have a Communication Disorder which requires diagnosis and treatment by a Speech Therapist
ADHD and ADD is inherited and children are born with this problem. Most children outgrow this problem in adolescence although a small number continue to suffer all their lives.
Treatment
We treat ADHD and ADD because we want to limit the behavioural, educational, self-esteem and social skills problems that can occur for these children.
There is good evidence that 50% of children with ADHD has food sensitivities and an elimination diet is good to try.
See this site http://members.ozemail.com.au/~breakey/
Behaviour treatment is very necessary and these children need a much more controlled environment than other kids. As heir attention span is short, tasks need to be divided into small chunks, simple commands given, one at a time and rewards for completion of tasks immediate. They need time to get the ‘jumping beans’ out of them.
Medications are highly contested as people see that ADHD can be a societies intolerance to children rather than an illness. Some of the medications have side effects that are not nice for young children. If he child is suffering and their development is hampered and all the above has not worked, I think that the issue of medications needs to be discussed with the child’s needs in mind. Medications include
Antidepressants
The SSRI are stimulant but without the side effects of the other medications. They are not as strong and I think that they are a good place to start. They will also treat the depression component of ADHD/ADD.
Stimulants
Dexamphetamine, Methylphenindate(Ritalin, Concerta) , Atomexetine (Strattera) are used. Some are now in long acting formulae.
They are active within 20 minutes of taking them and last 4 to 8 hours.
They may reduce appetite, interfere with sleep, cause a rebound hyperactivity when they wear off , depression and delirium ( rarely). We try to keep the lowest dose needed and sometimes give drug holidays so that we only use the medications on school days.
Some kids need it every day because of the disruption to their home as well.
Useful links
Australian Government website with lots of papers and links
http://www.healthinsite.gov.au/topics/Attention_Deficit_Disorder__ADD_or_ADHD_\
Lots of information in this place
http://www.nimh.nih.gov/publicat/adhd.cfm
This website is easy to read and very useful for parents and teachers
http://www.kidshealth.org/parent/medical/learning/adhd.html
Diagnosis
http://www.cdc.gov/ncbddd/adhd/symptom.htm
a newsletter
http://familydoctor.org/118.xml
A symptom checklist
http://pediatrics.about.com/cs/adhd/l/bl_adhd_quiz.htm
Treatment information
http://www.keepkidshealthy.com/medicine_cabinet/adhd_medications.html
American Academy of Child and Adolescent Psychiatry
http://aacap.org/page.ww?section=Facts+for+Families&name=Children+Who+Can't+Pay+Attention%2FADHD
Post traumatic Stress Disorder
Symptoms
Flashbacks or bad memories
Triggers or things that bring back the memories
Avoiding things that remind you of the trauma
Withdrawal from people and life
Depression
Anxiety and Panic Attacks
Irritability
Increased arousal and startle reponses
Nightmares
Treatment
Medications
Antidepressants work well for the anxiety and depression symptoms of PTSD.
Tranquillisers are useful to help with sleep problems and reduce anxiety.
Psychotherapies
Cognitive Behaviour Therapy
Narrative Therapy
Psychodynamic Psychotherapy
These are some of the types of therapy used. You need a professional psychiatrist or psychologist for this sort of work. Psychotherapy is an important part of treatment Sometimes you need medications to feel well enough to be abele to cope with psychotherapy.
Some Useful Links
The Royal College of Psychiatrists
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/posttraumaticstressdisorder.aspx
for children and adolescents, American Academy of Child and Adolescent Psychiatry
http://aacap.org/cs/root/resources_for_families/glossary_of_symptoms_and_illnesses/posttraumatic_stress_disorder_ptsd
and another website about PTSD and children
http://www.kidshealth.org/parent/emotions/feelings/ptsd.html
Comprehensive website Mayo Clinic
http://www.mayoclinic.com/health/post-traumatic-stress-disorder/DS00246
This is a good website for Vietnam Veterans
http://www.dva.gov.au/health/vvcs/family.htm
more information
http://www.ncptsd.va.gov/ncmain/index.jsp
Secondary to cancer
http://www.cancer.gov/cancertopics/pdq/supportivecare/post-traumatic-stress/patient
Simple information
http://familydoctor.org/624.xml
Asperger’s syndrome
Asperger’s Syndrome is a Pervasive Developmental Disorder related to Autism.
This syndrome has become somewhat over-diagnosed of recent times because it attracts funding. It has also been levelled in an unkind way against men who don’t communicate their emotions well.
Symptoms
There is always a delay in language and communication skills for these people
This creates social skills problems and autistic behaviour (withdrawal form [people).
People with Asperger’s syndrome have a restricted areas of interested but become obsessional about them They also become obsessional about ritual and objects and have separation anxiety, panic and behavioural problems if you change things around.
People with Asperger’s syndrome have little understanding of emotions for themselves or other people so they lack empathy or emotional attachment to people. They don’t like cuddles and prefer to be alone.
There is often unusual and eccentric behaviour and language.
Children do not have ability for fantasy or play but may be drawn to spinning objects.
Co-Morbid Problems
People with Asperger’s Syndrome often have other psychiatric disorders that need diagnosis and treatment. These include
Depression
Schizophrenia
ADHD
OCD
Learning Disorders
Treatment
Children with Asperger’s Syndrome need Special Education
A Speech Therapist is important to help these people with their language, communication and social skills
Behaviour therapy is important but the usual interventions may not work well and help is needed to devise a good behaviour management plan. See your GP, child psychiatrist, child psychologist, special education teacher and Guidance officer at school or get help form the Autistic Association
Local support groups are useful for the carers of children with Asperger’s Syndrome
Some children respond well to Rispiridone or other tranquillisers although this is not a cure.
Some useful links
American Academy of Child and Adolescent Psychiatry
http://aacap.org/page.ww?section=Facts+for+Families&name=Aspergers+Disorder
This is a good summary and management plan from a teacher’s perspective
http://www.behavioradvisor.com/AspergersSyndrome.html
More information
http://www.aspergers.com/
Another useful link
http://www.disability.vic.gov.au/dsonline/dsarticles.nsf/pages/Asperger's_syndrome
Kid’s site
http://www.cyh.com/HealthTopics/HealthTopicDetailsKids.aspx?p=335&np=287&id=2339
Asperger’s Association
http://www.asperger.asn.au/Contact+Us
Autism Association
http://www.autismqld.com.au/
Schizophrenia
Symptoms
Sometimes before the following symptoms occur, the person suffers prodromal symptoms of depression, anxiety, OCD, difficulty organising themselves, thinking, and withdrawal from school, friends, work and family.
Delusions. There are thoughts and convictions that are based on faulty reasoning and are untrue. They may make people act in unsafe, self-b harmful or dangerous ways.
Hallucinations are voices, noises or visions that are not real but seem real to the person suffering them.
Thought disorder means that thoughts do not go in straight lines and become confused.
