NRNP 6665 Week 1: Discussion
NRNP 6665 Week 1: Discussion sample 1
What the Practitioner Did Well:
The professional began the discussion with a direct and compassionate inquiry, laying out the motivation behind the visit and making an opening for Tony to share. The expert kept a non-critical tone throughout the discussion, which was critical in causing Tony to have a real sense of reassurance and perception. The expert efficiently got some information about different side effects of depression and anxiety, for example, anger, sadness, energy levels, and interest in exercises. The professional distinguished and recognized the critical drop in Tony’s school execution and his apathy toward exercises he once delighted in, like basketball. The specialist asked about Tony’s utilization of medications and liquor, which is significant for understanding his strategies for dealing with tough times and potential risk factors. The professional associated Tony’s emotional state and the separation from his girlfriend, recognizing it as a likely trigger for his ongoing side effects. At the point when Tony referenced feelings of outrage and the urge to fight, the professional recognized it and demonstrated an eagerness to investigate this further.
Areas for Improvement:
At the point when Tony appeared to be uncertain about what the expert implied by “how you’re feeling” or “your mood,” the professional might have given more unambiguous models or made sense of these terms all the more obviously to guarantee understanding. The specialist might have offered more verbal approval of Tony’s sentiments throughout the meeting, for example, recognizing how hard it might be to experience these feelings. After hearing Tony’s articulation about not having any desire to be alive, the specialist ought to have promptly evaluated the seriousness and severity of the risk by posing direct inquiries about any plans or means he could have considered for self-hurt. The professional might have gotten some information about Tony’s emotional support network, like family, companions, or other critical connections, which could give further setting and roads to help. Utilizing more open-ended inquiries could urge Tony to expound more on his feelings and encounters, giving a more in-depth understanding of his circumstances.
ORDER PLAGIARISM-FREE WORK HERE
Compelling Concerns at This Point in the Interview:
Tony’s assertions about not having any desire to be alive and having considerations about harming himself are exceptionally unsettling and warrant prompt consideration. An extensive risk evaluation is needed to decide the degree of impending risk. The new separation from his girlfriend gives off an impression of being a critical stressor and profound trigger for Tony, adding to his depressive side effects and sensations of outrage. The critical drop in Tony’s scholastic execution and loss of interest in homework might demonstrate a more extensive effect of his profound state on his day-to-day functioning. Even though Tony referenced just periodic liquor use, it is critical to investigate this further to grasp the role of substances in his coping.
Next Steps:
Perform an intensive evaluation to decide the immediacy and seriousness of Tony’s suicidal thoughts. This incorporates getting some information about any plans, means, and intent. Devise a safety plan with Tony, which could include distinguishing safe individuals he can contact, eliminating methods for self-harm, and booking follow-up appointments. Keep on investigating Tony’s sensations of outrage, sadness, and anxiety, and talk about ways of dealing with especially difficult times. Include Tony’s family or friends, with his consent, to offer extra help. Consider referring Tony to a psychologist or psychiatrist for additional assessment and treatment, including therapy and perhaps medication if needed.
Next Question:
“Tony, when you say you don’t want to be alive and have had thoughts about hurting yourself, have you thought about how you might do it or made any plans?”
Importance of a Thorough Psychiatric Assessment of a Child/Adolescent
A thorough mental evaluation of a child/adolescent is critical because it gives a thorough comprehension of the child/adolescent’s psychological status, formative level, and psychosocial setting. This is fundamental because multiple factors such as recognizing and resolving mental issues early can improve results significantly and prevent the heightening of symptoms. Children/adolescents are at various formative stages, so side effects and ways of behaving should be deciphered inside the context of their formative level. An intensive evaluation considers different elements, including biological, mental, and social impacts, which are fundamental for accurate diagnosing and successful treatment. Understanding the particular necessities and conditions of the child/adolescent takes into consideration the advancement of customized plans of care that are bound to be effective (Srinath et. al., 2019).
