NRNP-6665 Discussion Wk1

Children and Adolescents Mental health Assessments Comprehensive Nursing Paper Sample

Children and adolescents’ mental health assessments are challenging and demand mental health practitioners to collaborate with parents, teachers, and caregivers to obtain comprehensive health information. Although depression is rare among children, the risks sharply rise during adolescence. Thus, identifying leading concerns, using validated tools, recognizing and solving safety issues, diagnosing a probable specified and unspecified disorder, and creating intervention strategies are vital for a comprehensive, integrated psychiatric assessment.(Children and Adolescents Mental health Assessments Comprehensive Nursing Paper Sample)

What did the Practitioner do Well, and how to Improve the Assessment?

In the YMH Boston, Vignette 5 Video, the practitioner did well by interviewing the patient in a private and safe location. Specifically, the interview takes place in a private and quiet room, which is critical to make patients feel safe and improve their concentration. The practitioner maintained eye contact and portrayed active listening by nodding her head, thus showing concern for the patient. The practitioner also allowed the patient enough time to explain their problem without interruption. The practitioner asked Tony about his mood (sad), suicidal thoughts or self-harm, drug abuse, and losing interest as common indicators of depression. The patient reported losing interest in school and his favorite activities, such as basketball. It was also important to ask when the patient started experiencing the symptoms to determine the extent of the problem.(Children and Adolescents Mental health Assessments Comprehensive Nursing Paper Sample)

However, one of the main areas that the practitioner needs to improve is building rapport with her patients. The practitioner was required to make a proper introduction to the patient. A proper introduction makes an excellent first impression to build positive provider-patient relationships that improve the patient’s respect and trust, making the treatment effective. The practitioner should have explained to Tony the significance of their meeting to build trust and confidence. Understanding the patient’s family and past medical history was vital for an accurate diagnosis.(Children and Adolescents Mental health Assessments Comprehensive Nursing Paper Sample)

Compelling Concerns, Next Question, and Why

One of the main compelling concerns for this assessment is Tony’s thoughts on dying. Tony claimed he felt that he had no reason to be alive and that he had thoughts of harming himself. Children and adolescents with depression are likely to feel sad, lose interest in previously exciting activities, and feel hopelessness, self-harm, or suicidal thoughts if their mental problems are not addressed. Retrieving information about Tony’s self-harm and suicidal thought is vital in this stage. Tony has suicide and self-harm idealizations. Thus, the next question should enquire about the plan and intent. For instance, “Have you planned to harm yourself or someone else?”, “How do you plan on harming yourself?” The question will help prevent Tony from harming others through observance while notifying others at risk.(Children and Adolescents Mental health Assessments Comprehensive Nursing Paper Sample)

Significance of Thorough Child/Adolescent Psychiatric Assessment

Children and adolescents’ psychiatric assessments formulate cases that guide the management of mental illness. Establishing a therapeutic alliance with the child, parents, teachers, and other caregivers aids in obtaining comprehensive health information to improve patient outcomes. As such, case studies give practitioners a more profound and broader insight into the patient’s concerns while making it easier to develop treatment plans and roles of different health professionals based on the patients’ needs. Retrieving key signs and symptoms through adequate history-taking and physical examinations aids in identifying potential mental health concerns (Srinath et al., 2019). Additionally, gathering information on the background and presentation contexts, socio-demographics, behavior, and environmental factors will aid in obtaining crucial information directed toward case management.(Children and Adolescents Mental health Assessments Comprehensive Nursing Paper Sample)

Symptom Rating Scales for Child/Adolescents Psychiatric Assessment

The Reynolds Adolescent Depression Scale (RADS) [13] is one of the rating scales that can be used to assess depressive symptomatology severity among children and adolescents aged 11-20 years (Zhou et al., 2020). The scale has 30 items in Likert response format with four options; (1 = rarely, 2 = hardly ever, 3 = sometimes, 4 = most of the time). Total scores range from 30-120, where the cut-off score severity in depressive symptomatology is 77 points and takes about 10 minutes. The scale determines somatic, cognitive, interpersonal, and psychomotor symptoms from DSM-III. The second symptom rating scale that can be used is Achenbach Child Behavioral Checklist (ACBCL), which offers information on six scales attention-deficit/hypersensitivity, affective problems, somatic problems, oppositional defiance, and conduct problems. The scale is part of extensive scale systems including self–report, teacher rating, and classroom observation measures. The Child Behavior Checklist for Youth Self-Report completed by children aged 11–18 assesses Anxiety, Withdrawal, Depression, Social Problems, Somatic Complaints, Thought Problems, Attention Problems, Rule-Breaking Behavior, Attention Problems, and Aggression.(Children and Adolescents Mental health Assessments Comprehensive Nursing Paper Sample)

