Tool For Schizophrenia And Paranoia


KGV (Krawiecka, Goldberg &Vaughan) assessment is one of the best psychotic assessment tools, which is used to assess the mental health problems. By using this assessment tool, staffs can assess the severity, intensity and duration of symptoms of the disease. This assignment will discuss the collaborative mental health assessment for the patient in the given case study. In addition to that, this essay will discuss the challenges in implementing the KGV psychotic tool in conducting a proper psychological assessment of Peter in the case study who is suffering from schizophrenia and paranoia.

Reflective model of discussion:

Gibbs Reflective Model is chosen to conduct Peter’s overall health assessment process. In this model, Graham Gibbs published the reflective Cycle “learning by doing’, in which he has represented that how people learn through the everyday experiences that they gathered through their regular doing. In this cycle, Gibbs has divided the customer into the five different phases such as:



This model assisted me to analyse and assess the intensity, duration and severity of his symptoms; hence through applying Gibbs’s each stage, I was able to analyse Peter’s mental health state. Gibb’s Reflective Model assisted Peter and facilitated me to use the KGV tools in order to analyse and evaluate intensity and the severity of the psychological disorders.

According to Assudani and Mason (2016), KGV psychotic scale assists the health professionals to conduct the collaborative assessment of the psychological health of the patient. KGV tools enabled me to elicit and measure the severity of psychotic symptoms, which are commonly experienced by individuals suffering from psychotic illnesses such as schizophrenia, paranoia and dementia. Based on the NHS guidelines, KGV psychotic should focus on the following aspects:

Mental Health Screening
Medication effect screening
Drug and alcohol screening
Self-evaluation screening
Making sense of data assessment
Living skill screening

As stated by Berry et al. (2015) this tool will assist the health professionals in order to measures the positive symptoms of service users, by conducting the semi-structured interview. This tool will assist the health professionals in determining the anxiety, phobias, delusions, suicidal thoughts, hypochondriac behaviour and hallucination in Peter. Moreover, KGV psychotic tool will also assist service providers to track the mental health progress in the case of Peter by evaluating the impact of medication, screening tools and therapies.

The reason behind selecting KGV assessment tool:

While it comes to treatment of schizophrenia, KGV psychotic tool is one of the best methods in evaluating the mental health of patients (Ceylan et al. 2016). Peter was diagnosed with schizophrenia; he needed important psychotic screening tools such as KGV psychotic tool which could assist me to determine his psychological status and needs. Ellaithy et al. (2015) stated that KGV is best psychotic tool which aims to facilitate the collaborative health assessment process, in which service providers and service users can work together to evaluate the mental health issues. In addition, as he experienced different adverse symptoms of schizophrenia such as paranoia, hyper-vigilant, erratic speech, high level of hallucination and delusion; KGV tool was highly appropriate in evaluating the reasons, outcomes and severity of these symptoms.

Collaborative assessment using KGV tool:

According to Chisholm et al. (2017), the collaborative mental health assessment is important for evaluating the psychological status, severity of symptoms and current psychological needs of a patient suffering from schizophrenia. According to Ellaithy et al. (2015) schizophrenia needs immediate collaborative mental health assessment which will emphasize measuring the severity of four symptoms such as cognitive impairment, negative symptoms, positive symptoms and affective symptoms. Based on the guidelines of NHS on mental health, KGV tool can facilitate the collaboration among service providers, service users and the patient’s family members (Fornells-Ambrojo et al. 2016). I conducted a collaborative assessment of Peter's mental health using KGV assessment tool, which not only determined the psychological issues but also assisted me to understand his financial, psychosocial stressors, his timeline and family background. Prior to start the assessment, I called Peter couple of days ago to arrange to see him for the KGV assessment. I explained the importance of this interview. I also explained to Peter that this would give me more insight into his illness and I would be able to signpost him appropriately. I requested him to sign the consent form after reading the decoration it. I also reassured Peter that if he felt anxious or did not want to carry on with this interview at any point, he was allowed to ask me to stop.

KGV is more objective in the case of psycho assessment:

As stated by González-Maeso (2017) KGV is one of the important psychotic assessment tools that assist the health professionals to develop interview and Socratic questioning in order to evaluate the actual mental health status of the patients. By analysing the effectiveness of KGV assessment process in different mental health assessment, it can be stated that KVG tool can be highly focused with more objective approaches and get a good gage, through which staffs can involve patients with his own psychological assessment process.

