Assignment: Week 1 Comprehensive Integrated Psychiatric Assessment/NRNP 6665

Assignment: Week 1 Comprehensive Integrated Psychiatric Assessment/NRNP 6665

Assignment: Week 1 Comprehensive Integrated Psychiatric Assessment/NRNP 6665

Comprehensive Integrated Psychiatric Assessment
What did the practitioner do well? In what areas can the practitioner improve?
The video “YMH Boston Vignette 5” showcased the practitioner’s adeptness in using communication tactics, including attentive listening, articulate language, and politeness, to effectively collect the required information for an accurate diagnosis. The practitioner exhibited empathy, which is crucial for establishing a productive therapeutic connection with the patient. The practitioner should have initiated introductions and engaged in an open discourse with the patient to discuss the purpose of their referral and enhance her communication skills.
Do you have any compelling concerns at this point in the clinical interview? If so, what are they?
The patient’s current focus on suicidal ideation is the primary issue during the clinical interview. Individuals who are prone to suicide often express their sentiments of loneliness and anguish via their words and actions. They hold the belief that their hardship is incomprehensible to everyone. Showing empathy to others reduces the amount of judgment and misunderstanding they encounter (YMH Boston, 2013).

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What would be your next question, and why?
The patient’s communication of any information on their suicide ideation will form the basis for my further inquiry. I would want to query the potential stimuli and fundamental causes of his self-harming conduct. I will assess if he has actively sought help or taken any required actions to improve his current mental condition (YMH Boston, 2013).
Explain why a thorough psychiatric assessment of a child/adolescent is essential.
A significant proportion of children and adolescents have challenges in expressing their psychological issues until their condition deteriorates, resulting in more profound repercussions. Hence, it is crucial to carry out a thorough psychiatric assessment to rapidly and efficiently detect developmental, emotional, and behavioral problems in this specific age range (Chakraborty & Bhide, 2020). The assessment findings will be used to ascertain the most appropriate intervention for implementation.
Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent.
The Revised Children’s Anxiety and Depression Scale (RCADS) and The Children’s Depression Rating Scale-Revised (CDRS-R) are appropriate tools for evaluating anxiety and depression in children and adolescents during psychiatric assessments. The RCADS, consisting of 47 items, is a self-administered assessment designed for individuals between the ages of 8 and 18 (Tindall et al., 2024). The 17-item CDRS-R assessment tool is conducted in a semi-structured interview. This product is designed for youngsters aged six to twelve, although teens may also use it.
Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.
Parent-child interaction therapy (PCIT), along with play therapy, are not efficacious for adults, but they are effective in addressing mental health concerns in children and adolescents. Parents use PCIT to cultivate favorable connections and enhance their children’s understanding and embrace of concrete emotions (Sehli et al., 2021). Play therapy is a therapeutic approach that utilizes items to encourage the expression of emotions and experiences in children.
Explain the role parents/guardians play in assessment.
A mental assessment thoroughly examines a child’s behavioral, developmental, and psychological needs. Therapists need relevant information from guardians and parents to understand a child’s behavior at home and progress, development, and achievements (De Oliveira Meneses et al., 2022). In collaboration with the parent, the healthcare professional will use informal observations, discussions, surveys, visual aids, and other techniques to determine the child’s skills, requirements, and level of involvement in daily tasks.
Explain why each of your supporting sources is considered scholarly.
The initial supporting source, Chakraborty and Bhide (2020), is regarded as scholarly due to its publication in the Indian Journal of Psychiatry, a peer-reviewed academic journal. The second supporting source, De Oliveira Meneses et al. (2022), is regarded as a scholarly publication due to its inclusion in Psicologia Teoria E Pesquisa, a peer-reviewed journal specializing in psychology. The supporting source, Sehli et al. (2021), is regarded as scholarly as published in the journal Case Reports in Psychiatry. Finally, Tindall et al. (2024) can be considered an academic source due to its publication in European Child & Adolescent Psychiatry. This journal is a highly regarded and peer-reviewed publication specializing in child and adolescent mental health research.

References
Chakraborty, K., & Bhide, A. (2020). General Principles for Psychotherapeutic Interventions in Children and Adolescents. Indian Journal of Psychiatry, 62(8), 299. https://doi.org/10.4103/psychiatry.indianjpsychiatry_811_19
De Oliveira Meneses, G., Santos, W. S. D., Biermann, M. C., Farias, M. G., & Plutarco, L. W. (2022). Influence of values and parenting styles perceived by children in the value transmission. Psicologia Teoria E Pesquisa, 38. https://doi.org/10.1590/0102.3772e38318.en
Sehli, S. a. A., Helou, M., & Sultan, M. A. (2021). The Efficacy of Parent-Child Interaction Therapy (PCIT) in Children with Attention Problems, Hyperactivity, and Impulsivity in Dubai. Case Reports in Psychiatry, 2021, 1–4. https://doi.org/10.1155/2021/5588612
Tindall, L., Kerrigan, P., Li, J., Hayward, E., & Gega, L. (2024). Is behavioral activation an effective treatment for depression in children and adolescents? An updated systematic review and meta-analysis. European Child & Adolescent Psychiatry. https://doi.org/10.1007/s00787-024-02429-3
YMH Boston. (2013). Vignette 5 – Assessing for Depression in a Mental Health Appointment. In YouTube. https://www.youtube.com/watch?v=Gm3FLGxb2ZU

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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

Learning Resources

Required Readings

Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health

Links to an external site.. American Psychiatric Association Publishing.

Chapter 1, “Introduction”

Chapter 4, “The 15-Minute Pediatric Diagnostic Interview”

Chapter 5, “The 30-Minute Pediatric Diagnostic Interview”

Chapter 6, “DSM-5 Pediatric Diagnostic Interview”

Chapter 9, “The Mental Status Examination: A Psychiatric Glossary”

Chapter 13, “Mental Health Treatment Planning”

Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents

Links 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.

Chapter 32, “Clinical assessment and diagnostic formulation”

Required Media

Symptom Media. (2014). Mental status exam B-6

Links 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

Western Australian Clinical Training Network. (2016, August 4). Simulation scenario-adolescent risk assessment

Links 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 appointment

Links to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=Gm3FLGxb2ZU

Optional Resources

Boland, R. Verdiun, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.

Chapter 1, “Examination and Diagnosis of the Psychiatric Patient”

Section 1.2, “Children and Adolescents” (pp. 74-87)

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.

Upload a copy of your discussion writing to the draft Turnitin for plagiarism check. Your faculty holds the academic freedom to not accept your work and grade at a zero if your work is not uploaded as a draft submission to Turnitin as instructed.

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!