Adolescent Psychiatric Assessment
Adolescent Psychiatric Assessment Comprehensive Essay Example
discussion 1
The practitioner was able to quickly establish a therapeutic alliance with the patient. Long-term goals of good rapport include giving the adolescent a secure, private, and judgment-free space where they can “unburden” and explore potential solutions to their problems. If a child or adolescent is having problems, he or she should be able to tell the clinician about them honestly rather than hiding them, which could put them in further danger. As a result, the therapeutic partnership with the child produces compliance. However, the practitioner could improve in asking leading questions that are open ended. Therefore, the adolescent would be encouraged to talk more to the practitioner. Adolescents like reasoned arguments and enjoy regularity. So, it is best for the doctor to be open and honest about the boundaries of confidentiality, which was not emphasized in this video.(Adolescent Psychiatric Assessment Comprehensive Essay Example)
The most compelling concern I have is that the patient is a potential danger to himself, especially with the lack of insight and impulsivity that can accompany a young client. My next question I would present to the patient, is to ask to speak to his caregivers. Teenage years are a crucial time for the emergence of depression, which carries a high risk of functional impairment, co-occurring psychopathologies, and suicidal ideation (Cohen, et al., 2019). Even though it’s less common, childhood depression causes significant impairment and is an indication of future mental health issues. Therefore, there is an urgent need for early intervention and improved depression screening techniques given the prevalence and effects of juvenile depression (Cohen, et al., 2019).(Adolescent Psychiatric Assessment Comprehensive Essay Example)
A thorough psychiatric assessment of a child or adolescent is important due to the impelling risk of danger or harm to themselves due to lack of insight into the psychiatric process. To aid in the correct diagnosis of the adolescent, the clinician can employ symptom rating scales. The 22-item Columbia Depression Scale is a screening tool for depression in children and adolescents aged 11 and older; separate parent versions are provided (Gipson, et al., 2015). Depression is “likely” to occur if you score 12 to 15 “YES” answers and it’s “very likely” if you score 16 or higher. Additionally, a 4-item questionnaire called the Ask Suicide Screening Questionnaire was created to evaluate the risk of suicide in pediatric emergency settings (Aguinaldo, et al., 2021). The need for additional testing or a referral for mental health services is indicated by one or more positive responses. Depression symptom questionnaires are frequently used as screening tools to determine people who may have depression as well as to evaluate the severity of the symptoms. Based on published sensitivity and specificity estimates, they are not intended to determine diagnostic status and would potentially be predicted to overestimate prevalence (Levis, et al., 2019). However, it is more advantageous to err on the side of caution in this regard and overestimate rather than underestimate the prevalence of depression.(Adolescent Psychiatric Assessment Comprehensive Essay Example)
Two psychiatric treatment options for children and adolescents that are not used in the treatment of adults include shared decision-making, and potentially group therapy. While treating children, clinicians can forgo building rapport in certain situations in favor of solely parental care. In addition to watching out for the child’s best interests, one must respect their liberty, so this consideration must be carefully weighed. Ultimately, the optimal approach is to use shared decision-making, especially when working with kids and families.(Adolescent Psychiatric Assessment Comprehensive Essay Example)
The role that parents or guardians play in assessment is paramount to achieving diagnostic accuracy. Parents and other members of the patient’s family should be present throughout the evaluation and treatment sessions when it is clinically appropriate and at the clinician’s discretion. Yet, there are some clinical circumstances that can call for the child to be absent during a therapy session conducted on his or her behalf. The clinician could need to address negative parental behavior, for instance, or instruct parents on how to conduct sophisticated interventions with the child both at home and in other places.(Adolescent Psychiatric Assessment Comprehensive Essay Example)
Aiding factors can be crucial in the process of depressed teenagers and young adults seeking help, and such factors may direct efforts to expand access to mental health services for this at-risk age group. Help-seeking is positively influenced by recognition and encouragement from school staff and peers as well as ease of access to care providers. Public or school programs targeted at reducing health illiteracy and stigma may be required to increase treatment-seeking and health care utilization in this age group. Health illiteracy and attitudinal factors have proved to be significant barriers to seeking treatment (Eigenhuis, et al., 2021). (Adolescent Psychiatric Assessment Comprehensive Essay Example)
My first article can be considered scholarly due to it being both peer reviewed and is up to date being published within the last five years, therefore making it also relevant. My second article can be considered scholarly due to it being a meta-research review, which is one of the highest levels of bodies of evidence in relation to validity of a research article. My third article can be considered scholarly due to it being a qualitative study, which provides in-depth explanations of material that complement the quantitative qualities of my previous research articles chosen. (Adolescent Psychiatric Assessment Comprehensive Essay Example)
References
Aguinaldo, L. D., Sullivant, S., Lanzillo, E. C., Ross, A., He, J. P., Bradley-Ewing, A., & Wharff, E. A. (2021). Validation of the ask suicide-screening questions (ASQ) with youth in outpatient specialty and primary care clinics. General hospital psychiatry, 68, 52-58.