It is uncommon to see children with schizophrenia although it is possible. Most symptoms start in puberty or early adolescence although some forms of schizophrenia do not have symptoms until mid-life,
Causes
Most schizophrenia has no known causes although there is a lot of research to find the cause. Genetics has an important role as there are some people who have inherited an increased risk of developing schizophrenia
Drugs cause schizophrenia
Head Injuries can cause schizophrenia
Schizophrenia is more common in people who have epilepsy orAsperger’s syndrome
Treatment
Medications
Antipsychotic medications
Older medications
Neulactil
Chlorpromazine (Thorazine)
Haloperidol (Haldol)
Flupenthixol
Trifluperazine ( Stelazine)
Newer medications have fewer side effects
This article summaries the issues although it is a little dated.
http://www.australianprescriber.com/magazine/22/4/81/3/
Risperidone ( Risperdal)
Quetiapine (Seroquel)
Olanzepine (Zyprexa)
Amisulpride (Solian)
Clozapine(Clozaril)
Aripiprazole (Abilify)
See these websites
http://www.sane.org/information/factsheets/antipsychotic_medication.html
http://support4hope.com/medications/antipsychotic/index.htm
http://support4hope.com/medications/antipsychotic/aripiprazole_abilify.htm#1
http://support4hope.com/medications/antipsychotic/chlorpromazine_thorazine.htm#1
http://support4hope.com/medications/antipsychotic/clozapine_clozaril.htm#1
http://support4hope.com/medications/antipsychotic/flupenthixol_fluanxol.htm#1
http://support4hope.com/medications/antipsychotic/olanzapine_zyprexa.htm#1
http://support4hope.com/medications/anti_anxiety/trifluoperazine_stelazine.htm#1
http://support4hope.com/medications/antipsychotic/quetiapine_seroquel.htm#1
http://support4hope.com/medications/antipsychotic/risperidone_risperdal.htm#1
Antidepressants are often used to treat the depression that often accompanies schizophrenia.
Support is important and includes your doctor, psychiatrist, family and community services.
Home life is often disrupted when someone suffers schizophrenia and there are supports for the family as well.
Work may need to understand the limitations that schizophrenia applies and the difficulties the person may have with some aspects of work. Supported work and occupational therapy are useful. In Toowoomba Clubhouse helps with this, CRS offers supported retraining and employment as well as the employment agencies that specialise in areas of need and people who have disabilities.
Friends
Accommodation is important and many people ill with schizophrenia lack basic resources. Centrelink and the Housing Department can help with these needs.
Find Free Clipart at School Clip Art
Finances can be assisted by Centrelink and managed by the Public Trustee if needed.
CBT can help deal with voices that are interfering.
RANZCP website
http://www.ranzcp.org/publicarea/cpg.asp#consumer
American Academy of Child and Adolescent Psychiatry
http://aacap.org/page.ww?section=Facts+for+Families&name=Schizophrenia+In+Children\
SANE
http://www.sane.org/information/factsheets/schizophrenia.html
Eating disorders
Anorexia nervosa
Bulimia nervosa
Obesity
These are the three main sorts of eating disorder and they can co-exist or move from one variety to another over time. These disorders are mostly suffered by girls but boys can get this too.
Symptoms
Not eating and the compulsion to avoid fatty, sugary, carbohydrate foods, or water constitutes a restrictive eating plan with the aim of losing significant amounts of weight. People will often not eat with other people to avoid conflict about their diet and because they feel guilty for eating what they do.
Exercise, usually compulsive and past the point of healthy can take up a significant part of the day.,
Bulimia is ‘ox appetite’. People binge or overeat. Sometimes they feel guilty and then induce vomiting or regurgitation. Sometimes they take laxatives or emetics.
People become obsessed with the eating part of their lives and weight themselves, talk about food, diet, exercise, weight a lot.
Medical symptoms include dizzy spells, fainting, feeling cold especially hands and feet, weight loss, hiding the weight loss.
People become irritable, moody, angry., secretive, withdrawn, suicidal and at times psychotic.
Treatment
Stage 1 Re-feed and save this person’s life
This sometimes needs hospitalisation and naso-gastric feeding. Corrections of electrolytes, glucose levels and protein intake, fluid levels become a medical emergency.
Stage 2 Regain normal weight
Your doctor will tell you your normal weight. A healthy diet is needed and dietary advice.
Stage 3 Maintain normal weight
This is the most difficult one and you need to be monitored and weighed weekly.
Stage 4 Deal with the underlying problems.
This can happen at any time but your brain needs to be working before you can think at this level. There are many problems that cause eating disorders so correct diagnosis sand treatment is needed. Antidepressants are often needed to treat underlying or secondary depression.
Stage 5 Long- term treatment, management and prevention
On average it take about 2 years of treatment and maintaining your weight for the problem to go away. It may return for a number of different reasons so learning how to monitor your illness and having your doctor monitor you especially at times of stress is important for the rest of your life.
Families need support and help to manage. Family therapy is often used.
Complications
There are medical complications of eating disorders
Heart muscles may not be able to work properly due to lack of potassium , protein and sugar. A slow pulse rate is the first sign , but the heart can stop suddenly as well.
Bone leaches calcium so that osteoporosis ( brittle bones) with spinal crush fractures and ‘dowager’s hump’ can occur in later life.
Brain
Dehydration
Hormones can be disrupted with loss of periods or ovulation for up to a year after recovery. Often girls get downy hair on their face due to the changes of hormones.
Infection and illnesses can occur secondary to immune suppression.
There are psychiatric complications
Depression
Anxiety
Schizophrenia/psychosis
OCD
There can be interference with school, work, relationships and friends.
Some useful information.
The RANZCP
http://www.ranzcp.org/publicarea/cpg.asp#consumer
The Royal College of Psychiatrists (UK)
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/eatingdisorders.aspx
American Academy of Child and Adolescent Psychiatry
http://aacap.org/cs/root/resources_for_families/glossary_of_symptoms_and_illnesses/anorexia_nervosa
This is a good and comprehensive article, well referenced
http://www.mja.com.au/public/mentalhealth/articles/wilhelm/wilhelm.html
Government information
http://www.healthinsite.gov.au/topics/Eating_Disorders
another useful site
http://www.nimh.nih.gov/publicat/eatingdisorders.cfm
try this one
http://www.medicinenet.com/anorexia_nervosa/article.htm
lots of information here.
http://www.mayoclinic.com/health/eating-disorders/DS00294/DSECTION=2
Behaviour management
Here are some useful guidelines.
STEP 1
Analyse the behaviour. When and where does it happen- are there any clues here or use?
How often?
Is there a pattern?
Am I expecting too much given the independent developmental level of my child?
STEP 2
Set the RULES- in a positive frame- ie Do xxxxxxxx ( don’t do xxxxxxxxx is to too hard to follow). Have a family meeting once a week to set 5 rules each time as you update the past ones. Written rules are much easier to remember..
STEP 3
Set the goals- start with small achievable goals first.
STEP 4
The most powerful thing you can do is the POSITIVE REINFORCER.
The second most powerful thing you can do is the NEGATIVE REINFORCER.. That means that if you may lots of attention to unwanted behaviour, even in an angry way, it will increase!
The best way to stop behaviour you don’t want is to IGNORE it. Of course some behaviours are dangerous so they can’t be ignored. Ah the wisdom to know which is what. Take heart- we all get there by trial and error. There is no foolproof way for anything because humans are so complex.