Symptom Rating Scales for Psychiatric Assessment
The Child Behavior Checklist (CBCL):
The CBCL is a generally utilized parent-report survey intended to evaluate a wide scope of conduct and profound issues in kids aged 6-18. It includes things for social capabilities and a great many profound and conduct issues, yielding scores on several syndrome scales (e.g., anxious/depressed, withdrawn/depressed, somatic complaints) and DSM-situated scales. This scale helps in distinguishing explicit trouble areas and following changes after some time, making it important for both analysis and treatment monitoring (Biederman et. al., 2020).
The Pediatric Symptom Checklist (PSC):
The PSC is a concise screening device used to distinguish psychosocial issues in kids aged 4-16. It comprises 35 things that guardians rate as “never,” “at times,” or “frequently” present in their kid’s way of behaving, covering assimilating, externalizing, and attention issues. The PSC is helpful for the early detection of psychosocial issues, directing further evaluation and intercession (Pagano et. al., 2000).
Psychiatric Treatment Options for Children and Adolescents
Play Therapy:
Play treatment uses the normal way children put themselves out there — through play. It permits them to investigate their sentiments, resolve psychosocial hardships, and accomplish ideal turn of events. Particularly for younger kids who might not have the verbal abilities to communicate complex feelings, play treatment gives a protected climate to manage injury, tension, and social issues (Koukourikos et. al., 2021).
Parent-Child Interaction Therapy (PCIT):
PCIT centers around working on the nature of the parent-kid relationship and evolving guardian-child connection designs. This treatment is especially helpful for children with problematic conduct problems. It includes training guardians in real-time interactions with their children, advancing positive ways of behaving, and diminishing negative ones (Vess & Campbell, 2022).
References
Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical Practice Guidelines for Assessment
of Children and Adolescents. Retrieved 5/29/2024 from:
https://doi.org/10.4103/psychiatry.IndianJPsychiatryLinks to an external site.
Biederman, J., DiSalvo, M., Vaudreuil, C., Wozniak, J., Uchida, M., Yvonne Woodworth, K., Green, A.,
& Faraone, S. V. (2020). Can the Child Behavior Checklist (CBCL) help characterize the types
of psychopathologic conditions driving child psychiatry referrals? Retrieved 5/30/2024 from:
https://doi.org/10.21307/sjcapp-2020-016Links to an external site.
Pagano, M. E., Cassidy, L. J., Little, M., Murphy, J. M., & Jellinek, M. S. (2000). IDENTIFYING
PSYCHOSOCIAL DYSFUNCTION IN SCHOOL-AGE CHILDREN: THE PEDIATRIC SYMPTOM
CHECKLIST AS A SELF-REPORT MEASURE. Retrieved 5/30/2024 from:
Koukourikos, K., Tsaloglidou, A., Tzeha, L., Iliadis, C., Frantzana, A., Katsimbeli, A., & Kourkouta, L.
(2021). An Overview of Play Therapy. Retrieved 5/30/2024 from:
https://doi.org/10.5455/msm.2021.33.293-297Links to an external site.
Vess, S. F., & Campbell, J. M. (2022). Parent-child interaction therapy (PCIT) with families of children
with autism spectrum disorder. Retrieved 5/30/2024 from:
https://doi.org/10.1177/23969415221140707
NRNP 6665 Week 1: Discussion sample 2
Main Post
Introduction
Psychiatric evaluation of children and adolescents is an essential process in helping to identify their diagnoses and to develop proper treatment plans suitable for each child or adolescent. Children and adolescents are in the process of still developing cognitively, emotionally and socially unlike the adults. This developmental context means that their mental health can only be understood in a more complex manner. An in-depth assessment enables one to understand the other related issues for instance, family and peer relations, and environmental factors which have a bearing on the patient’s health (Hilt & Nussbaum, 2016).
Analysis of the Practitioner’s Techniques
The practitioner demonstrated several effective techniques during the session. Interestingly, he outlined the client’s right to privacy and confidentiality at the beginning; this is crucial as it establishes trust between the therapist and the client (American Psychological Association, 2017). Also, the application of humor as well as the use of active listening to the jokes told by the client also played a crucial role in enhancing the relationship between the two of them. When the practitioner asked about the client’s interests and school, it demonstrated that the practitioner wanted to know more about the client, which is vital in adolescent assessments (Sadock, Sadock & Ruiz, 2014).
