Week 1-Response 2: Comprehensive Integrated Psychiatric Assessment
Please respond to the following discussion. This assignment is a graduate level Masters in Nursing Psychiatric Nurse Practitioner program, and the work should be reflective of the highest standards of graduate work. Please read and and follow assignment instructions and rubic
Please use APA 7 format only. Please use APA 7 format only. Please use at least three (3) USA based peer-reviewed, evidence-based articles in the past 5 years for references. Also attach PDFs of references.
Per our NP program; All discussions and assignments require supportive evidence which must be based on scholarly sources only, NOT dictionaries, encyclopedias, newspapers, commercial journals or public websites which will not be accepted. Examples of sources that are not acceptable include Stat Pearls, Mayo Clinic, GoodTherapy, etc.
Generally, literature that is cited should not be older than five years unless it is considered a classical work
Please respond to the following discussion.
Below is the assignment and instructions. Please let me know if you have any questions. Thank you in advance.
Tanya.
Please Respond to this discussion:
Comprehensive Integrated Psychiatric Assessment
The Vignette Video (5) gives us a visual into the assessment being conducted by the mental health provider of 15-year-old Tony, who is being seen for concerns of having depression and anxiety after being referred by his PCP.
1. What did the practitioner do well? In what areas can the practitioner improve?
There are quite several steps the provider took that helped effectively. Asking the patient why he came to the clinic is the first important step when performing an assessment. Getting this answer in the patient’s own words helps to understand what they know about why they are in the clinic. Studies show that young adolescent males and older men are less likely to seek out help on their own for mental health treatment (Lynch et al., 2016). Therefore, as the provider, it’s important to know whether they came on their own or as a referral, as I believe the approach to the assessment greatly differs. Asking the patient if he feels sad, depressed, or hopeless is another important step taken by the provider. Generally, young males do not express depression based on the normal symptoms, but rather irritability, anger, and difficulty concentrating are noted (Khesht-Masjedi et al., 2017). Asking Tony in depth how he feels when depressed instead of using the typical behaviors was an important step also taken by the provider. Inquiring about his education and relationship status helped the provider understand how his behavior symptoms affected his social and educational life. This highlighted how he went from an A and B student to poorly managing his academics and revealed his recent breakup two months ago, which he noted continuously made him angry towards his girlfriend and others when he remembered the incident. While he may state anger, his countenance appears sad, and his expression of suicidal thoughts highlights that there may be more symptoms he may not be revealing.
Based on the video, the provider did not introduce herself accordingly unless the video was incomplete. Establishing patient trust and a therapeutic relationship between provider and patient begins with an introduction, which, if not done, can be seen as rudeness or disrespect, depending on the patient’s cultural background. She did not inform the patient of his right to privacy and confidentiality, which, when dealing with adolescents, is an important step to take. Letting them know, based on the state allowances, their rights is important not just to establish care but also a human right and a step toward providing quality care (Pathak & Chou, 2019)
2. At this point in the clinical interview, do you have any compelling concerns? If so, what are they?
I had no concerns regarding the clip as it was short but seemed to be headed in the right direction once the provider began to ask the patient if he was experiencing symptoms that were more so aligned with being seen in young males who experienced depression.
3. What would be your next question, and why?
My next step would be to assess the severity of his depression and suicidality risk by utilizing screening tools such as PHQ-9. I would also dive a bit deeper into why his girlfriend broke up with him. It seems that could possibly be the trigger to his depression, and his response to her “making him angry” may need to be investigated to ensure the safety of both him and his girlfriend.
Part 2
1. Explain why a thorough psychiatric assessment of a child/adolescent is important.
A thorough psychiatric assessment is important because it allows for early intervention of symptoms showcased by the child or adolescents, which can potentially avert long-term consequences. Early intervention helps the parents and the provider get a bigger picture of the child or adolescent may be experiencing. It can help set a different atmosphere during their developing years. In my opinion, it is easier to correct behaviors while they are in their formative years than when they are grown adults. A comprehensive assessment will also allow for tailored treatment for the child, which can produce therapeutic outcomes for both the child and the family.
2. Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent.
The Child Behavior Checklist (CBCL) is a questionnaire completed by parents or caregivers to assess for emotional and behavioral problems in children aged 6 to 18 years. Its comprehensive nature covers many internalizing and externalizing symptoms (Biederman et al., 2020).
The Screen for Child Anxiety-Related Emotional Disorders (SCARED) is used as a tool to assess pediatric anxiety symptoms and disorders in children and adolescents based on the parent and child report (Behrens et al., 2018).
3. Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.
Play Therapy: Play therapy is a developmentally appropriate approach that utilizes play to help children express their thoughts, emotions, and experiences.
Parent-Child Interaction Therapy (PCIT): PCIT is an evidence-based treatment specifically designed for children with disruptive behavior disorders, such as oppositional defiant disorder (ODD) or conduct disorder (CD), typically between the ages of 2 to 7 years.
Explain the role parents/guardians play in assessment.
Parents play a profound role during the assessment of a pediatric patient. Some of them include providing information about the child’s medical background, developmental history, and behavior in various settings such as home, school, church, extracurricular activities, etc. In addition, the parent can provide insight into their child’s behavior and interactions that may not be evident during clinical assessment. Collaborating with the provider can help foster a holistic approach towards creating an effective treatment plan for the child. Finally, being supportive and advocating for their child is important during assessment.
References
Behrens, B., Swetlitz, C., Pine, D. S., & Pagliaccio, D. (2018). The screen for child Anxiety Related Emotional Disorders (SCARED): informant discrepancy, measurement invariance, and Test–Retest Reliability. Child Psychiatry & Human Development, 50(3), 473–482. https://doi.org/10.1007/s10578-018-0854-0
Biederman, J., DiSalvo, M., Vaudreuil, C., Wozniak, J., Uchida, M., Woodworth, K. Y., Green, A., & Faraone, S. V. (2020). Can the Child Behavior Checklist (CBCL) help characterize the types of psychopathologic conditions driving child psychiatry referrals? Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 8(1), 157–165. https://doi.org/10.21307/sjcapp-2020-016
Lynch, L., Long, M., & Moorhead, A. (2016). Young Men, Help-Seeking, and Mental Health Services: exploring Barriers and solutions. American Journal of Men’s Health, 12(1), 138–149. https://doi.org/10.1177/1557988315619469
Pathak, P., & Chou, A. (2019). Confidential care for adolescents in the U.S. health care system. Journal of Patient-Centered Research and Reviews, 6(1), 46–50. https://doi.org/10.17294/2330-0698.1656
Schlack, R., Peerenboom, N., Neuperdt, L., Junker, S., & Beyer, A. (2021). The effects of mental health problems in childhood and adolescence in young adults: Results of the KiGGS cohort. PubMed, 6(4), 3–19. https://doi.org/10.25646/8863
Van Roy, B., Grøholt, B., Heyerdahl, S., & Clench‐Aas, J. (2010). Understanding discrepancies in parent-child reporting of emotional and behavioural problems: Effects of relational and socio-demographic factors. BMC Psychiatry, 10(1). https://doi.org/10.1186/1471-244x-10-56
Initial Assignment and instructions
Comprehensive Integrated Psychiatric Assessment
The focus of week 1 is on Child and Adolescent Assessment. All diagnoses start with an assessment or examination. Diagnostic tests can be used to decide organic basis for most medical disorders while the field of psychiatry is different in that patients cannot be sent to the lab for blood tests or to the radiology department for a “scan” to determine the severity of mental illness. Instead, the field of psychiatry must use psychiatric assessments, such as the comprehensive integrated physical exam, diagnostic interviews, and questionnaires to make diagnoses. These tools must be specialized to address the needs of children and adolescents.
This week, you explore psychiatric assessment techniques and tools for children and adolescents. You also examine the role of the parent/guardian in the assessment process for this patient population.
To Prepare
• Review the Learning Resources and consider the insights they provide on comprehensive, integrated psychiatric assessment. Watch the Mental Status Examination B-6 and Simulation Scenario-Adolescent Risk Assessment videos.