Once you have established a behaviour you want, INTERMITTANTLY REINFORCE it
STEP 5.
Relax and enjoy life as you deserve it. Have fun and let your kids know that you much prefer each other’s company when you are having FUN.
What else.
A star chart is useful.
You get a star, positive reinforcer, for every time you do the required behaviour. There are no negative reinforcers on a star chart. That means no black marks or stars taken off etc.
It won’t work if the reinforcers are not valued by the person or they do not have a stake in the programme.
So sometimes we have to use CONSEQUENCES to behaviour. These are not punishment, they are about teaching your child to make choices, hopefully the right choice, and how to cope with the real world of choices and consequences.
The good news is that you don’t have to do too much here. Life offers lots of NATURAL CONSEQUENCES.
If you luck out and have to come up with your own consequences, give the offer only once then act. Don’t threaten consequences you can’t carry out. Use consequences as symbols rather than punishments. Use LOGICAL CONSEQUENCES as they make more sense to everyone.
AND
Children learn from others so you can model the right behaviour.
Need more information?
Triple P Parenting
http://www10.triplep.net/?pid=58
The Royal College of Psychiatrists (UK)
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthandgrowingup/2goodparenting.aspx
A nice website, based on education and behaviour management
http://www.ext.vt.edu/pubs/family/350-052/350-052.html
this is interesting
http://www.ext.vt.edu/pubs/family/350-052/350-052.html
This one is for FUN and lets you know that you are nor alone
http://www.behavioradvisor.com/
About Conduct Disorder
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Conduct_disorder?OpenDocument=
About ADHD
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Attention_deficit_hyperactivity_disorder?OpenDocument
Behaviour disorders in children
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Behavioural_disorders_in_children?OpenDocument
Discipline
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/discipline_children?OpenDocument
Bullying
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Bullying?OpenDocument
Children with disabilities
A heavy read but worth it
http://www.aihw.gov.au/publications/index.cfm/title/10086
I think this is the best part to read
http://www.aihw.gov.au/publications/dis/cda/cda-c02.pdf
Anger management
Do you find yourself blowing up like a volcano?
roaring like a lion?
Well we all are likely to blow up at times. But some people have shorter fuses than others.
So Step 1
STOP
When you notice the anger rising, stop and take your self away from the conflict zone
Step 2
THINK
This is the hardest bit. Why is there conflict? What was the miscommunication, misinformation? How can you handle this better.
BRAINSTORM some ideas.
ANALYSE them so you are anticipating the outcomes of your actions and prepared for the outcomes.
Step 3
TRY out your plan and analyse the result
LEARN from your mistakes and don’t make them again.
If you are a repeated hothead, blow off some steam with exercise, hard work and some creative arts.
Be a cool cat.
Kidzone
Kids Helpline call 1800551800
http://www.kidshelpline.com.au/home_KHL.aspx?s=6
OCD/ for kids
http://www.kidshealth.org/kid/health_problems/learning_problem/ocd.html
Asperger’s Syndrome
http://www.cyh.com/HealthTopics/HealthTopicDetailsKids.aspx?p=335&np=287&id=2339
Depression / for kids
http://www.cyh.com/HealthTopics/HealthTopicDetailsKids.aspx?p=335&np=287&id=2369
About eating disorders
http://www.kidshealth.org/kid/health_problems/learning_problem/eatdisorder.html
Help
Call 000 for all emergencies.
Toowoomba Ambulance
Toowoomba Police
Tooowoomba Fire Department
See your general practitioner
Kids Helpline freecall 1800551800
http://www.kidshelpline.com.au/home_KHL.aspx?s=6
Commonwealth Carelink
Toowoomba office, 10 Russell Street
http://www9.health.gov.au/ccsd/usr_general/find_centre_04.cfm?section=centre&state=6®ion=7073&shopfront=30&postcode=4350
.
There are emergency centres at
St Vincent’s Hospital Toowoomba
http://www.stvincents.org.au/index.asp
Toowoomba Health Services
http://www.health.qld.gov.au/wwwprofiles/twmba_twmba_hosp.asp
Psychiatric Hospitals
You will need a referral from a psychiatrist or your general practitioner will arrange admission for you if you are going to a private hospital.
Toowoomba
St Andrew’s Hospital has the only private hospital psychiatric ward
http://www.sath.org.au/
Toowoomba Health Services – a public hospital
http://www.health.qld.gov.au/wwwprofiles/twmba_twmba_hosp.asp
Brisbane
Toowong Private Hospital
http://www.toowongprivatehospital.com.au/
Belmont Private Hospital
http://www.apha.org.au/details/Belmont+Private+Hospital.html
New Farm Private Hospital
http://www.ramsayhealth.com.au/nfc/default.htm
Results of the Survey March 2007
Thank you for all your help getting some background information to help me put this site together. Here are the results.
Do you own a computer in your home yes 50 no 3
Do you use a computer outside your home yes 20 no 32
Do you research on the Internet ? yes 44 no 9
Would you visit a Web-page designed for education concerning psychiatric illness?
yes 45 no 7
Would you like links to information from this web-page?
yes 43 no 3
What information would you like on such a web-page?
The responses can be summarised as – signs and symptoms for Depression, Schizophrenia, Asperger’s syndrome, adolescent social problems, Children’s behaviour problems, Bipolar disorder
Treatments- medications and their side effects
Group therapy, hospitals and clinics available
Self help groups and chat rooms
Help for carers and parents
How to handle difficult behaviour
Where to find help.
Support for staff
Anger management
RESOURCES
Useful links
RANZCP have a patient portal for patients and carers with lots of wonderful information
http://www.ranzcp.org/publicarea/public.asp
and their website for resources
http://www.ranzcp.org/publicarea/resources.asp#aus
The Australian Government has a useful website that covers all sorts of things.
http://www.healthinsite.gov.au/
The Queensland Government .Queensland Health website
http://www.health.qld.gov.au/
The Royal College of Psychiatrists has a comprehensive website
http://www.rcpsych.ac.uk/mentalhealthinformation.aspx
and RCP (UK)website on treatment is very good
http://www.rcpsych.ac.uk/mentalhealthinformation/therapies.aspx\
This carers webpage is also excellent
http://www.rcpsych.ac.uk/campaigns/partnersincare.aspx
Beyond Blue for depression management
http://www.beyondblue.org.au/
Kids Helpline
http://www.kidshelpline.com.au/home_KHL.aspx?s=6
SANE Australia- useful information particularly for carers.
http://www.sane.org/
Some good information on this site- Auseinet
http://auseinet.flinders.edu.au/
ARAFMI Association of relatives and friends of the mentally ill.- Support services- Queensland branch
http://www.arafmiaustralia.asn.au/
Toowoomba Clubhouse
http://www.toowoombaclubhouse.org.au/access.html
Commonwealth Rehabilitation Services
Lots of information
http://psychcentral.com/
project
Psycho-education and setting up a web-site.
Key words
Psychoeducation; Website; Constructionism; Connectivism
Introduction
This project is an authentic learning activity with naturalistic feedback, online community learning feedback and scafolding and facilitator response. Patient, peers and community feedback also informed the connectivist model of learning. The fnal outcome of a Web-site for the purposes of Psychoeducation is a dynamic project that will grow within a model of life-long and life-wide learning.