Psychiatric Treatment Options for Children and Adolescents

Multisystemic therapy is one of the evidence-based interventions for adolescents with serious delinquency, offending, physical abuse, and neglect problems (Blankestein et al., 2019). The strategy addresses environmental factors within the home, school, and neighborhood to promote behavior change. The treatment uses cognitive behavioral therapy to reduce family conflicts, decrease negative peer pressure, provision of support from parents and family, and positive influence and coordination between parents/family, school, and community in promoting problem-solving strategies to improve mental health. Secondly, play therapy allows children to play in a structured and protected environment as the therapist observes their behavior and engages in conversations to comprehend their thoughts and feelings. Play therapy is mainly used for children who have undergone adverse childhood events where the children use their imagination to modify their story, promoting healing and recovery.(Children and Adolescents Mental health Assessments Comprehensive Nursing Paper Sample)

Roles of Parents/Guardians Play in Assessment

Parents and guardians are influential in children’s and adolescents’ psychiatric assessments. While birth and neonatal events affect infant growth and development, parents and caregivers are the best sources of information about pregnancy, delivery, and development. The patients and caregivers can also describe the child’s emotional and psychological responses. Mental health professionals obtain chronological information about the child’s growth, development, and history of traumatic events that influence future health and well-being. Therefore, parents/family and caregivers are instrumental sources of information required by mental health professionals to create a treatment plan for children or adolescents with mental concerns.(Children and Adolescents Mental health Assessments Comprehensive Nursing Paper Sample)

Supporting the Sources

The sources used are peer-reviewed articles published within the last five years. Experts in mental health have written the articles and have undergone peer review before publication. Srinath et al. (2019) article relates to the topic and features Clinical practice guidelines for assessing children and adolescents. The article has been published in a reliable journal, ‘The Indian Journal of Psychiatry.’ Blankestein et al. (2019) features multisystemic therapy for adolescents and has been published in the ‘Journal of Applied Research in Intellectual Disabilities .’Zhou et al. (2020) enshrines therapy for adolescents and children with depressive symptoms and has been published in a reliable journal, ‘The Lancet Psychiatry.'(Children and Adolescents Mental health Assessments Comprehensive Nursing Paper Sample)

References

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. (Children and Adolescents Mental health Assessments Comprehensive Nursing Paper Sample)https://journals.lww.com/indianjpsychiatry/Fulltext/2019/61002/Clinical_Practice_Guidelines_for_Assessment_of.6.aspx

Blankestein, A., van der Rijken, R., Eeren, H. V., Lange, A., Scholte, R., Moonen, X., … & Didden, R. (2019). Evaluating the effects of multisystemic therapy for adolescents with intellectual disabilities and antisocial or delinquent behavior and their parents. Journal of Applied Research in Intellectual Disabilities, 32(3), 575-590. (Children and Adolescents Mental health Assessments Comprehensive Nursing Paper Sample)https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/jar.12551

Zhou, X., Teng, T., Zhang, Y., Del Giovane, C., Furukawa, T. A., Weisz, J. R., … & Xie, P. (2020). Comparative efficacy and acceptability of antidepressants, psychotherapies, and their combination for acute treatment of children and adolescents with depressive disorder: a systematic review and network meta-analysis. The Lancet Psychiatry, 7(7), 581-601(Children and Adolescents Mental health Assessments Comprehensive Nursing Paper Sample). https://www.sciencedirect.com/science/article/pii/S2215036620301371

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(Children and Adolescents Mental health Assessments Comprehensive Nursing Paper Sample)