NURS 6660: Psychiatric Mental Health Nurse Practitioner Role I: Child and Adolescent | Week 11

“Here we go again; another foster home. My father kicked me out when he saw me wearing Mom’s clothes. He did not understand that deep down, I know that I am a girl. My birth certificate may say male, but it is wrong. I feel so much better being myself… being a girl. Maybe this foster family will understand and accept me for who I am, or I am just going to run away again.”

Joseph/Josephine, age 16

In your practice as a PMHNP, you may see many children and adolescents who are faced with challenges that go beyond the standard DSM-5 diagnoses. Children in foster homes or who have been adopted may have emotional scars from previous abuse or neglect; adolescents experiencing issues with gender dysphoria may be faced with peer and family issues; and children involved in acts of terrorism may face reoccurring fear and mistrust. NURS 6660:Week 11: Special Topics in Child and Adolescent Psychiatry

This week, you explore psychological issues that may arise in children faced with special circumstances and the assessment and treatment options specific to these special populations. You also take your final exam for the course.

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

• Standards 11 “Communication” (page 75)

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 31, “Child Psychiatry” (pp. 1279–1323)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

• “Somatic Symptom and Related Disorders”
• “Other Conditions That May Be a Focus of Clinical Attention”
• “Assessment Measures”
• “Cultural Formulation”

Note: You will access this book from the Walden Library databases.

American Academy of Child & Adolescent Psychiatry (AACAP). (2011). Practice parameter for child and adolescent forensic evaluations. Journal of the American Academy of Child & Adolescent Psychiatry, 50(12), 1299-1312. Retrieved from http://www.jaacap.com/article/S0890-8567(11)00883-5/pdf

American Academy of Child & Adolescent Psychiatry (AACAP). (2012c). Practice parameter on gay, lesbian, or bisexual sexual orientation, gender nonconformity, and gender discordance in children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 51(9), 957–974. Retrieved from http://www.jaacap.com/article/S0890-8567(12)00500-X/pdf

Lee, T., Fouras, G., & Brown, R. (2015). Practice parameter for the assessment and management of youth involved with the child welfare system. Journal of the American Academy of Child & Adolescent Psychiatry, 54(6), 502–517. Retrieved from http://www.jaacap.com/article/S0890-8567(15)00148-3/pdf

Human Rights Campaign. (n.d.). Growing up LGBT in America. Retrieved June 8, 2017, from http://assets.hrc.org//files/assets/resources/Growing-Up-LGBT-in-America_Report.pdf?_ga=1.83582870.1279387255.1493224749

Optional Resources NURS 6660:Week 11: Special Topics in Child and Adolescent Psychiatry

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.). Hoboken, NJ: Wiley Blackwell.

• Chapter 19, “Legal Issues in the Care and Treatment of Children With Mental Health Disorders” (pp. 239–249)
• Chapter 49, “Forensic Psychology” (pp. 636–647)

Discussion: Special Topics in Child and Adolescent Psychiatry

Many children face special issues that impact everyday life, whether it is within themselves, their families, or their environment. The PMHNP must be sensitive to these many issues that children and adolescents are faced with during important developmental years.

In this Discussion, you select a special population and analyze the psychological issues that the population faces. You also address the assessment and treatment needs of the population.

Learning Objectives

Students will:

• Analyze psychological issues that may arise in children faced with special circumstances
• Evaluate assessment measures used with children faced with special circumstances
• Evaluate treatment options used with children faced with special circumstances
• Analyze cultural influences on treatments (D)

To Prepare for the Discussion:

• Review the Learning Resources.
• Select one of the following topics for the Discussion:
  • Adoption
  • Foster care
  • Gender dysphoria
  • Forensic issues
  • Impact of terrorism on children

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking Submit!

By Day 3

Post:

• Write your selected disorder in the subject line of your Discussion post.
• Explain the psychological issues that may result from your topic.
• Describe the most effective assessment measure that could be used, and explain why you selected this.
• Explain the treatment options available for children and adolescents involved with your selected disorder.
• Explain how culture may influence treatment.

By Day 6

Respond to at least two of your colleagues who selected a topic other than the topic you selected. Provide at least two additional treatment strategies that could be used with this client and at least one additional cultural influence that you think should be considered. Explain your responses. NURS 6660:Week 11: Special Topics in Child and Adolescent Psychiatry

ADDITIONAL INFORMATION 

Special Topics in Child and Adolescent Psychiatry

Introduction

Child and adolescent psychiatry is a specialty that deals with children, teenagers and young adults. It’s not as well-known as other pediatric subspecialties like pediatrics or neurology, but it’s an important part of treating children who are struggling with mental health issues. In this article we’ll cover some of the most common disorders in child psychiatry and how they affect your child’s ability to function at school or home.