However, the following areas of improvement were identified. The practitioner’s body language, for instance, having one foot crossed over the other and shrugging shoulders, was unbecoming and could have been inconsequential to the client. Furthermore, using an aggressive tone and making critical comments about the client’s mother may frustrate the client and impact the communication process negatively. It would have been more professional and helpful for the therapeutic process to remain neutral and avoid negative language (Wheeler, 2014).
Compelling Concerns
Some issues were raised during the session. The client reported a lot of dislike for school, the school environment, academic activities, teachers and peers, which shows that the client is experiencing significant distress in the school context. This can be problems like bullying, academic pressure or lack of friends. The client has some signs of negative affectivity and the ability to manage anger, which can also be a reflection of the presence of anxiety or depression (American Academy of Child & Adolescent Psychiatry, 2012). Another question is that the client seems to seek support from a coach and a girlfriend rather than family members which may imply some problems with family relations.
Next Questions
To further elaborate these concerns, the next questions should shift to the family environment of the client and how the client manages stress. For example: Possible questions may include: “How do you handle your father and siblings?” Here, it is possible to learn more about the support system of the client and possible sources of tensions within the family. Another crucial question is: ”Have you ever contemplated to harm yourself or hurting somebody else?” Considering the client is highly charged emotionally and expressing a lot of anger, it is crucial to check on the possibility of self harm or harm to others for the safety of the client and those around him/her.
Symptom Rating Scales
Two suitable self-rating symptom checklists for children and adolescents are Child Depression Inventory (CDI) and Strengths and Difficulties Questionnaire (SDQ). The CDI is a well-established self-report measure that is commonly used to screen for depression in children between the ages of 7 and 17 and could be helpful for monitoring children’s mood and informing decisions about their care. On the other hand, the SDQ is used to measure behavioral and emotional problems, peer relations, and pro-social behavior which provides a brief overview of the child’s mental health status (Srinath et al. 2019).
Treatment Options
For the pediatric and adolescent population, play therapy and family therapy are some of the most helpful interventions. Play therapy is a type of treatment that uses play as a way for young clients to communicate with their therapist because this can be easier for them than talking. Family therapy is a type of counseling that aims at treating the pathological patterns of interaction within the family and enhance the supportive structures within the family system. These approaches are based on the developmental stages of children and adolescents and are not the same as the general adult therapies which are mostly cognitive behavioral therapies (Thapar et al., 2015).
Role of Parents/Guardians
Parents and caregivers are vital partners in the identification and management of children and young people. They contain crucial historical and descriptive information regarding the child’s behavior, development, and background. It helps to coordinate the care of the child with his or her parents/guardians to make sure that the set treatment plan is embraced by the family and does not go against their beliefs and culture. Young clients are likely to benefit from the improvement in the therapeutic process and outcomes when parents or guardians are involved and communicated with effectively (Wheeler, 2014).
References
American Academy of Child & Adolescent Psychiatry (AACAP). (2012). Practice parameter for psychodynamic psychotherapy with children. Journal of the American Academy of Child & Adolescent Psychiatry, 51(5), 541–557.
American Psychological Association. (2017). Code of Ethics.
Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.
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.
Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian Journal of Psychiatry, 61(2), 158–175. http://doi.org/10.4103/psychiatry.IndianJPsychiatry_580_18Links to an external site.
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.
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
PIIS0890856712001414.pdfDownload PIIS0890856712001414.pdf
Wheeler_Ancillary.pdfDownload Wheeler_Ancillary.pdf
Rutter s Child and Adolescent Psychiatry – 2015 – Thapar – Front Matter.pdfDownload Rutter s Child and Adolescent Psychiatry – 2015 – Thapar – Front Matter.pdf
IndianJPsychiatry_CPG_Assessment_CAP.pdfDownload IndianJPsychiatry_CPG_Assessment_CAP.pdf
NRNP 6665 Week 1: Discussion sample 3
Main Discussion
In the YMH Boston vignette 5 video, the social worker established rapport with the patient to foster communication and trust. In doing so, she got Tony to talk about his feelings. The social worker showed compassion and empathy throughout her discussion with the patient and provided a comfortable therapeutic environment that helped the client feel comfortable enough to share his daily struggles. Areas in which the social worker can improve include the style of question utilized to elicit information during the patient assessment and her ability to obtain detailed information about the patient’s experiences and symptoms. Utilizing an open-ended technique to obtain detailed patient information geared to determining an appropriate therapeutic plan is ideal and essential.