Discussion
Aims and Projected outcomes
Psycho-education has been found to be an important adjunct to good wholistic treatment of mental illness.( Shimazu et al (2005); Sorensen, Done & Rhodes 2006; Pekkala & Merinder, 2002; United States Department of health and human services; Queensland Health; Psycho-Educational Counselling Services, Inc. 2003) I have been using ‘talk and chalk’ methods for many years as a clinical psychiatrist in private practice. I felt quite advanced when I moved to the technology of a white board. Many patients are technologically savvy and it is easier to refer them to the Internet (HON Surveys 2001; Leu et al 2004). In fact many patients have already researched their illness and treatments before they come and see me. Psychiatrists today have learnt that they can’t know everything that has been stated about psychiatry on the Internt or in the popular press and that our role has offten become that of facilitator in the learning process. We help people make meaning of all the things they have heard, give a professional perspective and direct them to other sources for a balanced view. It was important however to ensure that psychoeducation was not learned only in an online format as the therapeutic relationship and medical treatment were the most important treatment parameters.
Rationale
For many years I have realised that a website that collated this information, from my perspective was neccesary. Offering links to information and resources to patients and their families was also a frequently requested item.Referring people to the website for ememergency procedures, contacts and advise could help cover the resource issues in this rural region especially in ‘after-hours’ timeframe (RANZCP 2007 ).
This project seemed like the ideal time to put the process into action and gave me a structure to use.There was a timeframe set by the university calendar and the resources, support, ideas, supervision available from facilitator and online study community. I already had in mind the general outline, structure and design of the website based on projected need, visiting other websites and my own creativity. The added content from this course to think about was multimodal and online learning pedagogies.
Evaluation
Researching what is already there was a good place to start. There were no other colleaugues who had established a website for reference, that I know. The Royal Australian and New Zealand has a very useful website (The Royal Australian and New Zealand College of Psychiatrists).The American and British colleges and the American Academy of Child and Adolescent Psychiatry all had reams of information and proffesionally designed website(Royal College of Psychiatrists ; The American Academy of Child and Adolescent Psychiatry; The American College of Pscyhiatrists) . Googlesearchs of the main diagnoses and treatments revealed huge numbers of resources. The problem was too much information.
Researching patient’s needs became the next most important step. I designed a quick questionairre to assess the perceived needs.(Appendix 2). I checked with my lecturer about the ethics of that research. By keeping the responses anonymous and asking my receptionist to ask people to fill in the questionairre, I was appying no pressure to the patients and they would know that their treatment or the therapeutic relationship was not harmed by this process. It was interesting to see that everyone was keen to fill out the form. Even some carers, colleaugues and occasional visitors showed a keen interest in the project, projected benefits from it and volunteered to fill in the form.By keeping it simple and small it was not an onerous task. By keeping the questions yes or no, it was easy to score. The final question was a projective question that was seeking areas of need and interest and was the most useful.
It was interesting to note that almost all my patients had a computer and Internet facilities.This may reflect the bias of this sample as they are all private patients who may have more disposable income that the general population. They were mostly keen to see a website devoted to their needs and this was reflected in their choices for content. Most patients asked about the project and the website and discussed this as part of their consultation, giving me extra feedback.They were keen to see the website when completed and give feedback online.
I had aimed to put the information together in a weekend and have the site ready within a week. I found that it was much more work than that.Each topic needed to be concise but give structure to the reader. Some of my patients need basic information and others need academic, scientific levels of information. I did not want to write a text book but took the idea that the World Wide Web is really a network and to make it productive, networking and links to other information was its very essence (Lee ). I spend more time researching the various websites for inclusion and excluding those that were unsuitable. I realised that this website I am constructing will always remain a work in progress.Once the basic structure is in place, I can keep adding to it and altering information as it is needed. In this way the website can remain a dynamic document but will always require a few hours of work a week to maintain.
The webmaster was my son who studies Bachelor of Information Technology and is a computer technician. I began to understand that the communication required to direct him towards the creation of the website was a whole new field of learning for me. I was frustrrated that I could not navigate html myself so it is next on the list of things to learn. It took a lot of work and time to construct the website, more than I thought it would. The nice things about websites is that they are interesting and not like a book, so the creative component of the website, colour, layout, design, fonts were all important aspects of communication to the webmaster. The webmaster used his e-mail for feedback. He soon realised that the e-mail name ‘addlebrains’ was potentially disrespectful and so had to change this to his workplace account.
I wanted pictures and photographs for a multimodal effeect as I could see that text was not very enticing (Semali & Fueyo, 2001). Another son gave me the link to deviant art which was a wonderful place to lose more time in a pleasant way (Deviantart). I have always used art to convey meaning in lectures and found it useful. I added photographs and art work so that the website started to look really lovely. Then I realised that I had a copyright problem.I had already needed to limit some of the work on my website as the text would have breached copyright, although no knowledge is plaigarism free. So I had to remove all the pictures and start again. I found some clipart that sufficed and was free to use. My next part of this project is to photograph my own artwork and use those pieces and take my own photographs to illustrate the website. Gradually you can see that although I have learnt a lot of useful information along the way, the process was becoming more complex over time. The timeframe for launching the website and obtaining feedback from colleaugues and patients, and the general public was escaping.
I was able to launch the first draft website and got some interesting feedback from two of my peers in my online learning community. I have yet to add a wiki as a simple and easy to administer feedback system. We changed the headings and highlights for links in keeping with other feedback. I was interested to note that my peers were also keen to see the site and give me their thoughts and useful links. This was a pleasant pat of the learning experience.
The pedagogies in use in the website involve a constructivist approach. By providing links to information and a baseline framework of how to look at the various illnesses and contact with other sufferers in the global community, there is validation for each person as well as their capacity to seek and understand information to their own needs and levels of understanding. The connection to various websites and pieces of information allows a connectivist approach (Kinzer, 2003).
This reflects Vygotsky’s approach of a zone of proximal development and scafolding towards learning (Blunden, 2001). There is a sense of the socio-historico-cultural learning process in such a website. One can also see that there is the potential for discourse for learning as well. My pedagogy for learning was a project based, authentic, problem-based approach (Finkle & Torp, 2005; Holland, 2005; Jarvin, 2006).
Linguistic design was an important component to me (Cope & Kalantzis, 2000). The words used need to be explained and simple without infantalising. This was complex given the differrent levels of education my patients have. I think that people prefer simple language and not to feel overwhelmed by techincal or academic language.This is difficult for me as my mind is well versed and trained to think academically and I love a rich vocabulary. There is no feedback from patients as when they are in my rooms so I had to be careful of using simple language but not to insult anyone’s intelligence (Cope & Kalantzis 2000 (2). I found that a website about metal illness to be very depressing, serious and dour which reflects the problems of mental illness. I wanted the information to be positive, without denying or failing to validate the suffering and to be lighthearted without being irreverant.