Recovery Model:

Recovery model of mental health is the person-centred and holistic approach that assists the mental health professional in order to make a proper mental assessment of the patient (Hall et al. 2013). This model is based on the two simple premises: It is possible to recover the mental health status of the patient by using effective strategies Patient-directed strategies are most effective strategies the health professional should use Based on this model, I motivated Peter and his family regarding his recovery (Johnson, 2013). By applying this model into practice, I was able to get proper support and encouragement in terms of utilising an effective clinical setting that assisted Peter to address different mental health disorders. In Peter’s case, I used his own place where he felt safe and comfortable.

On the other hand, this model assisted me to apply the innovative healthcare setting and strategies that will help the mental health patient to recover from the illness. In this aspect, by using the KGV tool, Peter could get proper support and care by implementing different innovative mental health assessment tools.

Trust Engage Therapeutic Rapport:

For evaluating the mental health status of a patient it is important for the health professional to maintain string relation with them (Joubert, 2015). Throughout the therapy, I supported and built a therapeutic relationship. Peter needed strong support, motivation and encouragement from his family and our Services. Peter being well-known to our Services has enhanced my interview process and a good rapport was built and he was very connected and opened during the assessment. Hence, facilitate Peter to express his views and involvement during the assessment.

According to Kane et al. (2015), although implementation of KGV tool in conducting the collaborative mental health assessment is useful in making the proper diagnosis, there are several challenges associated with KGV tool that affect the expected outcomes of the treatment process.

Patient's consent is one of the most common challenges that mental health professional generally faces while dealing with the patient with schizophrenia. As stated by Kline and Thomas (2018) in most of the patients with schizophrenia, patients do not provide their full consent in terms of passing through the innovative treatment process or diagnosis. According to Marsh-Picksley (2016) schizophrenia treatment needs proper consent of the patient, as well as, of the family members while it comes to implement some innovative psychotic tools such as the KGV tools into the collaborative assessment process. Peter has been non-compliant with his Clozapine, which is one of the most important medicines in treating his illness. Peter also suffers from hallucination, delusional thoughts, suicidal intent and hyper-vigilant activities; he can pose severe ethical dilemmas on the Servic

As stated by Oluwoye (2018), KGV tool is one of the effective and appropriate tools with semi-structured questions that involve the patient to assess his or her own mental health. While using this tool, the health professional should ensure that the patient is informed about the purpose and meaning of each question so that he or she can provide the accurate as well as useful information.
However, while using this tool, I ensured that Peter was informed about the purpose and meaning of each question so that he could provide accurate and useful information. I ensured that I had relevant questions that could assist me in assessing his mental health. Moreover, I reassured Peter to answer each question thoroughly. I informed Peter about the main objective of setting these questions and reassured him that Peter understood the meaning of each question. Health professionals who work on the social, developmental and health need of community people should be highly trained. In this aspect, Yung (2017) argued that in terms of getting the appropriate measures of psychological symptoms is based on the efficiency trained, as well as, experienced personnel. In this aspect Marsh-Picksley (2016), stated that positive result and appropriate measures by using KGV tool can only be gained if it is conducted by the professional hand. In Peter’s case, he needed professional staffs that could understand his mental illness and set the clinical strategies based on the actual needs. Using the KGV tool for the first time was a challenge for me. I had proper knowledge on using KGV tool in an appropriate manner. In most of the cases, when KGV is used inappropriately, patients and their family suffer and staffs do not have the skill to make proper application of different psychotherapeutic tools.
Therefore in Peter's case, as he suffers from schizophrenia, he needed a proper assessment of his overall mental health that would assist him to take control of his depression, anxiety and loneliness. He needed KGV trained professional to gain high-quality outcomes. Since I have been using the KGV tool; I have built some good skills that are needed for being a good interviewer such as:

Good communication skill, the tone of voice, body posture, body language Highly organised understand the skill Good interactive skill; show empathy, sympathy and talk the clients’ language Intelligence and strong decision-making ability Good problem-solving ability

d challenges, I was able to develop the following strategies to implement the KGV tools efficiently: By conducting direct communication with Peter such as meeting him at home, it enhanced him to share his health issues, viewpoints and interests. If Peter was not interested to meet at home, he was invited for small day-out, to make him feel comfortable. By communicating with Peter and his family members to send him Recovery College, where he would be provided with training and build a good repertoire of several coping strategies which would allow me to gather proper information regarding Peter’s mental health condition and recovery process. This would then facilitate me to formulate relevant questions while using KGV tool into his health assessment. By providing psycho-education to Peter, informing him about the dangers of being non-concordant with his Clozapine, I motivated him to take control of his health. GP was advised to conduct regular health check-up for Peter by wither sending health staffs to his home or advising him to attend the hospital. Through tracking Peter’s regular behaviour, attitude and activities, I was able to easily understand Peter’s current health condition.