The area of compelling concern noted in the video is the provider’s missed opportunity to obtain detailed information concerning the patient’s symptoms or to follow through with critical information such as the patient’s anger issues, struggles with school, and alcohol use (i.e., frequency of alcohol use, and reasons (if any) for alcohol use). For example, enquiring about what triggers the patient’s anger, how the patient’s anger is expressed (i.e., angry outbursts, destructive or violent behaviors), and coping mechanisms the patient utilizes to manage anger (if any) are questions to ask to develop a better understanding of the patient and his struggles. Asking in-depth questions about the patient’s struggles with school and current alcohol use is also essential to addressing the patient’s mental health challenges.
A thorough, comprehensive mental health evaluation of a child or adolescent is essential for early detection and making the proper diagnosis necessary to develop an appropriate, efficient, timely, and successful course of treatment suitable for the child or adolescent’s age and developmental stage. A thorough evaluation also offers a thorough grasp of the child or adolescent’s surroundings, encompassing social interactions, familial relationships, and academic achievement. Taking a comprehensive approach is crucial to creating interventions that touch on every facet of the child’s life. According to Srinath et al. (2019), clinical assessment’s main objective is to build a case that will serve as a guide for management choices; determining the presence or absence of a mental health condition and essential areas of concern can be accomplished by defining signs and symptoms through a thorough clinical history and examination.
Examples of two different rating scales utilized during the psychiatric assessment of a child or adolescent are the Child Behavior Checklist (CBCL) and the Children’s Depression Inventory (CDI). The Child Behavior Checklist (CBCL) is a popular tool for evaluating emotional and behavioral issues in kids. As a valuable instrument for assessing psychopathology, the Child Behavior Checklist (CBCL) is an inexpensive, easy-to-use tool derived from empirical research that parents complete to provide essential data on general and definite psychopathology and functional domains (Biederman et al., 2020). The Children’s Depression Inventory (CDI) is a self-report tool used by kids ages 7 to 17 to gauge the intensity of depression symptoms. According to Jelínek et al. (2021), the Children’s Depression Inventory (CDI), developed by Maria Kovacs and adapted from the Beck Depression Inventory, is the most widely used instrument for evaluating depression symptoms in adolescents and serves as a gauge for one’s present state of depression and can be used to track shifts in depressive states. Utilizing the CDI makes measuring the effectiveness of therapy strategies and diagnosing depression easier.
Two psychiatric treatment options utilized for children and adolescents are Play Therapy and Parent-Child Interaction Therapy (PCIT). Because children frequently do not have the linguistic abilities to communicate their feelings and ideas, play therapy is an ideal treatment option. Play therapy allows children to express themselves, comprehend their feelings, and resolve problems. Koukourikos et al. (2021) explain that play therapy is the methodical application of a theoretical framework that creates an interpersonal process whereby licensed therapists utilize play’s therapeutic potential to assist kids in preventing or resolving psychosocial issues and achieving their full potential. This kind of therapy works exceptionally well with younger patients who might not be able to participate in conventional talk therapy. Parent-child interaction therapy (PCIT) aims to modify how parents and children engage with each other and enhance the quality of the parent-child bond. The goal of parent-child interaction therapy (PCIT), an evidence-based behavioral parent education program for preschool-aged children, is to improve the quality of parent-child interactions and child behavior by supporting the parent-child interaction patterns (Vess & Campbell, 2022). According to Vess & Campbell (2022), in parent-child interaction therapy (PCIT), parents learn how to develop a safe, caring relationship with their child and increase their prosocial conduct while decreasing negative behavior.
