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.

 

 

 

 

The practitioner in the video created a calm and comfortable environment for the patient, maintained eye contact, used open-ended questions, and actively listened to the patient’s responses. The practitioner demonstrated empathy and professionalism by summarizing the client’s narratives, which comforted the client and allowed him to share the main source of his anger and depression. Older children and adolescents may not want to be consulted about their behavior, especially if it is disruptive or if they are embarrassed to have their parents discuss their behavior with others (Srinath et al., 2019). She asked appropriate questions to identify the source of his feelings and spoke calmly, using familiar vocabulary. At this point in the interview the practitioner should ask more specific and targeted questions to gather additional information about the patient’s symptoms and provide more education on depression. Open-ended questions would allow for greater interaction between the client and provider. The biggest concern I have is treating the patient’s anger and depression early before it progresses. The next question should be focused on gathering more information about the patient’s suicidal thoughts and ideation (YMH Boston, 2019). This could include asking about the frequency and intensity of these thoughts, any previous attempts or plans for suicide, and any current support systems or coping strategies in place. These questions can help assess the severity of the patient’s depression and determine the level of intervention needed.

Adolescence is a critical period for the onset of mood disorders, and depression in adolescence is associated with relapse later in life, social and educational impairment, and physical health difficulties, and represents a significant risk factor for suicide (Orchard et al., 2019). A thorough psychiatric assessment of a child or adolescent is important for many reasons. First, it allows for the identification and diagnosis of any mental health disorders that may be impacting the child’s functioning and overall well-being. This is crucial as early detection and intervention can lead to better outcomes and prevent the development of more severe symptoms in the future. Additionally, a thorough psychiatric assessment considers all aspects of a child’s life, including their family dynamics, school environment, and social relationships. It can help identify any underlying factors or stressors that may be contributing to the child’s mental health concerns.

Two different symptom rating scales that would be appropriate to use during a psychiatric assessment of a child or adolescent are the Children’s Depression Inventory (CDI) and the Child Behavior Checklist (CBCL). The CDI is a self-report questionnaire used to assess depressive symptoms in children and adolescents, while the CBCL is a comprehensive checklist that evaluates a wide range of emotional and behavioral problems in children. Two psychiatric treatment options for children and adolescents that may not be used when treating adults are play therapy and family therapy. Play therapy involves using toys, games, and other activities to help children express their thoughts and emotions. It can be an effective way to engage younger children who may struggle with verbal communication. Family therapy involves working with the child’s family to improve communication, resolve conflicts, and address any issues that may be contributing to the child’s symptoms.

Adolescents need support and protection due to their physical, psychological and social vulnerabilities, and excessive adverse exposure can have destructive effects on adolescents’ lives and health (Rahmani et al., 2022). Although social support could play a pivotal role in helping adolescents transition to a new role as a caregiver, adolescents often perceive themselves as supportless and neglected. Parents and guardians play a crucial role in the assessment process. They can provide valuable information about the child’s behavior, symptoms, and family history, aiding the diagnostic process. They can also provide insight into the child’s daily functioning and help monitor any changes in symptoms or behaviors. In some cases, parents may also participate in therapy sessions with their child, making them an essential part of the treatment process.

 

References

Orchard, F., Pass, L., Cocks, L., Chessell, C., & Reynolds, S. (2019). Examining parent and child agreement in the diagnosis of adolescent depression. Child and Adolescent Mental Health, 24(4), 338–344. https://doi.org/10.1111/CAMH.12348

Rahmani, F., Roshanghar, F., Gholizadeh, L., & Dickens, G. L. (2022). Caregiver or care receiver: Adolescents’ experience of caregiving to a parent with severe mental illness: A qualitative study. Child and Family Social Work, 27(4), 795–804. https://doi.org/10.1111/CFS.12926

Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescentsLinks to an external site.Links to an external site..Indian Journal of Psychiatry, 61(2), 158–175. http://doi.org/10.4103/psychiatry.IndianJPsychiatry_580_18

YMH Boston. (2013, May 22). Vignette 5 – Assessing for depression in a mental health appointmentLinks to an external site.

NRNP-6665

 

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. 

 

• 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.

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.

 

 

 

 

https://video.alexanderstreet.com/p/369oB4joR

(LINK TO VIDEO)

 

 

 

https://youtu.be/wNF1FIKHKEU?si=8-4p-OdWpQuNCNur (FOR WORK CITED)

 

 

Vignette 5 – Assessing for Depression in a Mental Health Appointment (For WORK CITED)