NRNP 666 Discussion Week 1 Essay

NRNP 666 Discussion Week 1 Essay

NRNP 666 Discussion Week 1 Essay

Discussion Week 1 Walden University 6665
From my analysis of the YMH Boston Vignette 5 interview video, I identified some areas the interviewer did well and others that need improvement. The elements that went well include the interviewer being calm and patient with the client and giving him adequate time to express his concerns about the depression symptoms he experiences. This helped the client to be comfortable and talk about his symptoms. Besides, the interviewer did well by asking the patient about his academics and history of alcohol and drug use, which is crucial in mental health assessment for adolescents. However, the interviewer can improve her rapport with the patient by greeting and welcoming him and assuring him of confidentiality (Bhide & Chakraborty, 2020). The interviewer should also introduce herself by name and profession and explain to the client the course of the interview to foster cooperation.

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Compelling Concerns
The client states he wishes not to be alive and would want retribution for his ex-girlfriend. This raises concerns about whether the patient has suicidal and homicidal ideas or thoughts and is a danger to himself and others (Bhide & Chakraborty, 2020). Concerns may also arise about the client’s anger management strategies since he mentions getting angry and having a rapid heartbeat when he remembers his breakup with his former girlfriend
My next question to the client will be: What do you often think of doing when you feel the anger related to the breakup? The question will help identify if the patient usually has thoughts of harming himself or the ex-girlfriend and if he has made plans to do so.
Importance of a thorough psychiatric assessment of a child/adolescent
A thorough psychiatric assessment in a child/adolescent is crucial in identifying mental health issues, which often affect adaptation and functionality in adulthood. The assessment helps to identify common mental health problems in pediatrics, like anxiety, depression, and developmental and behavioral disorders (Caqueo-Urízar et al., 2020). Furthermore, the assessment helps to identify issues that should be addressed to prevent them from persisting to adulthood when it becomes harder to treat.
Symptom Rating Scales
Psychiatric symptom rating scales that can be used with a child or adolescent include CRAFFT and Strengths and Difficulties Questionnaire (SDQ). CRAFFT is a behavioral health screening tool used in children and adolescents up to 20 years. It is used to screen adolescents for alcohol and substance abuse disorders (Mulvaney-Day et al., 2018). SDQ is a self-administered behavioral questionnaire used to screen children and adolescents 3-16 years for emotional problems, conduct problems, hyperactivity and inattention, peer relationships, and prosocial behaviors.
Psychiatric Treatment Options for Children and Adolescents
Play Therapy and Parent-child interaction therapy (PCIT) are psychotherapy options used only in children. Play therapy addresses children’s emotional problems and behavioral disorders since it meets their unique developmental needs. PCIT is designed for preschool children with behavioral disorders. It enables a parent to interact with the child and manage undesired behaviors (Vess & Campbell, 2022). During psychiatric assessment, parents/guardians play a crucial role in providing the child’s history, including birth and developmental history. They also provide accurate information on the symptoms and course of the child’s mental disorder over time.

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_19
Caqueo-Urízar, A., Flores, J., Escobar, C., Urzúa, A., & Irarrázaval, M. (2020). Psychiatric disorders in children and adolescents in a middle-income Latin American country. BMC psychiatry, 20(1), 104. https://doi.org/10.1186/s12888-020-02512-4
Mulvaney-Day, N., Marshall, T., Downey Piscopo, K., Korsen, N., Lynch, S., Karnell, L. H., Moran, G. E., Daniels, A. S., & Ghose, S. S. (2018). Screening for Behavioral Health Conditions in Primary Care Settings: A Systematic Review of the Literature. Journal of general internal medicine, 33(3), 335–346. https://doi.org/10.1007/s11606-017-4181-0
Vess, S. F., & Campbell, J. M. (2022). Parent-child interaction therapy (PCIT) with families of children with autism spectrum disorder. Autism & developmental language impairments, p. 7, 23969415221140707. https://doi.org/10.1177/23969415221140707

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COMPREHENSIVE INTEGRATED PSYCHIATRIC ASSESSMENT

Many assessment principles are the same for children and adults; however, unlike with adults/older adults, where consent for participation in the assessment comes from the actual client, with children it is the parents or guardians who must make the decision for treatment. Issues of confidentiality, privacy, and consent must be addressed. When working with children, it is not only important to be able to connect with the pediatric patient, but also to be able to collaborate effectively with the caregivers, other family members, teachers, and school counselors/psychologists, all of whom will be able to provide important context and details to aid in your assessment and treatment plans.

Some children/adolescents may be more difficult to assess than adults, as they can be less psychologically minded. That is, they have less insights into themselves and their motivations than adults (although this is not universally true). The PMHNP must also take into consideration the child’s culture and environmental context. Additionally, with children/adolescents, there are lower rates of neurocognitive disorders superimposed on other clinical conditions, such as depression or anxiety, which create additional diagnostic challenges.

In this Discussion, you review and critique the techniques and methods of a mental health professional as the practitioner completes a comprehensive, integrated psychiatric assessment of an adolescent. You also identify rating scales and treatment options that are specifically appropriate for children/adolescents.

RESOURCES

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

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

Based on the YMH Boston Vignette 5 video, post answers to the following 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?

What would be your next question, and why?

Then, address the following. 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.

Read a selection of your colleagues’ responses.

BY DAY 6 OF WEEK 1

Respond to at least two of your colleagues on 2 different days 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.

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 Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!

REQUIRED MEDIA

 

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

 

 

 

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