Cohen, J. R., So, F. K., Young, J. F., Hankin, B. L., & Lee, B. A. (2019). Youth Depression Screening with Parent and Self-Reports: Assessing Current and Prospective Depression Risk. Child Psychiatry and Human Development, 50(4), 647–660. https://doi.org/10.1007/s10578-019-00869-6Links to an external site.(Adolescent Psychiatric Assessment Comprehensive Essay Example)
Eigenhuis, E., Waumans, R. C., Muntingh, A. D. T., Westerman, M. J., van Meijel, M., Batelaan, N. M., & van Balkom, A. J. L. M. (2021). Facilitating factors and barriers in help-seeking behaviour in adolescents and young adults with depressive symptoms: A qualitative study. PLoS ONE, 16(3), e0247516. https://doi.org/10.1371/journal.pone.0247516Links to an external site.
Gipson, P. Y., Agarwala, P., Opperman, K. J., Horwitz, A., & King, C. A. (2015). Columbia-suicide severity rating scale: predictive validity with adolescent psychiatric emergency patients. Pediatric emergency care, 31(2), 88–94. https://doi.org/10.1097/PEC.0000000000000225Links to an external site.
Levis, B., Yan, X. W., He, C., Sun, Y., Benedetti, A., & Thombs, B. D. (2019). Comparison of depression prevalence estimates in meta-analyses based on screening tools and rating scales versus diagnostic interviews: a meta-research review. BMC Medicine, 17(1), 65. https://doi.org/10.1186/s12916-019- 1297-6Links to an external site.(Adolescent Psychiatric Assessment Comprehensive Essay Example)
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Dicussion 2
Assessing Children and Adolescents
Every patient is unique, and each assessment and treatment plan should be individualized to the client. Stigma is often associated with mental health, and certain age groups and genders are more prone to being stigmatized, causing issues with the client seeking treatment. Studies show that there is a great disproportion between males who are struggling with mental illness and those who actually seek help (Chatmon, 2020).(Adolescent Psychiatric Assessment Comprehensive Essay Example)
The purpose of this discussion is to evaluate and assess the methods of a behavioral health practitioner as a comprehensive psychiatric assessment is being done on an adolescent patient. Rating scales and treatment options will also be identified for this patient group.(Adolescent Psychiatric Assessment Comprehensive Essay Example)
A Review of the YMH Vignette 5 Video Clip
The video clip that is used for this discussion is of a male adolescent who has been referred to a social worker by his medical health provider due to self-reported depression and anxiety. The client appears to be guarded initially when the practitioner asks the patient if he knows why he is there. Asking a question that is open-ended initially would allow the client to elaborate more instead of giving short answers with little substance. According to Thapar et al, asking open-ended questions during the initial assessment will help in creating a positive therapeutic alliance (Thapar et al., 2015). The practitioner could improve on building rapport with the client before starting to screen him for depression. She could also improve on asking open-ended questions. The practitioner did well with being very fluent in assessing the client. The questions that she asked to screen him for depression flowed smoothly throughout the encounter.(Adolescent Psychiatric Assessment Comprehensive Essay Example)
At this point in the interview, there are some compelling concerns. The concerns are suicidal ideations, as the client states that he has thoughts of not wanting to be alive. The client was also hesitant to answer the question about using substances as he states that he has some beer with his friends sometimes he guesses. The practitioner should have asked more questions about the substance use such as how often the client drinks and how much he drinks. This would give her a better idea about the client abusing alcohol.(Adolescent Psychiatric Assessment Comprehensive Essay Example)
In regard to suicidal ideations, this is certainly worrisome seeing that the client states that he has had thoughts of doing something to harm himself. Studies show that adolescence is a critical time to screen clients for suicide as they are at risk for suicidal thoughts and working out plans during this age range (Davis et al., 2021). The next question that I would ask would be about a formulated plan. Seeing that the client has had thoughts of wanting to harm himself, it is important to evaluate his intention. At this point, I would screen the client for suicide by asking if he has had any previous attempts, if he has worked out a plan, and if he has had any thoughts about killing himself in the last week. The reason that I would screen the patient for suicide is that it is important to ensure that he remains safe. It will be important for the client to be evaluated for safety.(Adolescent Psychiatric Assessment Comprehensive Essay Example)
General Questions About Child/Adolescent Treatment
