The film the soloist is a true-life story that is based on Nathaniel Ayers. Lopez struggled with his personal and professional life when developing the film since he wanted to find meaning and purpose. While walking in the streets, Lopez meets a homeless man Nathaniel Ayers playing violin in Los Angeles Park, which sparked their friendship. Apart from Ayers being homeless, he also has Schizophrenia (Pawlicki, 2014). Schizophrenia is one of the mental health disorders that is characterized by significant social and occupational impairments. Additionally, is it is often associated with cognitive impairment, an aspect that impairs one’s ability to function properly (Pawlicki, 2014). Schizophrenia is also associated with both positive and negative symptoms. The positive symptoms on most occasions consist of hallucinations and delusions. On the other hand, negative symptoms are characterized by a reduced ability to express oneself and effectively interact with others. Before one is diagnosed with Schizophrenia, they must have experienced both the positive and negative symptoms for the past six months, and these symptoms must have also occurred gradually (Pawlicki, 2014). Most schizophrenic patients experience auditory hallucinations whereby they hear the voices of people. On some occasions, the patient may also have delusional thoughts and aspect that impairs their ability to make sound judgments. Lastly, patients can be diagnosed with Schizophrenia from 18-25 years, and the disease is often hereditary. When using the ICD 10 and DSM 5, the code F 20.0 should be used when coding Schizophrenia. By following this procedure, it is evident that the patient in the film has Schizophrenia.
Overview of the Client
Ayers is the main character in the film, and despite suffering from Schizophrenia, he is also homeless. While walking in the street, Lopez meets Ayers and realizes that he has immense talent in music. After Lopez made this realization about Ayers, he immediately started to write some music columns from Ayers. Lopez finds out that Ayers was studying at Julliard during their interactions, although he dropped out during his junior years. During the first encounters with Lopez, Ayers started by apologizing for his poor appearance. Ayers also notes that he has experienced several setbacks, which predisposed him to have shame.
During their conversations, Ayers would, on most occasions, repeat the words that Lopez had said. For instance, when Lopez would say, “I come from Los Angeles,” Ayers would also repeat the same words after him. One aspect that prompted Ayers to drop from Julliard was when he started hearing multiple voices, and since he could not manage to contain them, he dropped out. Additionally, in one scene of the film, Ayers hears numerous voices, which makes him lie in the fetal position and start crying. All these are signs that he has Schizophrenia. Apart from hearing voices, Ayers also exhibits paranoia and violence. Additionally, he would be easily agitated on some occasions but would stay compassionate on different scenes. Despite Ayers having symptoms of Schizophrenia, a differential diagnosis of bipolar disorder is likely to have been made. This is attributed to people who have bipolar disorder since they also experience delusions, hallucinations, and mood swings.
Probable social and development precursors
Schizophrenia is often caused by many factors, including stress, family relationships, drug and substance abuse, and isolation (Wenzel et al., 2016). When analyzing Ayers, his development of Schizophrenia was gradual. It started with Ayers withdrawing from all social interactions with his peers. This made him solely prefer the company of his music to that of his friends or family. With his continued isolation, Ayer’s emotions started becoming more unpredictable and inappropriate since he would, on some occasions, be calm while, on some occasions, he would be violent and angry. Through the constant hallucinations, Ayers becomes disoriented, but he does not appear to be scared. With the intensification of the hallucinations, Ayers begins getting worried and disturbed. His auditory hallucinations make Ayers more worried, which makes him always hide since the hallucinations make him believe the world is a terrifying place. Although Ayers was aware of his condition, he continued isolating himself, an aspect that may have played a role in worsening his condition.
According to the lifespan development domains, individuals have to successfully undergo social, cognitive, language, and socio-emotional development (Sigelman & Rider, 2021). However, when analyzing Ayer’s case, he may have not successfully developed in almost all the domains. For instance, Ayers seems not to have developed properly in the cognitive domain since he has problems thinking about abstract concepts and differentiating between what is real and false. Failure to develop in this stage makes Ayers believe the voices he is hearing are real, preventing him from functioning properly. Additionally, Ayers is also having problems with respect to his social-emotional development. His impairs social development makes it impossible for him to interact with his peers and friends effectively. For instance, Ayers violent nature indicates that he does not have the ability to effectively control his emotions and impulses, an aspect that he should have developed at his age. All his impaired development is among the factors that may impair his functioning and ability to relate well with his family, friends, and the world.