ADHD

Attention-deficit/hyperactivity disorder (ADHD) is a neuropsychiatric condition that can affect children and adults. It has been estimated that ADHD affects about 8 percent of school-age children, or about 6 million Americans.

The symptoms of ADHD include:

• Inattention (difficulty paying attention to details)

• Hyperactivity (overactive behavior or impulse control problems)

It’s important to note that not all children with these symptoms will develop the full syndrome, but if they do, there may be other issues at play as well. For example: A child who has trouble focusing on one thing at a time may also have difficulty sitting still during class; another child might talk constantly without paying attention when she’s supposed to be listening; in some cases it could take months before these symptoms become apparent!

Anxiety disorders

Anxiousness is a normal part of childhood, but if it becomes excessive or lasts for more than six months, it may be an anxiety disorder.

Anxiety disorders are the most common mental health problem in children and adolescents. It’s important to get help early because there are effective treatments available for most cases. Anxiety disorders often occur together with other mental illnesses such as depression or drug abuse (e.g., alcoholism).

Autism spectrum disorder

Autism spectrum disorder (ASD) is a group of developmental disorders that affect the way a person functions in society. It’s usually characterized by social deficits, repetitive behaviors, and unusual interests or activities.

Asperger’s syndrome is a subtype of autism where there are no obvious delays in development but affected individuals have trouble communicating with others because they do not understand the emotions of others around them.

Rett syndrome is another childhood-onset neurodevelopmental disorder that causes brain problems similar to those seen in autism; however, Rett syndrome doesn’t appear until ages 3–12 years old while autism typically develops after 2 years old or later.

Bipolar disorder

Bipolar disorder is a mental health condition that causes shifts in mood, energy, activity levels and the ability to carry out day-to-day tasks. People with bipolar disorder experience extreme highs (mania) and lows (depression).

In addition to experiencing symptoms of mania or depression, people with bipolar disorder may experience episodes of extreme irritability that last for days on end called hypomania or hypermania. These episodes can result from medications prescribed by your doctor to treat your symptoms.

Depression and other mood disorders

Depression is a serious medical illness that can be treated and prevented. It’s not a character flaw, nor should it be something to be ashamed of.

Disruptive mood dysregulation disorder

Disruptive mood dysregulation disorder is a psychiatric condition that can be diagnosed in children and adolescents. It is characterized by extreme irritability, aggression, or anger episodes that last for at least six months. These episodes often occur at inappropriate times—for example, when the child is tired or hungry—and may result in yelling or other disruptive behaviors. DMDD also tends to occur alongside other disorders such as oppositional defiant disorder (ODD), attention deficit hyperactivity disorder (ADHD), anxiety disorders, depression/trauma-related posttraumatic stress disorder (PTSD), autism spectrum disorder and/or substance use problems.

Eating disorders

Eating disorders are serious mental illnesses that can have a significant impact on your life. They’re also associated with high mortality rates, so it’s important to know how they work and what you can do to prevent them.

Anorexia nervosa (AN) is characterized by an obsession with thinness that causes severe restriction of food intake, leading to weight loss and muscle wasting; bulimia nervosa (BN) involves binge eating followed by purging via vomiting or excessive exercise—examples of behaviors that may be seen in both AN and BN include avoiding carbohydrates altogether or never eating breakfast.

Both AN/BN are classified as obsessive-compulsive spectrum disorders because they involve repetitive thoughts about food or shapely body parts often accompanied by behavioral rituals such as avoiding certain foods or exercising excessively.[1] These symptoms make up the core features of these disorders but other factors such as family history may play a role as well.[2]

Obsessive-compulsive disorder (OCD)

Obsessive-compulsive disorder (OCD) is a mental health disorder characterized by obsessions, such as intrusive thoughts and repetitive behaviors that are difficult to resist or control. Compulsions may include repeated hand washing, ordering items in a particular way and checking for danger.

OCD usually begins in childhood or adolescence but can also occur later in life. It affects about 1% of people worldwide; however, some people with OCD may not recognize their symptoms until later on in their lives.

Takeaway:

The takeaways from this course are that mental health is important and it’s not just about the child, but also about the whole family. There are many options for treatment, and children can be helped and recovered.

Conclusion

In conclusion, it is important to remember that while each of these disorders is unique and has its own set of symptoms, they are all treatable. The best way to ensure that your child receives the care they deserve is by contacting a mental health provider who can help you navigate through life’s challenges with confidence.