• Watch the YMH Boston Vignette 5 video and take notes; you will use this video as the basis for your Discussion post.
By Day 3 of Week 1 (Deadline is 9:59 pm MT or 11:59pm ET), submit your initial posting (include the questions on your write-up) to address the following:
Based on the YMH Boston Vignette 5 video, post answers to the following 5 questions:
• What did the practitioner do well? In what areas can the practitioner improve?
• At this point in the clinical interview, do you have any compelling concerns? If so, what are they? THINK SAFETY!
• What would be your next question, and why?
Then, address the following 4 Questions. Your answers to these prompts do not have to be tailored to the patient in the YMH Boston video.
• Explain why a thorough psychiatric assessment of a child/adolescent is important.
• Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent.
• Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.
• Explain the role parents/guardians play in assessment.
Support your response with at least three peer-reviewed, evidence-based sources and EXPLAIN WHY each of your supporting sources is considered scholarly.
Attach the PDFs of your sources.
Review the grading rubrics for points assignment and separate your write-up into paragraphs with the appropriate headlines or questions.
LEARNING RESOURCES
The Videos:
Required Media
• Symptom Media. (2014). Mental status exam B-6Links to an external site.. [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/mental-status-exam-b-6/cite?context=channel:volume-2-new-releases-assessment-tools-mental-status-exam-series
https://video.alexanderstreet.com/p/369oB4joR
• Western Australian Clinical Training Network. (2016, August 4). Simulation scenario-adolescent risk assessmentLinks to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=wNF1FIKHKEULinks to an external site.
• YMH Boston. (2013, May 22). Vignette 5 – Assessing for depression in a mental health appointmentLinks to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=Gm3FLGxb2ZU
Required Readings:
• Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental healthLinks to an external site.. American Psychiatric Association Publishing.
o Chapter 1, “Introduction”
o Chapter 4, “The 15-Minute Pediatric Diagnostic Interview”
o Chapter 5, “The 30-Minute Pediatric Diagnostic Interview”
o Chapter 6, “DSM-5 Pediatric Diagnostic Interview”
o Chapter 9, “The Mental Status Examination: A Psychiatric Glossary”
o Chapter 13, “Mental Health Treatment Planning”
• Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescentsLinks to an external site.. Indian Journal of Psychiatry, 61(2), 158–175. http://doi.org/10.4103/psychiatry.IndianJPsychiatry_580_18
• Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.
o Chapter 32, “Clinical assessment and diagnostic formulation”
Optional Resources:
• Boland, R. Verdiun, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.
o Chapter 1, “Examination and Diagnosis of the Psychiatric Patient”
Section 1.2, “Children and Adolescents” (pp. 74-87)
NRNP_6665_Week1_Discussion_RubricCriteriaRatingsPts
Main Posting:Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
view longer description
44 to >39 pts
Excellent
Thoroughly responds to the Discussion question(s)… Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources… No less than 75% of post has exceptional depth and breadth… Supported by at least three current credible sources
39 to >34 pts
Good
Responds to most of the Discussion question(s)… Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module… 50% of the post has exceptional depth and breadth… Supported by at least three credible references
34 to >30 pts
Fair
Responds to some of the Discussion question(s)… One to two criteria are not addressed or are superficially addressed… Is somewhat lacking reflection and critical analysis and synthesis… Somewhat represents knowledge gained from the course readings for the module… Post is supported by fewer than two credible references
30 to >0 pts
Poor
Does not respond to the Discussion question(s)… Lacks depth or superficially addresses criteria… Lacks reflection and critical analysis and synthesis… Does not represent knowledge gained from the course readings for the module… Contains only one or no credible references
/ 44 pts
Main Posting:Writing
view longer description
6 to >5 pts
Excellent
Written clearly and concisely… Contains no grammatical or spelling errors… Adheres to current APA manual writing rules and style
5 to >4 pts
Good
Written concisely… May contain one to two grammatical or spelling errors… Adheres to current APA manual writing rules and style with minor errors
4 to >3 pts
Fair
Written somewhat concisely… May contain more than two spelling or grammatical errors… Contains some APA formatting errors
3 to >0 pts
Poor
Not written clearly or concisely… Contains more than two spelling or grammatical errors… Does not adhere to current APA manual writing rules and style
/ 6 pts
Main Posting:Timely and full participation
view longer description
10 to >8 pts
Excellent
Meets requirements for timely, full, and active participation… Posts main Discussion by due date
8 to >7 pts
Good
Posts main Discussion by due date… Meets requirements for full participation
7 to >6 pts
Fair
Posts main Discussion by due date
6 to >0 pts
Poor
Does not meet requirements for full participation… Does not post main Discussion by due date
/ 10 pts
First Response:Post to colleague’s main post that is reflective and justified with credible sources
view longer description
9 to >8 pts
Excellent
Response exhibits critical thinking and application to practice settings… Responds to questions posed by faculty… The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.