5 Axial Diagnostic System and Generic intervention plan.
Mental and personality disorders often follow the five axial diagnostic systems when making a diagnosis. On most occasions, major psychiatric disorders are classified under Axis 1. Most disorders that fall under this axis are found in the general public. Additionally, most disorders under these episodes tend to be episodic in that they have a clear onset and remission period. The common symptoms exhibited by Ayers include auditory hallucinations where he would hear voices and paranoia. Since Ayers presents the symptoms of a mental disorder and not a personality disorder, he fits in Axial 1.
Developing robust intervention plans that meet the client’s needs will play an influential role in positive outcomes; since the patient has Schizophrenia, the treatment plans will consist of psychotherapy and pharmacologic interventions.
In psychotherapy, Cognitive behavioral therapy will be used in helping Ayers modify his character. Using CBT involves teaching strategies that can assist the patient to modify their beliefs and behavior patterns that predispose them to negative emotions. CBT has two main components: the cognitive and behavioral components (Wenzel et al., 2016). The cognitive components are crucial in helping patients change their thinking habits, while the behavioral component helps them change their reaction patterns. Since CBT is short-term, it runs for approximately 16 weeks and helps patients with Schizophrenia have effective coping skills that help them manage difficult situations (Wenzel et al., 2016). The effectiveness associated with CBT assists patients in developing improved social and problem-solving skills; hence, this helps reduce the severity of the symptoms and lower the risk of relapse. Taking Ayers through CBT will help him develop the skills needed to overcome his fears (Wenzel et al., 2016).
Antipsychotic medications are effective treatment plans for helping patients with Schizophrenia recover from their symptoms (Vita & Barlati, 2018). These medications are important since they help a patient to manage their hallucinations and delusions effectively. According to Ayers, his constant auditory hallucinations make it impossible to concentrate (Vita & Barlati, 2018). When faced with massive hallucinations, Ayers falls on the grounds and starts crying, indicating that he needs help. During the pharmacologic therapies, medications will be given orally and intravenously.
How the client’s gender may affect his treatment plan.
When providing care to a schizophrenic patient, it is important that it is specialized and meets individual needs. When assessing and providing care, gender plays a crucial role since it influences the onset and prominence of schizophrenic symptoms. According to Seeman (2018), most female patients who have Schizophrenia are often groomed, friendly and smart. On the other hand, most male patients are emotionally distant, apathetic, and angry. Additionally, women develop these symptoms later in life while men experience these symptoms during their junior life, and these determine the type of treatment that should be used (Seeman, (2018). Since Ayers developed his symptoms early in life, the need of more extensive psychotherapies should be used.
Client’s Strengths, Long term, and Short term goals.
One of the major strengths of Ayer’s is that although he was unwilling to accept help from his friends and family, he had learned the skills needed to cope with his condition. As a result, since he already has coping skills, it will help him practice the different techniques that he will be given in the psychotherapy sessions. Regarding the short-term and long-term goals, the short-term goals relate to reducing his hallucinations and delusions. In contrast, the long-term goal relates to preventing relapse of his symptoms and possible hospitalization.
Specific Treatment Considerations
When giving treatment to schizophrenic patients, it is pivotal that they are tailored to meet their needs. Most patients suffering from this disorder are often mentally unstable hence may skip the scheduled counseling sessions (Wenzel et al., 2016). As a result, it is important to consider the patient’s ability to attend the treatment sessions and the ability to comply with medications. If the patient cannot take medical medications, the intravenous root of drug medication will be used. Apart from psychotherapy and psychosocial supports, the administered medications will play key roles in helping the client recover fully.
Schizophrenia is a condition affecting different people in society. As a result, the media is also widely using their platforms to communicate about this mental disorder. When analyzing Ayer’s case, he has effectively presented the challenges faced by schizophrenic patients and how lack of timely treatment can impair one’s social, physical, and cognitive abilities. Due to the consequences associated with Schizophrenia, combining psychotherapy and pharmacologic interventions will be key in helping the patient fully recover.
Pawlicki, S. (2014). Paranoid Schizophrenia in the Media. spark.parkland.edu
Seeman, M. V. (2018). Clinical Implications of Gender Differences in Schizophrenia.
Sigelman, C. K., & Rider, E. A. (2021). Lifespan human development. Cengage Learning.
Vita, A., & Barlati, S. (2018). Recovery from Schizophrenia: is it possible?. Current opinion in psychiatry, 31(3), 246-255. ingentaconnect.com
Wenzel, A., Dobson, K. S., & Hays, P. A. (2016). Cognitive-behavioral therapy techniques and strategies. American Psychological Association.