I chose light blue/gray as a background and the front page with limited colur and information to present a professional image and not to clutter the non-verbal presentation (Callow 2003). I chose to not include audio input at this point in time because it was too complex and would delay the launch of the website. The project for the future is to record, using authentic presentation, an intoduction, providing audio input for the visually impaired and expanding the sensory learning. The pages lead towards the centre and contain concise information so as not to overwhelm the reader. I also wanted plenty of space and not clutter the pages as some patients are already thought disordered and would find it too confusing. I think that the basic information needed to be linear and the links for divergent thinking were scafolded on top of this.This is reflected in the architecture of the pages. I originally used a stream of consciousness to write the pages but found that it was too easy for others to get lost in the flow. I then introduced headings and spaces to allow a framework to develop and room to think between topics. I think tha the page ‘anger management’ reflects this style well especially given that people with anger management problems often get frustrated, have language and communication problems and poor concentration (Apendix 4)
The website can be found at http://drjoycearnold.freehostia.com/psych.html. There is still more information that the webmaster needs to load which is available on my blog (http://joycearnoldsspace.blogspot.com/). As discussed above, this is an evolving process, a work-in-progress and will have continual updating. Some of the updating will be in repsonse to the wiki included and feedback from site visitors. I intend to give all my patients this address on my business card so that they can visit and comment online or when they see me. I intend to advertise this link to general practitioners so they can access it and the links and they can provide feedback. I will give this link to my colleuagues at our Maintenence of professional standards (MOPS ) meetings and obtain feedback from them. They are already aware of this project and agree that it is useful and innovative.It reflects the future of learning in the digital age (North Central Regional Educational Laboratory 2005).They were happy to allow me to set it up and give feedback before they would do this project themsleves. Thay are more likely to refer their patients to my website than set up their own as time is precious and are psychiatrists are busy people.
I also kept a reflective journal about the process so I did not lose any ideas I had, could revisit the issues and build on them, using a constructivist appoach, Some of these ideas are on my blog and others in a private journal. http://joycearnoldsspace.blogspot.com/
I think that the process of setting up a website was a huge learning curve and an authentic learning project for me.As part of life- long and life -wide learning, this is the first step ( Education Queensland nd) There is more to do and learn and this project wil lalso help people with mental illnes and their carers obtain information, find resources and steer away from negative or wrong information. I have experienced an authentic learning project and have realised its potential to teach. At this point in time I do not see this as useful for the website design but it may be possible, particulalrly in the kidszone part where projects will be posted (O’Brien, 2001). I already use this technique for treating specific phobias and there is no reason it could not be incorporated into the design of the website.
Conclusion
A personalised Website for my patients allows access to information, using connectivism and constructionist learning . The value of such psychoeducation has been well established. Using digital technology as the medium for learning provides new opportiuities for learning and access. This project also established the value of a website for psychoeducation for my patients.
I learned using a project based, authentic process of learning. I will also learn from feedback from peers, facilitator and recipients. Within a sociocultural learning environemnt, I also was given scafolding to learn from this project. The outcome is a a living educational resource that will change over time, new information and new technologies. It will also change as I learn new aspects of digital literacies.
List of references
American Academy of Child and Adolescent Psychiatry retrieved 6/5/2007
http://www.aacap.org/
Arnold, J (2007) blog
http://joycearnoldsspace.blogspot.com/
website
http://drjoycearnold.freehostia.com/psych.html
Blunden, A (2001). The Vygotsky school Spirit, Money and ModernitySeminar retrieved 6/5/2007
http://home.mira.net/~andy/seminars/chat.htm
Callow, J (2003), Talking about visual texts with students, Reading online, vol. 6 (8) retrieved 6/5/2007,.
Cope, B & Kalantzis,M, (2000) (2) Investigating Identity and Power relationships
Retrieved Googlesearch 6/4/2007
http://www.thenetwork.sa.edu.au/identity_web/multiliteracies.html.
Deviantart, retrieved 6/5/2007 http://browse.deviantart.com/
Education Queensland (nd): New times, new literacies, Literate futures, pps. 1–12, retrieved 6/5/2007
Finkle & Torp (2005) Problem based learning Retrieved Googlesearch 6/4/2007
http://www.cotf.edu/ete/teacher/teacherout.html
Holland,S.,(2005) Problem based learning. Department of Education and Children’s Services Government of South Australia Retrieved Googlesearch 6/4/2007
http://www.tsof.edu.au/resources/pbl/
HONSurveys (2001) Evolution of Internet use for Health Purposes retrieved 6/5/2007
http://www.hon.ch/Survey/FebMar2001/survey.html
Jarvin.L.,(2006). What is the Big 6? TM V Retrieved Googlesearch 6/4/2007
http://big6.com/showarticle.php?id=415
Kinzer, C.K, (2003), The importance of recognizing the expanding boundaries of literacy, Reading online, vol. 6(10), retrieved 6/5/2007,
Lee, S (nd) The World Wide Web: Its uses as a teaching tool Online Teaching Tools and Projects retrieved 6/5/2007
http://www.oucs.ox.ac.uk/ltg/projects/jtap/reports/teaching/chapter4.html
Leu, D, Kinzer, C K, Coiro J.L & Cammack, D.W (2004), ‘Toward a theory of new literacies emerging from the internet and other information and communication technologies’, Reading online, retrieved 6/5/2007
North Central Regional Educational Laboratory (2005), 21st century skills, retrieved 6/5/2007
O’Brien,D (2001) At-risk Adolescents: re-definig competence through the multiliteracies of intermediality, visual arts and representation, retrieved 6/5/2007
Papert , S & Harel, I (1999) Situated Constructionism retrieved 6/5/2007 http://www.papert.org/articles/SituatingConstructionism.html\
Pekkala E, & Merinder L. (2002) Psychoeducation for schizophrenia. in The Cochrane Database of Systematic Reviews 2007 Issue 2,The Cochrane Collaboration. John Wiley and Sons, Ltd. Art No.: CD002831. DOI: 10.1002/14651858.CD002831.retrieved 22/4/2007 Googlesearch
http://www.cochrane.org/reviews/en/ab002831.html
Psycho-Educational Counselling Services, Inc. (2003) Psychoeducation retrieved 21/4/2007 Googlesearch
http://www.psychoeducation.com/psychoeducation.htm
Queensland Health (nd) Psychoeducation retrieved 21/4/2007 Googlesearch
http://www.health.qld.gov.au/rbwh/inbmhs/factsheets/psychoeducation.pdf
RANZCP (2007) RANZCP Trainee survey: Perspectives on rural pscyhatry and rural experience, RASTS Project retrieved 6/5/2007
http://ranzcp.org/pdffiles/policy/RANZCP%20trainee%20survey%20-%20Perspectives%20on%20rural%20psychiatry%20and%20rural%20experience.pdf
Semali, M & Fueyo, J (2001) Transmediation as a metaphor for new literacies in multimedia classrooms retrieved 6/5/2007
Shimazu, A, Kawakami, N, Irimajiri, H, Sakamoto, M & Amano, S (2005) The effects of web-based psychoeducation on self-efficacy, problem solving behaviour, stress responses and job satisfaction among workers: a controlled trial, Journal of Occupational Health 47 (5) pps 405-413, retrieved 21/4/2007 Googlesearch
http://www.jstage.jst.go.jp/article/joh/47/5/47_405/_article
Siemens, G (2004) Connectivism a theory for the digital age elearnspace retrieved 5/6/2007
http://www.elearnspace.org/Articles/connectivism.htm
Sorensen, J, Done, D.J & Rhodes, J (2006) A case series evaluation of a brief, psycho-education approach intended for the prevention of relapse in Bipolar Disorder Behaviour and Cognitive Psychotherapy, Cambridge University Press retrieved 21/4/2007 Googlesearch
http://journals.cambridge.org/action/displayAbstract;jsessionid=D39006D069A0540BCA952650ABF94CCD.tomcat1?fromPage=online&aid=461240
The American College of Psychiatrists retrieved 6/5/2007
http://www.acpsych.org/
The Royal Australian and New Zealand College of Psychiatrists retrieved 6/5/2007
http://www.ranzcp.org/
The Royal College of Psychiatry retrieved 6/5/2007
http://www.rcpsych.ac.uk/default.aspx?page=0
United States Department of health and human services (nd) Evidence –Based Practices: Shaping Mental Health Services Toward Recovery, Family Psychoeducation, Retrieved 21/4/2007 Goooglesearch
http://mentalhealth.samhsa.gov/cmhs/communitysupport/toolkits/family/
Appendix 1
Definitions
Psycho-education Psycho-education is teaching and learning about psychiatric illness and mental health and psychological treatment.
