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.(Comprehensive Integrated Psychiatric Assessment Essay)

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. (Comprehensive Integrated Psychiatric Assessment Essay)

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. (Comprehensive Integrated Psychiatric Assessment Essay)

·       Symptom Media. (2014). Mental status exam B-6Links 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(Comprehensive Integrated Psychiatric Assessment Essay)

·       Western Australian Clinical Training Network. (2016, August 4). Simulation scenario-adolescent risk assessmentLinks 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 appointmentLinks to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=Gm3FLGxb2ZU(Comprehensive Integrated Psychiatric Assessment Essay)

Comprehensive Integrated Psychiatric Assessment Essay

A comprehensive assessment is crucial for a patient who presents for psychotherapy to make a diagnosis and develop an appropriate treatment plan or referral. Typically, a thorough assessment is conducted during the initial session with a client by a skillful therapist who knows how to engage the client, perform an accurate assessment, and respond to the client’s concerns (Wheeler, 2020). Ideally, an accurate assessment during the initial session and all through psychotherapy are crucial in guiding treatment.(Comprehensive Integrated Psychiatric Assessment Essay)

In the given instance, the social worker identified the history and current status of the client’s complaints to some degree. In comprehensive psychiatric assessment, the baseline aims to develop a database of the client’s symptoms from which a tentative diagnosis can be made and collaboratively identify problems the client encounters and therapeutic goals (Wheeler, 2020). In this case, the social worker identified the cause and some symptoms of depression and anxiety presented by the client, including a breakup with the girlfriend, loss of interest in activities, suicide ideation, and risk of harm to self and others in collaboration with the client (YMH Boston, 2013). Such information is crucial in making a preliminary diagnosis for the client.(Comprehensive Integrated Psychiatric Assessment Essay)

However, the social worker failed to establish appropriate rapport with the client, and the psychiatric interview was relatively shallow to make a definitive diagnosis. A comprehensive psychiatric interview should obtain all the relevant information to guide evidence-based diagnosis (Boland & Verduin, 2021). The social worker did not conduct the interview effectively to understand the relevant biophysical aspects of depression and anxiety disorder to provide a foundation for creating a person-centered psychiatric intervention. Moreover, the social worker did not provide informed consent and assure the client of maintaining confidentiality at the beginning of the interview to promote the therapeutic alliance. Considering the centrality of psychiatric interviews in mental health treatment, the social worker failed to establish an appropriate therapeutic alliance with the client, which is crucial in obtaining relevant clinical information, ascertaining the diagnosis, and influencing future relationships.(Comprehensive Integrated Psychiatric Assessment Essay)

My next question in the case scenario would be identifying the client’s social support and support system. For instance, I would ask, do you have parents and siblings? This question would lead to other questions identifying the client’s association with the parents, siblings, or other close friends. In mental health assessment, diagnosis, and treatment, understanding the client’s social background and availability of social support and support systems are crucial in determining stressors and promoters of good health (Boland & Verduin, 2021). Support from parents or siblings and available psychological and material resources are vital in establishing coping mechanisms among mental health clients.(Comprehensive Integrated Psychiatric Assessment Essay)

A comprehensive psychiatric assessment is essential in the mental health treatment process. A psychiatric evaluation is vital in obtaining information to establish criteria for diagnosis, predict the course of illness and prognosis, and guide treatment decisions (Boland & Verduin, 2021). In this case, various scales can be used to ascertain depression and diagnosis in children and adolescents. These scales include the severity measure for depression (SMD) and the beck youth inventory (BAI). SMD assesses episodes of depression and the severity of depressive symptoms in children between 11 and 17 years old (Wheeler, 2020). Beck youth inventory is a self-report measure for depressive and anxiety symptoms among other mental disorders in children and adolescents ages 7 and 18 (Lau et al., 2021). These scales have been validated and widely used across mental health care settings.(Comprehensive Integrated Psychiatric Assessment Essay)