8 to >7 pts
Good
Response has some depth and may exhibit critical thinking or application to practice setting.
7 to >6 pts
Fair
Response is on topic, may have some depth.
6 to >0 pts
Poor
Response may not be on topic, lacks depth.
/ 9 pts
First Response:Writing
view longer description
6 to >5 pts
Excellent
Communication is professional and respectful to colleagues…. Response to faculty questions are fully answered, if posed…. Provides clear, concise opinions and ideas that are supported by two or more credible sources… Response is effectively written in standard, edited English.
5 to >4 pts
Good
Communication is mostly professional and respectful to colleagues…. Response to faculty questions are mostly answered, if posed…. Provides opinions and ideas that are supported by few credible sources… Response is written in standard, edited English.
4 to >3 pts
Fair
Response posted in the Discussion may lack effective professional communication…. Response to faculty questions are somewhat answered, if posed…. Few or no credible sources are cited.
3 to >0 pts
Poor
Responses posted in the Discussion lack effective communication…. Responses to faculty questions are missing…. No credible sources are cited.
/ 6 pts
First Response:Timely and full participation
view longer description
5 to >4 pts
Excellent
Meets requirements for timely, full, and active participation… Posts by due date
4 to >3 pts
Good
Meets requirements for full participation… Posts by due date…
3 to >2 pts
Fair
Posts by due date
2 to >0 pts
Poor
Does not meet requirements for full participation… Does not post by due date
/ 5 pts
Second Response:Post to colleague’s main post that is reflective and justified with credible sources
view longer description
9 to >8 pts
Excellent
Response exhibits critical thinking and application to practice settings…. Responds to questions posed by faculty… The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.
8 to >7 pts
Good
Response has some depth and may exhibit critical thinking or application to practice setting.
7 to >6 pts
Fair
Response is on topic, may have some depth.
6 to >0 pts
Poor
Response may not be on topic, lacks depth.
/ 9 pts
Second Response:Writing
view longer description
6 to >5 pts
Excellent
Communication is professional and respectful to colleagues…. Response to faculty questions are fully answered, if posed…. Provides clear, concise opinions and ideas that are supported by two or more credible sources… Response is effectively written in standard, edited English.
5 to >4 pts
Good
Communication is mostly professional and respectful to colleagues…. Response to faculty questions are mostly answered, if posed…. Provides opinions and ideas that are supported by few credible sources… Response is written in standard, edited English.
4 to >3 pts
Fair
Response posed in the Discussion may lack effective professional communication…. Response to faculty questions are somewhat answered, if posed…. Few or no credible sources are cited.
3 to >0 pts
Poor
Responses posted in the Discussion lack effective communication…. Responses to faculty questions are missing…. No credible sources are cited.
/ 6 pts
Second Response:Timely and full participation
view longer description
5 to >4 pts
Excellent
Meets requirements for timely, full, and active participation… Posts by due date
4 to >3 pts
Good
Meets requirements for full participation… Posts by due date
3 to >2 pts
Fair
Posts by due date
2 to >0 pts
Poor
Does not meet requirements for full participation… Does not post by due date
/ 5 pts
Total Points: 0
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