Website. On the World WideWeb and Internet resources a virtual space is created that looks like a page on which text, graphics, audio, video can be found. The Webpage is then part of a website which is a collection of webpages linked to one another.
Constructionism. The pedagogy of constructionism was introduced by Vygotsky and Papert. They constrasted constructionism with instructionism. By allowing induvuduals to learn and construct their own meaning in the process, the teacher does not instruct but facilitates from the side , the student to learn by construction. Social and distributed construction are used to describe the network connectivity in constructionsism (Papert &Harel 1999)
Connectivism Chaos theory describes the complexity of knowldedge especially since the technology revoultion and information/knowledge explosion. Overriding older pedagogies, connectivism describes the mulitple networkeed pathways that learning can take (Siemens 2004).
Appendix 2
Research Questionairre
1. Do you own a computer in your home?
Circle yes or no
2. Do you use a computer outside your home?
Circle yes or no
3. Do you research on the Internet?
Circle yes or no
4. Would you visit a webs-page designed for education concerning psychiatric illness?
Circle yes or no. If no thank you for your help.
5. Would you like links to information from this web-page.
Circle yes or no
6. What information would you like on such a webbpage?
Appendix 3
Research results ( taken from proposed webpage and will soon be available at http://drjoycearnold.freehostia.com/psych.html)
Thank you for all your help getting some background information to help me put this site together. Here are the results.
Do you own a computer in your home yes 50 no 3
Do you use a computer outside your home yes 20 no 32
Do you research on the Internet? yes 44 no 9
Would you visit a Web page designed for education concerning psychiatric illness?
yes 45 no 7
Would you like links to information from this web page?
yes 43 no 3
What information would you like on such a web page?
The responses can be summarised as – signs and symptoms for Depression, Schizophrenia, Asperger’s syndrome, adolescent social problems, Children’s behaviour problems, Bipolar disorder
Treatments- medications and their side effects
Group therapy, hospitals and clinics available
Self help groups and chat rooms
Help for carers and parents
How to handle difficult behaviour
Where to find help.
Support for staff
Key words
Psychoeducation; Website; Constructionism; Connectivism
Introduction
This project is an authentic learning activity with naturalistic feedback, online community learning feedback and scafolding and facilitator response. Patient, peers and community feedback also informed the connectivist model of learning. The fnal outcome of a Web-site for the purposes of Psychoeducation is a dynamic project that will grow within a model of life-long and life-wide learning.
Discussion
Aims and Projected outcomes
Psycho-education has been found to be an important adjunct to good wholistic treatment of mental illness.( Shimazu et al (2005); Sorensen, Done & Rhodes 2006; Pekkala & Merinder, 2002; United States Department of health and human services; Queensland Health; Psycho-Educational Counselling Services, Inc. 2003) I have been using ‘talk and chalk’ methods for many years as a clinical psychiatrist in private practice. I felt quite advanced when I moved to the technology of a white board. Many patients are technologically savvy and it is easier to refer them to the Internet (HON Surveys 2001; Leu et al 2004). In fact many patients have already researched their illness and treatments before they come and see me. Psychiatrists today have learnt that they can’t know everything that has been stated about psychiatry on the Internt or in the popular press and that our role has offten become that of facilitator in the learning process. We help people make meaning of all the things they have heard, give a professional perspective and direct them to other sources for a balanced view. It was important however to ensure that psychoeducation was not learned only in an online format as the therapeutic relationship and medical treatment were the most important treatment parameters.
Rationale
For many years I have realised that a website that collated this information, from my perspective was neccesary. Offering links to information and resources to patients and their families was also a frequently requested item.Referring people to the website for ememergency procedures, contacts and advise could help cover the resource issues in this rural region especially in ‘after-hours’ timeframe (RANZCP 2007 ).
This project seemed like the ideal time to put the process into action and gave me a structure to use.There was a timeframe set by the university calendar and the resources, support, ideas, supervision available from facilitator and online study community. I already had in mind the general outline, structure and design of the website based on projected need, visiting other websites and my own creativity. The added content from this course to think about was multimodal and online learning pedagogies.
Evaluation
Researching what is already there was a good place to start. There were no other colleaugues who had established a website for reference, that I know. The Royal Australian and New Zealand has a very useful website (The Royal Australian and New Zealand College of Psychiatrists).The American and British colleges and the American Academy of Child and Adolescent Psychiatry all had reams of information and proffesionally designed website(Royal College of Psychiatrists ; The American Academy of Child and Adolescent Psychiatry; The American College of Pscyhiatrists) . Googlesearchs of the main diagnoses and treatments revealed huge numbers of resources. The problem was too much information.
Researching patient’s needs became the next most important step. I designed a quick questionairre to assess the perceived needs.(Appendix 2). I checked with my lecturer about the ethics of that research. By keeping the responses anonymous and asking my receptionist to ask people to fill in the questionairre, I was appying no pressure to the patients and they would know that their treatment or the therapeutic relationship was not harmed by this process. It was interesting to see that everyone was keen to fill out the form. Even some carers, colleaugues and occasional visitors showed a keen interest in the project, projected benefits from it and volunteered to fill in the form.By keeping it simple and small it was not an onerous task. By keeping the questions yes or no, it was easy to score. The final question was a projective question that was seeking areas of need and interest and was the most useful.
It was interesting to note that almost all my patients had a computer and Internet facilities.This may reflect the bias of this sample as they are all private patients who may have more disposable income that the general population. They were mostly keen to see a website devoted to their needs and this was reflected in their choices for content. Most patients asked about the project and the website and discussed this as part of their consultation, giving me extra feedback.They were keen to see the website when completed and give feedback online.