Performing a thorough psychiatric assessment is essential to treatment planning and patient outcomes. When assessing a child/adolescent it can be more challenging seeing that the information does not come from one source. When doing an assessment of a child/adolescent it is important to not only assess the child individually but to assess their interaction with their guardian and/or caretakers and family to evaluate the client’s safety. A child/adolescent may not give accurate timeframes and details, or they may limit information due to embarrassment or not wanting to be looked at as a bad person (Srinath et al., 2019). A thorough assessment is important to ensure all possible information is gathered and verified so that the client’s safety and mental stability are both taken into consideration.(Adolescent Psychiatric Assessment Comprehensive Essay Example)
Assessment Tools
When assessing a child/adolescent there are several assessment tools that can be used to help in evaluating the child/adolescent. A symptom rating scale that would be useful during a psychiatric assessment would be the Screen for child anxiety-related disorders (SCARED) assessment. This assessment tool can be completed by the child/adolescent during the in-person assessment. It is a scale that ranges from 1 -2 where 0 is hardly ever true and 2 is very true. The child is asked many questions related to anxiety symptoms in different environments such as home, school, and other social environments. This assessment would be appropriate as it would help to gather information about the child’s feelings of security while at home or at school. This will help to narrow down possible solutions and/or coping strategies for alleviating anxious feelings of the child/adolescent. Another symptom rating scale that would be beneficial to use when assessing a child/adolescent would be the C-SSRS, the Columbia suicide severity rating scale. There has been a gradual increase in suicide in the child and adolescent age group (Cwik et al., 2020). The C-SSRS tool is used when assessing for suicidal ideation; it can be used for children and adolescents to monitor symptoms of suicidal risk (Cwik et al., 2020).(Adolescent Psychiatric Assessment Comprehensive Essay Example)
Treatment Options
A psychiatric treatment option that would be specific to children and adolescents would be CBPT, cognitive behavioral play therapy. This form of therapy uses cognitive behavioral approaches alongside play to teach and provide therapy to younger clients (Bhide & Chakraborty, 2020). Another treatment option that can be used for children/adolescents is MBT (Mentalization-based treatment) therapy. This treatment is used to help children with understanding their thoughts and the thoughts of others (Thapar et al., 2015).(Adolescent Psychiatric Assessment Comprehensive Essay Example)
Patents/Guardian Role in Assessment
The parents/guardian’s role in child and adolescent assessment is important. While the assessment is compounded of information from many different sources, the guardian of the child is able to give insight into the child/adolescent’s behavior in the home environment as well as information on family history and culture (Thapar et al., 2015). The parent can also give information in regard to academic performance and when and if changes in the child’s work ethic or behaviors changed.(Adolescent Psychiatric Assessment Comprehensive Essay Example)
Why Supporting Sources are Considered Scholarly
The sources that were used to support this discussion are considered scholarly based on the information that the articles provided. The titles of the articles were found to be detailed and logical. The articles did not appear to have advertisements or pictures within the text. The information was geared toward professionals. The reports that were included in this discussion contained all sections of scientific writing. The articles were peer-reviewed and provided credible information.(Adolescent Psychiatric Assessment Comprehensive Essay Example)
References
Bhide, A., & Chakraborty, K. (2020). General principles for psychotherapeutic interventions in children and adolescents. Indian Journal of Psychiatry. https://doi.org/10.4103/psychiatry.indianJPsychiatry_811_19Links to an external site.(Adolescent Psychiatric Assessment Comprehensive Essay Example)
Chatmon, B. N. (2020). Males and mental health stigma. Mental Health and Wellbeing. https://doi.org/10.1177/1557988320949322Links to an external site.
Cwik, M. F., O’Keefe, V. M., & Haroz, E. E. (2020). Suicide in the pediatric population: screening, risk assessment, and treatment. International review of psychiatry. https://doi.org/10.1080/09540261.2019.1690051Links to an external site.
Davis, M., Rio, V., Farley, A. M., Bush, M. L., Beidas, R. S., & Young, J. F. (2021). Identification and follow-up for adolescent suicide risk in the context of depression screening in pediatric primary care: a retrospective electronic health record review. International Journal of Public Health. https://doi.org/10.1007/s00038-018-1196-1Links to an external site.(Adolescent Psychiatric Assessment Comprehensive Essay Example)
Srinath, S., Jacob, P., & Gautam, A. (2019). Clinical practice guidelines for the assessment of children and adolescents. Indian Journal of Psychiatry. https://doi.org/10.4103/psychiatry.indianJPsychiatry_580_18Links to an external site.
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., , M. J., Snowling, & Scott, E. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.(Adolescent Psychiatric Assessment Comprehensive Essay Example)
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