Parents and guardians are essential during the child and adolescent assessment process because they can freely discuss their concerns and observations regarding the client’s conduct at home. Knowing one’s historical background is crucial to comprehending how symptoms begin and develop. Parents and guardians can provide priceless information regarding the child’s developmental history, family history of mental illnesses, previous medical conditions, and significant life events. Parental observations in various contexts might shed light on a child’s social relationships, academic success, and behavior at home. These insights give a complete picture of the child’s functioning in many contexts. According to Mackova et al. (2022), parents are essential to the process of giving psychological care to their children because teenagers are incapable of making decisions about their health; hence, caregiving begins with parents’ capacity to identify issues and seek help from the system, followed by their desire to collaborate and follow instructions through to the treatment’s completion. Including parents in the evaluation procedure encourages a team-based approach to treatment planning. In addition to being more involved in the therapy process, parents may help set reasonable goals and ensure at-home compliance with methods and treatment suggestions.
Finally, a thorough peer review has ensured that the scholarly publications used for this assignment are authentic, trustworthy, and relevant to the academic community. Experts in the area evaluate the publication’s approach, conclusions, and content before publication.
References
Biederman, J., DiSalvo, M., Vaudreuil, C., Wozniak, J., Uchida, M., Yvonne Woodworth, K., Green, A., & Faraone, S. V. (2020). Can the child behavior checklist (CBCL) help characterize the types of psychopathologic conditions driving child psychiatry referrals? Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 8(1), 157–165. https://doi.org/10.21307/sjcapp-2020-016Links to an external site.
Jelínek, M., Květon, P., Burešová, I., & Klimusová, H. (2021). Measuring depression in adolescence: Evaluation of a hierarchical factor model of the children’s depression inventory and measurement invariance across boys and girls. PLOS ONE, 16(4). https://doi.org/10.1371/journal.pone.0249943Links to an external site.
Koukourikos, K., Tsaloglidou, A., Tzeha, L., Iliadis, C., Frantzana, A., Katsimbeli, A., & Kourkouta, L. (2021, December). An overview of play therapy. Materia socio-medica. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8812369/Links to an external site.
Mackova, J., Veselska, Z. D., Geckova, A. M., Jansen, D. E., van Dijk, J. P., & Reijneveld, S. A. (2022). The role of parents in the care for adolescents suffering from emotional and behavioral problems. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.1049247Links to an external site.
Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019, January). Clinical practice guidelines for assessment of children and adolescents. Indian journal of psychiatry. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345125/Links to an external site.
Vess, S. F., & Campbell, J. M. (2022). Parent–child interaction therapy (PCIT) with families of children with autism spectrum disorder. Autism & Developmental Language Impairments, 7, 239694152211407. https://doi.org/10.1177/23969415221140707Links to an external site.
vess-campbell-2022-parent-child-interaction-therapy-(pcit)-with-families-of-children-with-autism-spectrum-disorder.pdfDownload vess-campbell-2022-parent-child-interaction-therapy-(pcit)-with-families-of-children-with-autism-spectrum-disorder.pdf
sjcapp-08-016.pdfDownload sjcapp-08-016.pdf
fpsyg-13-1049247.pdfDownload fpsyg-13-1049247.pdf
s00787-020-01530-7.pdfDownload s00787-020-01530-7.pdf
journal.pone.0249943.pdfDownload journal.pone.0249943.pdf
NRNP 6665 Week 1: Discussion sample 4
Comprehensive Integrated Psychiatric Assessment
Mental health is a significant social parameter that influences well-being, quality of life, and human rights, as well as economic factors like creativity, productivity, and sustainable development (Samartzis & Talias, 2019). Mental health services are essential for the prevention and treatment of mental disorders, aiming to maintain, improve, and restore the mental well-being of individuals. The comprehensive psychiatric assessment is a priority to recognize mental health disorders in any age group in the early phase. It not only affects the general population but also clinicians. A study conducted by researchers from the American Medical Association (AMA) and the Mayo Clinic in 2014, revealed that 54 percent of U.S. doctors experience burnout, a rate higher than in other industries. Additionally, the suicide rate among clinicians is terrifyingly high; a 40-year review of clinician suicides found that male clinicians have a 70% higher likelihood of suicide compared to the general population, while female clinicians face a 250%–400% higher risk (Wang & Wang, 2022).