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The aforementioned discussion concludes that schizophrenia is associated with impairment of mental health, which leads to hallucination, delusion and memory loss. KGV tools are widely used in conducting the collaborative psychotic assessment in order to formulate relevant questions on mental health issues. There are several challenges in order to use KGV tools into the collaborative mental health assessment process. The challenges are lack of professional training, lack of social, as well as, family support, patient’s consent and service providers’ ethical dilemma. However, these challenges can be avoided by conducting useful strategies such as face-to-face meeting with the patient, direct communication with patient’s family, psycho-education for the patient and offering regular health check-up, building a good rapport by frequently visiting the client.

Reference list:

  • Assudani, H. and Mason, O., 2016. Systematic Review of the Reliability and Validity of Translated Interview Measures of Psychotic Symptoms. Current Psychiatry Reviews, 12(3), pp.253-265.
  • Berry, K., Bucci, S., Kinderman, P., Emsley, R. and Corcoran, R., 2015. An investigation of attributional style, the theory of mind and executive functioning in acute paranoia and remission. Psychiatry research, 226(1), pp.84-90.
  • Ceylan, D., Yeşilyurt, S., Akdede, B.B., Sayın, Z. and Alptekin, K., 2016. The associations of the antipsychotic polypharmacy in schizophrenia treatment with the symptoms, side effects and the quality of life. Anatolian Journal of Psychiatry, 17(6), pp.433-441.
  • Chisholm, D., Heslin, M., Docrat, S., Nanda, S., Shidhaye, R., Upadhaya, N., Jordans, M., Abdulmalik, J., Olayiwola, S., Gureje, O. and Kizza, D., 2017. Scaling-up services for psychosis, depression and epilepsy in sub-Saharan Africa and South Asia: development and application of a mental health systems planning tool (OneHealth). Epidemiology and psychiatric sciences, 26(3), pp.234-244.
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  • Dixon, L.B., Holoshitz, Y. and Nossel, I., 2016. Treatment engagement of individuals experiencing mental illness: review and update. World Psychiatry, 15(1), pp.13-20.
  • Ellaithy, A., Younkin, J., Gonzalez-Maeso, J. and Logothetis, D.E., 2015. Positive allosteric modulators of metabotropic glutamate 2 receptors in schizophrenia treatment. Trends in neurosciences, 38(8), pp.506-516.
  • Fornells-Ambrojo, M., Gracie, A., Brewin, C.R. and Hardy, A., 2016. Narrowing the focus on the assessment of psychosis-related PTSD: a methodologically orientated systematic review. European journal of psychotraumatology, 7(1), p.32095.
  • González-Maeso, J., 2017. Metabotropic Glutamate 2 (mGlu2) Receptors and Schizophrenia Treatment. In mGLU Receptors(pp. 59-78). Humana Press, Cham.
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  • Johnson L (2013) Formulation in psychology & psychotherapy. London, Routledge Joubert, P.D., 2015. An investigation into the roles of registered nurses and psychiatric nurses at in-patient psychiatric facilities and its implications for nursing education in KwaZulu-Natal (Doctoral dissertation).
  • Kane, J.M., Robinson, D.G., Schooler, N.R., Mueser, K.T., Penn, D.L., Rosenheck, R.A., Addington, J., Brunette, M.F., Correll, C.U., Estroff, S.E. and Marcy, P., 2015. Comprehensive versus usual community care for first-episode psychosis: 2-year outcomes from the NIMH RAISE early treatment program. American Journal of Psychiatry, 173(4), pp.362-372.
  • Kline, E. and Thomas, L., 2018. Cultural factors in first episode psychosis treatment engagement. Schizophrenia research, 195, pp.74-75. Marsh-Picksley, S., 2016. Phenomenology of Intrusive Trauma Memory in Psychosis and its Relationship with Hallucinations and Persecutory Beliefs (Doctoral dissertation, UCL (University College London)). Oluwoye, O., 2018. 1.2 Racial Differences in First-Episode Psychosis Treatment Outcomes: Data From the National RA1SE Early Treatment Program (ETP) Study. Journal of the American Academy of Child & Adolescent Psychiatry, 57(10), p.S270. Yung, A.R., 2017. Treatment of people at ultra‐high risk for psychosis. World Psychiatry, 16(2), pp.207-208.

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