NRNP 6665 Week1 Discussion
What Did The practitioner do well?
In the YMH Boston Vignette 5 Vudeo, the clinician did an excellent job of making the client comfortable because it is challenging and sometimes complex to make an adolescent client comfortable and gain their trust. The clinician must build good rapport by providing the child with a safe, confidential, nonjudgmental place. The clinician also did an excellent job asking the 15-year-old male client specific questions to understand his symptoms and feelings better. When Tony became comfortable and trusted the clinician, he opened up about his true feelings and symptoms. He told the clinician about when his depression and anxiety started due to the separation of his girlfriend two months ago. Because of the clinician’s good interviewing techniques, Tony could express his true feelings, such as anger, low energy, and not wanting to be alive.
I think the clinician should improve assessment skills to know more about the client, such as the client’s social life, peer pressure or support, and family. It is critical to know about his friends because adolescents are influenced mainly by their peers and social media, which can be the client’s stressor or risk factor. It is also critical to ask if he experienced any trauma or abuse.
Concerns and Questions.
The primary concern while watching the video is his safety. The client reported during the interview and said, “It hurts, and I don’t want to be alive.” This comment is a red flag. After hearing his statement, I would ask him if he was suicidal, if he had any plans, and if has any means to carry out his plan. Also, I would ask him if he had a history of self-harm when was the last time he hurt himself, and how? While interviewing a client with suicidal ideation, safety is the highest priority, and more questions must be addressed to know the severity of the symptoms (Bhide and Chakraborty, 2020). The second concern in the video was that the client reported during the interview that he is angry and likes to fight someone. These symptoms must be adequately addressed because he might be dangerous to others. According to research, adolescents with homicidal tendencies are a growing concern in the United States, and the number of juvenile criminal homicides increased by 49% in the past five years (Sun et al., 2022). So, I will ask him if he has any plan to hurt anyone, the name of the person, and how.
Child/Adolescent Psychiatric Assessment.
A comprehensive psychiatric evaluation may be needed to diagnose emotional, behavioral, or developmental disorders. An evaluation of a child, adolescent, or adult is made based on behaviors present in physical, genetic, environmental, social, and cognitive (thinking, emotional, and educational) that may be affected by these behaviors. Common mental disorders such as anxiety and depressive disorders affect approximately 3.6 to 4.4% of the world’s adult population and 20% of adolescents (Silva et al., 2020). These most common mental health disorders are most common among adolescents and lead to suicide and self-harm, which is the second leading cause of death among young people between the ages of 10 and 24 (Farley, 2020). Assessing adolescents and children is a challenge due to the difficulty of gathering adequate information from the client because of their age, and they cannot report their symptoms, timing, and duration. The healthcare provider must collect the information from different sources, such as patients, teachers, or caregivers (Srinath et al., 2019). comprehensive psychiatric evaluation is critical to case formulation, guiding management, and treatment decisions.
The Two Different Symptoms’ Rating Scales.
The two symptom rating scales are the Child Behavior Checklist (CBCL) and the Strengths and Difficulties Questionnaire (SDQ). CBCL and SDQ help to measure emotional and behavioral problems in children and adolescents (Steenhoff et al., 2021). CBCL has many scoring options, such as syndrome scales, DSM-oriented scales, and Depressive and anxiety problems are some of them. SDQ gathers information about emotional, conduct, hyperactivity, peer, and prosocial problems (Mansolf et al., 2022).
Two Psychiatric Treatment Options for Children and Adolescents.
Children and adolescent counseling are very different from adult counseling due to their developmental stage; children prefer to communicate through play and creative activities as well as through conversation, and adolescents also share the same preferences as young children. Most psychotherapies focus on construction materials, artwork and drawing, reading and story books, worksheets, and workbooks. Different treatment play activities are available for children with mental and emotional issues (Mohammadi et al., 2019)
The Role of Parents/Guardians in Children and Adolescents Assessment.
Assessing or treating a child involves their parents or other significant family members. To conduct an effective assessment, the clinician must also involve family members because there is no effective treatment for the child. A child’s and the parent’s life is inextricably linked. Parents/guardians play a crucial role in diagnosing correctly and providing effective treatment (Bhide and Chakraborty, 2020). Guardians/parents are the primary sources of information about a child’s symptoms, behaviors, triggers, onset, frequency, and history. They are also involved with a treatment plan, cost, and consent (Bhide and Chakraborty, 2020). Clinicians cannot fully treat a child without a guardian or parents’ 100% cooperation.
The three scholarly peer-reviewed articles are (Silva et al., 2020), which is a systematic review and meta-analysis retrieved from the National Library of Medicine (Bhide and Chakraborty, 2020), and (Mohammadi et al., 2019) is an international peer-reviewed article.
References.
Bhide, A., & Chakraborty, K. (2020). General Principles for Psychotherapeutic Interventions in Children and Adolescents. Indian journal of psychiatry, 62(Suppl 2), S299–S318. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_811_19Links to an external site..
Farley, H. R. (2020). Assessing mental health in vulnerable adolescents. Nursing, 50(10), 48–53. https://doi.org/10.1097/01.nurse.0000697168.39814.93
Mansolf, M., Blackwell, C. K., Cummings, P., Choi, S., & Cella, D. (2022). Linking the Child Behavior Checklist to the Strengths and Difficulties Questionnaire. Psychological assessment, 34(3), 233–246. https://doi.org/10.1037/pas0001083Links to an external site.
Mohammadi Nia, N., Fatemi, F. S., Nasiri, M., & Pirnie, B. (2019). The effectiveness of cognitive-behavioral play therapy on anxiety and academic achievement among children with LD. International Journal of Applied Behavioral Sciences, 5(1), 41-48. https://doi.org/10.22037/ijabs.v5il.23334Links to an external site.
Sun, C. F., Mansuri, Z., Trivedi, C., Vadukapuram, R., & Reddy, A. (2022). Homicidal ideation and psychiatric comorbidities in the inpatient adolescents aged 12-17. Frontiers in psychiatry, 13, 933524. https://doi.org/10.3389/fpsyt.2022.933524Links to an external site.
Silva, S. A., Silva, S. U., Ronca, D. B., Gonçalves, V. S. S., Dutra, E. S., & Carvalho, K. M. B. (2020). Common mental disorders prevalence in adolescents: A systematic review and meta-analyses. PloS one, 15(4), e0232007. https://doi.org/10.1371/journal.pone.0232007Links 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(Suppl 2), 158–175. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_580_18
Steenhoff, T., Tharner, A., & Væver, M. S. (2021). Internalizing and externalizing problems in preschool children: The role of mothers’ and fathers’ observed parenting behavior in a well‐resourced sample. Scandinavian Journal of Psychology, 62(3), 374–385. https://doi.org/10.1111/sjop.12724Links to an external site.
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.
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