YMH Boston Vignette 5 video
Upon reviewing the YMH Boston Vignette 5 video, a few of the points the practitioner did well were ensuring the environment was quiet and free of distractions. The practitioner built a good rapport with the patient Tony and asked simple open-ended questions. The practitioner explored Tony’s symptoms of depression and anxiety and his responses to the symptoms. The practitioner validated the patient’s school struggles and the recent breakup that could potentially lead to the risk of self-harm.
The areas for improvement for the practitioner would be firstly the introduction part between her and Tony and the purpose of the assessment. This can help Tony feel more comfortable and build rapport. Secondly, the practitioner should have clarified Tony’s responses to the questions and tried to understand Tony’s feelings of anger, school struggles, and the impacts of the recent breakup on his daily activities.
At this point of the clinical interview, the compelling concern was whether Tony was having suicidal ideation or had initiated self-harm in the past. Since Tony verbalized that he does not want to be alive and had thought of self-harm he might require immediate safety attention. In addition, upon answering about substance use, Tony appeared to be discomfort and paused while answering.
The next questions as a practitioner for Tony are as follows,
- Do you have any suicidal ideations?
- Do you have any plans to act on your suicidal ideation?
- Tell me more about the thoughts of hurting yourself, how are you coping with it?
The importance of a thorough psychiatric assessment of a child/adolescent is important
The thorough assessment of children/adolescents can be challenging but is vital to diagnose and create a treatment plan for mental health disorders. While children can describe the nature of their symptoms, they often struggle with accurately reporting the timing and duration of their issues. Most of the time children/adolescents are brought for visits by their parents. Additionally, they may suppress information about problems that they find embarrassing. Therefore, clinical assessments of children and adolescents are intricate and require clinicians to be astute and diligent in collecting information from multiple sources and settings, such as the child, parents, teachers, and other caregivers (Srinath et al., 2019). Despite discrepancies in reports, multi-source information is essential for accurate diagnosis and management. Typically, assessments and treatments involve a multidisciplinary approach. Information is often gathered gradually to avoid overwhelming the child and family, and it must be shared among all professionals involved in the child’s care (Srinath et al., 2019).
Two different symptom rating scales for a psychiatric assessment of a child/adolescent
There are several rating scales appropriate for a psychiatric assessment of a child/adolescent to measure the mental health disorder’s symptom severity. The first rating scale is the Children’s Yale-Brown Obsessive Compulsive Scale (OCD). This rating scale helps practitioners to evaluate the severity of obsessive and compulsive symptoms in children/adolescents between the ages of 6-17 years (Srinath et al., 2019). The second rating scale is the Conners Rating Scale which is commonly used in the assessment of attention-deficit/hyperactivity disorder (ADHD). Conners rating scale evaluates ADHD symptoms and different behavioral concerns among ages 6- 18 years.
Two psychiatric treatment options for children and adolescents
The psychiatric treatment option for children and adolescents are first being Parent-child interaction therapy (PCIT). PCIT is an evidence-based therapy for preschool children focused on enhancing parent-child interaction patterns to improve child behavior and strengthen the parent-child relationship (Vess & Campbell, 2022). PCIT is effective in treating children with disruptive behavior disorders like autism spectrum disorder (ASD). It helps improve children’s behaviors, functions, and relationships with siblings and parents by building safe, secure, and nurturing relationships. The key aspects of PCIT include direct coaching of parent-child interactions, data-driven treatment guidance, the use of specialized space and equipment, a positive and nonjudgmental approach, targeting various behavioral issues, and focusing on interaction patterns rather than isolated behaviors (Vess & Campbell, 2022).
