Respond to?two?of your colleagues?by offering additional insights or alternative perspectives on their analysis of the video, other rating scales that may be used with children, or ot
Respond to two of your colleagues by offering additional insights or alternative perspectives on their analysis of the video, other rating scales that may be used with children, or other treatment options for children not yet mentioned. Be specific and provide a rationale with evidence.
Peer 1
YMH Boston Vignette 5 Video
The patient in the video has been referred due to a suspected case of depression. The practitioner did well in asking questions that are essential in the diagnosis of depression such as questions about mood, sleep patterns, anhedonia, and suicidal behavior. The practitioner also asked some open-ended questions and took the patient to a safe environment, which allowed for the creation of a conducive environment for the patient to open up and express himself. One of the things that the practitioner did not do well was asking close-ended questions with regard to some of the depression symptoms. Even though the client was referred due to depression, the practitioner would have kept an open mind and asked questions without being biased to the referral diagnosis so as not to miss out on other mental health needs of the patient. The therapist also did not give the client space to express himself and he was cut off several times as he tried to express himself (YMH Boston, 2013).
A compelling concern at this point is the suicidal ideation of the client. It is important to assess whether the client has had any self-injurious behaviors or has already come up with a plan to commit suicide
Suicidal and homicidal ideation are psychiatric emergencies and the client has already confirmed having suicidal thoughts secondary to a breakup. It is essential to explore homicidal ideation, especially to the ex-girlfriend, with the next clinical question which should be: “How do you feel about your ex-girlfriend?”
Children and Adolescent Psychiatric Assessment
Need for a Thorough Psychiatric Assessment of Children and Adolescents
The need for a thorough psychiatric assessment of children and adolescents is informed by different factors. The first one is that there is overreliance on observed symptoms or symptoms reported by other parties such as parents and teachers, which can often be a misjudgment. Children and adolescents do not understand their symptoms, for some children, they may be able to tell their symptoms, but may lack information on essential details such as the duration, onset, and associated factors (Srinath et al., 2019). Children and adolescents are also affected by diagnostic overshadowing and masking where psychiatric disorders are missed or misdiagnosed due to other problems such as developmental disorders, childhood discrete behaviors, atypical presentations, and the impact of environmental and other factors on childhood behaviors (Srinath et al., 2019).
Symptoms Rating Scales Used for Children and Adolescents
Different symptom rating scales are used for children and adolescents. One of the symptom rating scales used in children and adolescents is the pediatric symptoms checklist. It can be modified for different pediatric ages and is mainly used in the assessment of emotional and behavioral problems (Ramirez et al., 2023). The second tool is the child behavior checklist which is also used for children and adolescents with different versions of questions targeting parents and children’s caregivers. Its use is supported by vast evidence especially when used for affective, anxiety, somatic, attention-deficit hyperactivity, oppositional defiant, and conduct problems (Ramirez et al., 2023).
Psychiatric Treatment Options for Children and Adolescents
An intervention that is used for children and adolescents and not adults is school-based interventions, which have been proven to be essential in promoting mental well-being and can also be used for the management of different mental health disorders (Van Loon et al., 2019). Parental interventions are essential for children with mental health disorders and have been proven to be crucial in managing emotional and behavioral problems (Tarver et al., 2019).
Role of Parents or Guardians in Assessment
Parents play an essential role in assessment. They provide information on the presentation through observations made on changes in behavior or emotions. They also provide information that may be missed by children such as onset, duration, and associated problems. A majority of the symptoms rating scales are also filled by parents or guardians and these are an important part of the assessment (Srinath et al., 2019).
References
Ramírez, S., Gana, S., Godoy, M. I., Valenzuela, D., Araya, R., & Gaete, J. (2023). Validation of the Spanish version of the Pediatric Symptom Checklist (PSC) to identify and assess psychosocial problems among early adolescents in Chile. Plos One, 18(4), 1-18. https://doi.org/10.1371/journal.pone.0283921Links to an external site.
Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian Journal of Psychiatry, 61(2), 158-175. doi: 10.4103/psychiatry.IndianJPsychiatry_580_18.
Tarver, J., Palmer, M., Webb, S., Scott, S., Slonims, V., Simonoff, E., & Charman, T. (2019). Child and parent outcomes following parent interventions for child emotional and behavioral problems in autism spectrum disorders: A systematic review and meta-analysis. Autism, 23(7), 1630-1644. https://doi.org/10.1177/1362361319830042Links to an external site.
Van Loon, A. W., Creemers, H. E., Vogelaar, S., Saab, N., Miers, A. C., Westenberg, P. M., & Asscher, J. J. (2019). The effectiveness of school-based skills-training programs promoting mental health in adolescents: A study protocol for a randomized controlled study. BMC Public Health, 19(1), 1-12. https://doi.org/10.1186/s12889-019-6999-3Links to an external site. .
YMH Boston (2013, May 22). Vignette 5 – Assessing for Depression in a Mental Health Appointment [Video file]. YouTube. https://www.youtube.com/watch?v=Gm3FLGxb2ZULinks to an external site. .
VanLoon2019.pdf Download VanLoon2019.pdf
Tarver2019.pdf Download Tarver2019.pdf
Snirath2019.pdf Download Snirath2019.pdf
Ramirez2023.pdf Download Ramirez2023.pdf
Peer 2
Below are my answers to the questions based on the YMH BostonVignette
What did the practitioner do well? In what areas can the practitioner improve?
Dr. Sarah is an experienced practitioner. She was able to recap all the client's narratives to validate that something was not right with the client's presenting symptoms. She tried to asses the mood Heidi’s mood. Heidi is 16 years 16-year-old adolescent who tried to kill herself. Dr. Sarah asked such a question that can capture the depressive mood of the client. She asked the client what the things that she worried about. During the assessment doctor also noticed the level of eye contact and cooperativeness in her voice. The client replied that she does not have to worry about anything. The practitioner should ask more open-ended questions that allow the client to express her feelings more.
No, I do not have any compelling concerns.
My question is where do you want to end your life now? This question helps to measure the current mood and thoughts of the patient.
The thorough psychological assessment is helpful in understanding the behavioral, emotional and developmental problems of the assessment. It can assess how the behavior affect the life of the child or adolescent.
Two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent-
Child Behavior Checklist (CBCL)
It is the part of Achenbach System of Empirically Based Assessment (ASEBA) which is used to identify emotional and behavioural issues in children as well as in adolescents. The parents have to complete the CBCL. The other two components are – Youth Self-Report (YSR) and Teacher’s Report Form (TRF).
The Children's Psychiatric Symptom Rating Scale (CPSRS) is another effective tool to assess the condition of children and adolescents.
two psychiatric treatment options for children and adolescents that may not be used when treating adults are- Art and Play therapy.
The guardian and teacher of children are a vital part of psychological assessment. They provide information regarding the weaknesses and strengths of their children. They also provide information that how children react in different environments with themselves and others. The teacher provides the information regarding the child's behavior within the school and towards their teacher, classmates, and education.
References
Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian journal of psychiatry, 61(Suppl 2), 158.
Comprehensive Psychiatric Evaluation for Children – Health Encyclopedia – University of Rochester Medical Center. (n.d.). Www.urmc.rochester.edu.
Minot, D. (1970, January 1). The Children’s Psychiatric Symptom Rating Scale (CPSRS). Behavioral Health News. https://behavioralhealthnews.org/the-childrens-psychiatric-symptom-rating-scale-cpsrs/#:~:text=The%20ChildrenLinks to an external site.
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