I had aimed to put the information together in a weekend and have the site ready within a week. I found that it was much more work than that.Each topic needed to be concise but give structure to the reader. Some of my patients need basic information and others need academic, scientific levels of information. I did not want to write a text book but took the idea that the World Wide Web is really a network and to make it productive, networking and links to other information was its very essence (Lee ). I spend more time researching the various websites for inclusion and excluding those that were unsuitable. I realised that this website I am constructing will always remain a work in progress.Once the basic structure is in place, I can keep adding to it and altering information as it is needed. In this way the website can remain a dynamic document but will always require a few hours of work a week to maintain.
The webmaster was my son who studies Bachelor of Information Technology and is a computer technician. I began to understand that the communication required to direct him towards the creation of the website was a whole new field of learning for me. I was frustrrated that I could not navigate html myself so it is next on the list of things to learn. It took a lot of work and time to construct the website, more than I thought it would. The nice things about websites is that they are interesting and not like a book, so the creative component of the website, colour, layout, design, fonts were all important aspects of communication to the webmaster. The webmaster used his e-mail for feedback. He soon realised that the e-mail name ‘addlebrains’ was potentially disrespectful and so had to change this to his workplace account.
I wanted pictures and photographs for a multimodal effeect as I could see that text was not very enticing (Semali & Fueyo, 2001). Another son gave me the link to deviant art which was a wonderful place to lose more time in a pleasant way (Deviantart). I have always used art to convey meaning in lectures and found it useful. I added photographs and art work so that the website started to look really lovely. Then I realised that I had a copyright problem.I had already needed to limit some of the work on my website as the text would have breached copyright, although no knowledge is plaigarism free. So I had to remove all the pictures and start again. I found some clipart that sufficed and was free to use. My next part of this project is to photograph my own artwork and use those pieces and take my own photographs to illustrate the website. Gradually you can see that although I have learnt a lot of useful information along the way, the process was becoming more complex over time. The timeframe for launching the website and obtaining feedback from colleaugues and patients, and the general public was escaping.
I was able to launch the first draft website and got some interesting feedback from two of my peers in my online learning community. I have yet to add a wiki as a simple and easy to administer feedback system. We changed the headings and highlights for links in keeping with other feedback. I was interested to note that my peers were also keen to see the site and give me their thoughts and useful links. This was a pleasant pat of the learning experience.
The pedagogies in use in the website involve a constructivist approach. By providing links to information and a baseline framework of how to look at the various illnesses and contact with other sufferers in the global community, there is validation for each person as well as their capacity to seek and understand information to their own needs and levels of understanding. The connection to various websites and pieces of information allows a connectivist approach (Kinzer, 2003).
This reflects Vygotsky’s approach of a zone of proximal development and scafolding towards learning (Blunden, 2001). There is a sense of the socio-historico-cultural learning process in such a website. One can also see that there is the potential for discourse for learning as well. My pedagogy for learning was a project based, authentic, problem-based approach (Finkle & Torp, 2005; Holland, 2005; Jarvin, 2006).
Linguistic design was an important component to me (Cope & Kalantzis, 2000). The words used need to be explained and simple without infantalising. This was complex given the differrent levels of education my patients have. I think that people prefer simple language and not to feel overwhelmed by techincal or academic language.This is difficult for me as my mind is well versed and trained to think academically and I love a rich vocabulary. There is no feedback from patients as when they are in my rooms so I had to be careful of using simple language but not to insult anyone’s intelligence (Cope & Kalantzis 2000 (2). I found that a website about metal illness to be very depressing, serious and dour which reflects the problems of mental illness. I wanted the information to be positive, without denying or failing to validate the suffering and to be lighthearted without being irreverant.
I chose light blue/gray as a background and the front page with limited colur and information to present a professional image and not to clutter the non-verbal presentation (Callow 2003). I chose to not include audio input at this point in time because it was too complex and would delay the launch of the website. The project for the future is to record, using authentic presentation, an intoduction, providing audio input for the visually impaired and expanding the sensory learning. The pages lead towards the centre and contain concise information so as not to overwhelm the reader. I also wanted plenty of space and not clutter the pages as some patients are already thought disordered and would find it too confusing. I think that the basic information needed to be linear and the links for divergent thinking were scafolded on top of this.This is reflected in the architecture of the pages. I originally used a stream of consciousness to write the pages but found that it was too easy for others to get lost in the flow. I then introduced headings and spaces to allow a framework to develop and room to think between topics. I think tha the page ‘anger management’ reflects this style well especially given that people with anger management problems often get frustrated, have language and communication problems and poor concentration (Apendix 4)
The website can be found at http://drjoycearnold.freehostia.com/psych.html. There is still more information that the webmaster needs to load which is available on my blog (http://joycearnoldsspace.blogspot.com/). As discussed above, this is an evolving process, a work-in-progress and will have continual updating. Some of the updating will be in repsonse to the wiki included and feedback from site visitors. I intend to give all my patients this address on my business card so that they can visit and comment online or when they see me. I intend to advertise this link to general practitioners so they can access it and the links and they can provide feedback. I will give this link to my colleuagues at our Maintenence of professional standards (MOPS ) meetings and obtain feedback from them. They are already aware of this project and agree that it is useful and innovative.It reflects the future of learning in the digital age (North Central Regional Educational Laboratory 2005).They were happy to allow me to set it up and give feedback before they would do this project themsleves. Thay are more likely to refer their patients to my website than set up their own as time is precious and are psychiatrists are busy people.
I also kept a reflective journal about the process so I did not lose any ideas I had, could revisit the issues and build on them, using a constructivist appoach, Some of these ideas are on my blog and others in a private journal. http://joycearnoldsspace.blogspot.com/
I think that the process of setting up a website was a huge learning curve and an authentic learning project for me.As part of life- long and life -wide learning, this is the first step ( Education Queensland nd) There is more to do and learn and this project wil lalso help people with mental illnes and their carers obtain information, find resources and steer away from negative or wrong information. I have experienced an authentic learning project and have realised its potential to teach. At this point in time I do not see this as useful for the website design but it may be possible, particulalrly in the kidszone part where projects will be posted (O’Brien, 2001). I already use this technique for treating specific phobias and there is no reason it could not be incorporated into the design of the website.
Conclusion
A personalised Website for my patients allows access to information, using connectivism and constructionist learning . The value of such psychoeducation has been well established. Using digital technology as the medium for learning provides new opportiuities for learning and access. This project also established the value of a website for psychoeducation for my patients.
I learned using a project based, authentic process of learning. I will also learn from feedback from peers, facilitator and recipients. Within a sociocultural learning environemnt, I also was given scafolding to learn from this project. The outcome is a a living educational resource that will change over time, new information and new technologies. It will also change as I learn new aspects of digital literacies.
List of references
American Academy of Child and Adolescent Psychiatry retrieved 6/5/2007
http://www.aacap.org/
Arnold, J (2007) blog
http://joycearnoldsspace.blogspot.com/
website
http://drjoycearnold.freehostia.com/psych.html
Blunden, A (2001). The Vygotsky school Spirit, Money and ModernitySeminar retrieved 6/5/2007
http://home.mira.net/~andy/seminars/chat.htm
Callow, J (2003), Talking about visual texts with students, Reading online, vol. 6 (8) retrieved 6/5/2007,
Cope, B & Kalantzis,M, (2000) (2) Investigating Identity and Power relationships
Retrieved Googlesearch 6/4/2007
http://www.thenetwork.sa.edu.au/identity_web/multiliteracies.html.