The second treatment option is Play therapy. Play is a vital part of children during their growth and development which also helps in dealing with different behavioral issues. Play is effortless and helps children to express themselves and become socialized. Play therapy is defined as the systematic application of a theoretical model that creates an interpersonal process where trained therapists use the therapeutic power of play to help children prevent or resolve psychosocial difficulties and achieve optimal development (Koukourikos et al., 2021). It serves both as a psychotherapeutic approach and a psycho-diagnostic tool for children. Play therapy helps practitioners understand children’s level, their expression, understanding, and acceptance (Koukourikos et al., 2021).
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The role parents/guardians play in assessment
Parents/Guardians play a huge role in mental health assessment for their children. The quality and effectiveness of treatment plans increase by the involvement of caregivers. Parents/guardians recognize the mental health problems of their children, which helps children to get proper care in the early phase of their life. Since they cannot make proper medical decisions, parents play a huge role in providing mental healthcare to their children. Parents go through five stages of seeking help first, parents initially become aware of their adolescent’s distress. Secondly, parents acknowledge that the problem is serious and needs attention. Thirdly, parents explore options to help their child, and fourth, parents decide to seek mental health services. Fifth, parents take steps to find appropriate mental health services (Mackova et al., 2022). Parents play a role in regular attendance and adherence to treatment plans for children/adolescents’ quality of living and better outcomes for their mental health.
References
Koukourikos, K., Tsaloglidou, A., Tzeha, L., Iliadis, C., Frantzana, A., Katsimbeli, A., & Kourkouta, L. (2021). An Overview of Play Therapy. Materia Socio-Medica, 33(4), 293–297. https://doi.org/10.5455/msm.2021.33.293-297Links to an external site.
Mackova, J., Veselska, Z. D., Geckova, A. M., Jansen, D. E. M. C., van Dijk, J. P., & Reijneveld, S. A. (2022). The role of parents in the care for adolescents suffering from emotional and behavioral problems. Frontiers in Psychology, 13, 1–12. https://doi.org/10.3389/fpsyg.2022.1049247Links to an external site.
Samartzis, L., & Talias, M. A. (2019). Assessing and Improving the Quality in Mental Health Services. International Journal of Environmental Research and Public Health, 17(1). https://doi.org/10.3390/ijerph17010249Links to an external site.
Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian Journal of Psychiatry, 61, 158–175. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_580_18Links to an external site.
Vess, S. F., & Campbell, J. M. (2022). Parent-Child Interaction Therapy (PCIT) with Families of Children with Autism Spectrum Disorder. Autism & Developmental Language Impairments, 7. https://doi.org/10.1177/23969415221140707Links to an external site.
Wang, W., & Wang, X. (2022). Construction of a Comprehensive Mental Health Evaluation System for Clinicians. Journal of Healthcare Engineering, 2022, 7651549. https://doi.org/10.1155/2022/7651549Links to an external site.
NRNP 6665 Week 1: Discussion sample 5
What did the Practitioner do well, and in what areas can the Practitioner Improve?
The practitioner did a great job of interacting with the adolescent client. She was pleasant, friendly, and professional towards the client. She asked appropriate questions to gather vital information while allowing the client to open up more. The client shared that he likes playing basketball but doesn’t play as much because he sometimes doesn’t have enough energy to play. He was an A-B student, but his grades declined due to not wanting to do his homework. He admits to drinking 1-2 beers sometimes with his friends. He has been edgy and angry because his girlfriend ended their relationship two months ago without giving him a reason. He also admits to having tightness in his chest, a racing heartbeat, feeling hurt, and not wanting to be alive when he thinks about the breakup.
There were a few areas where the practitioner could have improved. The practitioner could have initially introduced herself and greeted the client to help build rapport. She could have asked more open-ended questions to gather more information on how he feels, his daily activities, his support system, and his relationship with his girlfriend.
Any Compelling Concerns during the Clinical Interview?
Suicide is an immediate health concern and a leading cause of preventable death (Bornheimer et al., 2022). The most compelling concern during the interview was the client’s suicidal thoughts. It should be an immediate priority for the Practitioner to assess suicidality. Assessing suicidality is a prompt warning for ensuing suicidal acts and also offers significant insights into the patient’s level of distress and their specific needs. This dual purpose emphasizes the significance of evaluating suicidality comprehensively (Harmer et al., 2024).