Parent-child interaction (PCIT) and play therapies (PT) are commonly used in children with depression but not adults. PCIT is frequently used with children having behavioral issues, which may be related to depression or anxiety, and involves building relationships between the caregiver and the child to help the child manage stress and improve behavior associated with developmental needs (Lieneman et al., 2018). Similarly, PT is often used with children and adolescents to treat depression and anxiety since it allows them to express emotions in a non-threatening way, develop coping skills, and build self-esteem (Cochran et al., 2022). Considering the capacity of children and adolescents and the age of consent, parents/guardians play a significant role in their mental health assessment. Specifically, they provide collateral information crucial for a definitive diagnosis (Owoyemi et al., 2021). Collateral information is often critical and is not always indicated in the client’s self-reports.(Comprehensive Integrated Psychiatric Assessment Essay)

References

Boland, R., & Verduin, M. (2021). Kaplan & Sadock’s Concise Textbook of Clinical Psychiatry. Lippincott Williams & Wilkins.

Wheeler, K. (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. Springer Publishing Company.(Comprehensive Integrated Psychiatric Assessment Essay)

Lau, C., Stewart, S. L., Saklofske, D. H., & Hirdes, J. (2021). Development and psychometric validation of the interRAI ChYMH externalizing subscale. Clinical child psychology and psychiatry, 26(1), 295-305. https://doi.org/10.1177/1359104520963143

Owoyemi, P., Salcone, S., King, C., Kim, H. J., Ressler, K. J., & Vahia, I. V. (2021). Measuring and Quantifying Collateral Information in Psychiatry: Development and Preliminary Validation of the McLean Collateral Information and Clinical Actionability Scale. JMIR Mental Health, 8(4), e25050. https://doi.org/10.2196%2F25050

Lieneman, C. C., Brabson, L. A., Highlander, A., Wallace, N. M., & McNeil, C. B. (2018) Parent-child interaction therapy: Current perspectives. Psychology research and behavior management, 239-256. https://doi.org/10.2147%2FPRBM.S91200

Cochran, N. H., Nordling, W. J., & Cochran, J. L. (2022). Child-Centered Play Therapy: A Practical Guide to Therapeutic Relationships with Children. Taylor & Francis.

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

FAQs

What are the components of a psychiatric assessment?

A psychiatric assessment typically comprises several key components. First, there’s the clinical interview, during which a mental health professional gathers detailed information about the individual’s current mental and emotional state, as well as their personal history. Second, a thorough evaluation of the individual’s symptoms and their duration is conducted, aiming to diagnose any potential mental health disorders. Third, a review of medical and family history is undertaken to understand potential genetic and environmental influences. Finally, collateral information from family members or caregivers may be gathered to gain a comprehensive view of the individual’s situation. The assessment process aims to inform appropriate treatment planning and interventions.(Comprehensive Integrated Psychiatric Assessment Essay)

What is the purpose of a psychiatric assessment?

The purpose of a psychiatric assessment is to comprehensively evaluate an individual’s mental and emotional well-being, identifying any potential psychological disorders, symptoms, or distressing issues they may be experiencing. This assessment involves gathering detailed information about the person’s personal history, current mental state, and any relevant environmental factors. The goal is to formulate an accurate diagnosis, develop a suitable treatment plan, and provide appropriate support to improve the individual’s mental health and overall quality of life.(Comprehensive Integrated Psychiatric Assessment Essay)

Why a thorough psychiatric assessment of a child adolescent is important?

A thorough psychiatric assessment of a child or adolescent is crucial to accurately diagnose and address potential mental health concerns. It allows for early identification of emotional, behavioral, and developmental issues, enabling timely intervention and treatment planning. Comprehensive assessment helps discern between normal developmental challenges and underlying disorders, guiding tailored interventions that can minimize long-term psychological distress. Furthermore, a proper assessment facilitates collaboration between mental health professionals, caregivers, and educators, promoting holistic support and optimal well-being for the young individual.(Comprehensive Integrated Psychiatric Assessment Essay)

How do you write a good mental health assessment?

Writing a comprehensive mental health assessment involves several key steps. First, establish rapport and gather demographic information. Then, conduct a thorough clinical interview, exploring the individual’s presenting issues, history, symptoms, and psychosocial context. Utilize validated assessment tools and scales to measure symptom severity and functional impairment. Finally, synthesize gathered information into a clear, organized, and objective report, including diagnostic impressions, treatment recommendations, and a comprehensive formulation of the individual’s mental health status.(Comprehensive Integrated Psychiatric Assessment Essay)