Deviantart, retrieved 6/5/2007 http://browse.deviantart.com/
Education Queensland (nd): New times, new literacies, Literate futures, pps. 1–12, retrieved 6/5/2007
Finkle & Torp (2005) Problem based learning Retrieved Googlesearch 6/4/2007
http://www.cotf.edu/ete/teacher/teacherout.html
Holland,S.,(2005) Problem based learning. Department of Education and Children’s Services Government of South Australia Retrieved Googlesearch 6/4/2007
http://www.tsof.edu.au/resources/pbl/
HONSurveys (2001) Evolution of Internet use for Health Purposes retrieved 6/5/2007
http://www.hon.ch/Survey/FebMar2001/survey.html
Jarvin.L.,(2006). What is the Big 6? TM V Retrieved Googlesearch 6/4/2007
http://big6.com/showarticle.php?id=415
Kinzer, C.K, (2003), The importance of recognizing the expanding boundaries of literacy, Reading online, vol. 6(10), retrieved 6/5/2007,
Lee, S (nd) The World Wide Web: Its uses as a teaching tool Online Teaching Tools and Projects retrieved 6/5/2007
http://www.oucs.ox.ac.uk/ltg/projects/jtap/reports/teaching/chapter4.html
Leu, D, Kinzer, C K, Coiro J.L & Cammack, D.W (2004), ‘Toward a theory of new literacies emerging from the internet and other information and communication technologies’, Reading online, retrieved 6/5/2007
North Central Regional Educational Laboratory (2005), 21st century skills, retrieved 6/5/2007
O’Brien,D (2001) At-risk Adolescents: re-definig competence through the multiliteracies of intermediality, visual arts and representation, retrieved 6/5/2007
Papert , S & Harel, I (1999) Situated Constructionism retrieved 6/5/2007 http://www.papert.org/articles/SituatingConstructionism.html\
Pekkala E, & Merinder L. (2002) Psychoeducation for schizophrenia. in The Cochrane Database of Systematic Reviews 2007 Issue 2,The Cochrane Collaboration. John Wiley and Sons, Ltd. Art No.: CD002831. DOI: 10.1002/14651858.CD002831.retrieved 22/4/2007 Googlesearch
http://www.cochrane.org/reviews/en/ab002831.html
Psycho-Educational Counselling Services, Inc. (2003) Psychoeducation retrieved 21/4/2007 Googlesearch
http://www.psychoeducation.com/psychoeducation.htm
Queensland Health (nd) Psychoeducation retrieved 21/4/2007 Googlesearch
http://www.health.qld.gov.au/rbwh/inbmhs/factsheets/psychoeducation.pdf
RANZCP (2007) RANZCP Trainee survey: Perspectives on rural pscyhatry and rural experience, RASTS Project retrieved 6/5/2007
http://ranzcp.org/pdffiles/policy/RANZCP%20trainee%20survey%20-%20Perspectives%20on%20rural%20psychiatry%20and%20rural%20experience.pdf
Semali, M & Fueyo, J (2001) Transmediation as a metaphor for new literacies in multimedia classrooms retrieved 6/5/2007
Shimazu, A, Kawakami, N, Irimajiri, H, Sakamoto, M & Amano, S (2005) The effects of web-based psychoeducation on self-efficacy, problem solving behaviour, stress responses and job satisfaction among workers: a controlled trial, Journal of Occupational Health 47 (5) pps 405-413, retrieved 21/4/2007 Googlesearch
http://www.jstage.jst.go.jp/article/joh/47/5/47_405/_article
Siemens, G (2004) Connectivism a theory for the digital age elearnspace retrieved 5/6/2007
http://www.elearnspace.org/Articles/connectivism.htm
Sorensen, J, Done, D.J & Rhodes, J (2006) A case series evaluation of a brief, psycho-education approach intended for the prevention of relapse in Bipolar Disorder Behaviour and Cognitive Psychotherapy, Cambridge University Press retrieved 21/4/2007 Googlesearch
http://journals.cambridge.org/action/displayAbstract;jsessionid=D39006D069A0540BCA952650ABF94CCD.tomcat1?fromPage=online&aid=461240
The American College of Psychiatrists retrieved 6/5/2007
http://www.acpsych.org/
The Royal Australian and New Zealand College of Psychiatrists retrieved 6/5/2007
http://www.ranzcp.org/
The Royal College of Psychiatry retrieved 6/5/2007
http://www.rcpsych.ac.uk/default.aspx?page=0
United States Department of health and human services (nd) Evidence –Based Practices: Shaping Mental Health Services Toward Recovery, Family Psychoeducation, Retrieved 21/4/2007 Goooglesearch
http://mentalhealth.samhsa.gov/cmhs/communitysupport/toolkits/family/
Appendix 1
Definitions
Psycho-education Psycho-education is teaching and learning about psychiatric illness and mental health and psychological treatment.
Website. On the World WideWeb and Internet resources a virtual space is created that looks like a page on which text, graphics, audio, video can be found. The Webpage is then part of a website which is a collection of webpages linked to one another.
Constructionism. The pedagogy of constructionism was introduced by Vygotsky and Papert. They constrasted constructionism with instructionism. By allowing induvuduals to learn and construct their own meaning in the process, the teacher does not instruct but facilitates from the side , the student to learn by construction. Social and distributed construction are used to describe the network connectivity in constructionsism (Papert &Harel 1999)
Connectivism Chaos theory describes the complexity of knowldedge especially since the technology revoultion and information/knowledge explosion. Overriding older pedagogies, connectivism describes the mulitple networkeed pathways that learning can take (Siemens 2004).
Appendix 2
Research Questionairre
1. Do you own a computer in your home?
Circle yes or no
2. Do you use a computer outside your home?
Circle yes or no
3. Do you research on the Internet?
Circle yes or no
4. Would you visit a webs-page designed for education concerning psychiatric illness?
Circle yes or no. If no thank you for your help.
5. Would you like links to information from this web-page.
Circle yes or no
6. What information would you like on such a webbpage?
Appendix 3
Research results ( taken from proposed webpage and will soon be available at http://drjoycearnold.freehostia.com/psych.html)
Thank you for all your help getting some background information to help me put this site together. Here are the results.
Do you own a computer in your home yes 50 no 3
Do you use a computer outside your home yes 20 no 32
Do you research on the Internet? yes 44 no 9
Would you visit a Web page designed for education concerning psychiatric illness?
yes 45 no 7
Would you like links to information from this web page?
yes 43 no 3
What information would you like on such a web page?
The responses can be summarised as – signs and symptoms for Depression, Schizophrenia, Asperger’s syndrome, adolescent social problems, Children’s behaviour problems, Bipolar disorder
Treatments- medications and their side effects
Group therapy, hospitals and clinics available
Self help groups and chat rooms
Help for carers and parents
How to handle difficult behaviour
Where to find help.
Support for staff
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