Comprehensive Integrated Psychiatric Assessment Paper

Comprehensive Integrated Psychiatric Assessment Paper

In the YMH Boston Vignette 5 interview video, the PMHNP did well by talking to the patient calmly and allowing the patient to talk about the depressive symptoms. The PMHNP created a conducive environment, which made the patient comfortable to express his health concerns. Nonetheless, the PMHNP can improve by explaining the importance of the information she is obtaining to increase the client’s enthusiasm in answering questions (Bhide & Chakraborty, 2020). My concern regarding the clinical interview is that the PMHNP did not create a rapport by greeting the client and introducing herself to promote trust and cooperation. My next question would be: Do you ever think of ending it all or ever attempted to end your life?

The question will establish if the client has suicidal ideations, which occur in moderate to severe depression cases (Srinath et al., 2019).

PMHNPs should conduct a thorough child/adolescent psychiatric assessment to ensure they identify signs and risk factors for developmental, emotional, and behavioral mental health disorders and thus initiate early treatment (Srinath et al., 2019). Brief Psychiatric Rating Scale for Children (BPRS-C) and Pediatric Symptom Checklist (PSC) are examples of general rating scales used in child/ adolescent psychiatric assessment of a child/adolescent. BPRS-C evaluates variations in emotional and behavioral problems among children and adolescents aged 5-18 years. The PSC is a brief parent-reported questionnaire that helps clinicians recognize and refer psychosocial problems among 4-16 year-olds during routine primary care visits (Piqueras et al., 2021).

Psychiatric therapies exclusive to psychotherapy for children and adolescents include Mentalization- Based Therapy (MBT) and Play Therapy. MBT is used in pediatric populations with difficulties defining themselves and aims to improve the mental health of children/adolescents. Play therapy involves children and adolescents using various types of play to help them identify and express their feeling and emotions and thus cannot be used in adults (Bhide & Chakraborty, 2020). The role of a parent/guardian during child assessment is to give the child’s symptoms and health history, especially for younger children who cannot express themselves (Srinath et al., 2019). The parent also gives consent and is involved in deciding the child’s treatment plan.

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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

Piqueras, J. A., Vidal-Arenas, V., Falcó, R., Moreno-Amador, B., Marzo, J. C., Holcomb, J. M., & Murphy, M. (2021). Short Form of the Pediatric Symptom Checklist-Youth Self-Report (PSC-17-Y): Spanish Validation Study. Journal of medical Internet research, 23(12), e31127. https://doi.org/10.2196/31127

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

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.

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.