What would be your next Question and why?
My priority would be to ask the client if he has an active suicide plan. Suicidal ideation, demonstrated by thoughts of ending one’s life or self-harm, is a substantial mental health issue with the capability for critical outcomes if not adequately addressed. Recognizing suicidal ideation promptly and identifying the primary causes are vital steps in increasing a patient’s quality of life and reducing the probability of suicide (Harmer et al., 2024).
Explain why a Thorough Psychiatric Assessment of a Child/Adolescent is Important
Assessing children and adolescents can be challenging, especially for new PHMNPs. Children and adolescents may have difficulty reporting their symptoms and the timing and duration of their problems. A thorough psychiatric assessment is important for a child/adolescent because it allows PHMNPs to obtain all the necessary information to evaluate the patient’s needs and formulate a treatment plan for optimal patient outcomes (Srinath et al., 2019).
Describe two Different Symptom Rating Scales that would be appropriate to use during the Psychiatric Assessment of a Child/Adolescent
The Pediatric Symptom Checklist (PSC) is a rating scale for children ages 4-18 that screens for emotional and behavioral problems (Jeffrey et al., 2021). The Spence Children’s Anxiety Scale (SCAS) is another rating scale for children ages 8-15 that screens for anxiety symptoms (Reardon et al., 2018).
Describe two Psychiatric Treatment Options for Children and Adolescents that may not be used when Treating Adults
Play therapy is one psychiatric treatment option for children and adolescents. It allows them to express themselves, recognize, identify, and verbalize feelings through toys, dolls, blocks, puppets, drawings, and games. The therapist examines how the child uses play materials and identifies patterns or themes to understand the child’s problems. Children can better understand and manage their feelings, behavior, and conflicts through talk and play (Koukourikos et al., 2021).
Parent-child Interaction therapy is another psychiatric treatment option for children and adolescents. It helps children and parents with behavior problems. Children and parents interact with each other while therapists guide them toward positive interactions (Bhide, & Chakraborty, 2020).
Explain the Role Parents/Guardians Play in Assessment
Parents/guardians play a crucial role in assessing children/adolescents. Parents/guardians present during their child/adolescent assessment can help provide comfort, information, treatment wishes, needs, and concerns. Working closely together with parents/guardians enables providers to build a solid therapeutic relationship and improve outcomes for their children (Bhide, & Chakraborty, 2020).
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_19Links to an external site.
Bornheimer, L. A., Hong, V., Li Verdugo, J., Fernandez, L., & King, C. A. (2022).
Relationships between hallucinations, delusions, depression, suicide ideation, and plan among adults presenting with psychosis in psychiatric emergency care. Psychosis, 14(2), 109–119. https://doi.org/10.1080/17522439.2021.1912815Links to an external site.
Harmer, B., Lee, S., Rizvi, A., & Saadabadi, A. (2024). Suicidal ideation. StatPearls.
https://www.ncbi.nlm.nih.gov/books/NBK565877/Links to an external site.
Jeffrey, J. K., Venegas-Murillo, A. L., Krishna, R., Hajal, N. J. (2021). Rating scales for
behavioral health screening system within pediatric primary care. Child and Adolescent Psychiatric Clinics of North America, 30(4), 777-795. https://doi.org/10.1016/j.chc.2021.06.003Links to an external site.
Koukourikos, K., Tsaloglidou, A., Tzeha, L., Iliadis, C., Frantzana, A., Katsimbeli, A., &
Kourkouta, L. (2021). An overview of play therapy. Materia Socio-Medica, 33(4), 293–297. https://doi.org/10.5455/msm.2021.33.293-297Links to an external site.
Reardon, T., Spence, S. H., Hesse, J., Shakir, A., & Creswell, C. (2018). Identifying
children with anxiety disorders using brief versions of the Spence Children’s Anxiety Scale for children, parents, and teachers. Psychological Assessment, 30(10), 1342–1355. https://doi.org/10.1037/pas0000570Links to an external site.
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_18Links to an external site.
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