Comprehensive Integrated Psychiatric Assessment Comprehensive Nursing Paper Example

Comprehensive Integrated Psychiatric Assessment Comprehensive Nursing Paper Example

Part I of II

Every nursing field requires a patient health assessment to collect information but the information collected varies depending on the nursing specialty. According to Srinath et al. (2019), assessing children and adolescents poses a significant challenge. However, a PMHNP can use comprehensive, integrated psychiatric assessment of a child or adolescent by gathering information from the child patient and other reliable sources that include but are not limited to the child’s teacher, caregivers, family members, or even a school counselor.(Comprehensive Integrated Psychiatric Assessment Comprehensive Nursing Paper Example)

What did the practitioner do well? In what areas can the practitioner improve?

The social worker appeared to do her best to ease the teenager, which made him relax in this new and unfamiliar office setting. The professional used direct yet probing questions tailored to respect the adolescent patient’s confidentiality, privacy, and consent (Samartzis & Talias, 2020). Besides, there are some areas that I would recommend to the practitioner to improve. To begin with, the SW does not shake hands with the client once he enters the room. She did not extend her hand to the patient, preferably with a smiling face, and gave the impression of a rigid provider in her thinking and devoid of humor. In my considered opinion, the handshake could be a vital indicator of the patient’s mental health status, particularly if Tony does not reciprocate. The ignored handshake would indicate a social-cultural issue that is significant and needs to be investigated later.(Comprehensive Integrated Psychiatric Assessment Comprehensive Nursing Paper Example)

At this point in the clinical interview, do you have any compelling concerns? If so, what are they?

There are several issues of compelling concern that I would give special note to. The patient cries typically, frequently gets angry or edgy to the point of feeling like engaging the other person in a physical fight, that he sometimes lacks the energy to play basketball despite it being his favorite sport, does not like school anymore. Nevertheless, he once used to be an A’s and B’s student, and he recently broke up with his girlfriend. These concerns would be pivotal in the assessment, especially concerning insights on perceptual disturbances, thought processes and content, judgment and insight, self-harm, risk of suicide (Farleym 2020).(Comprehensive Integrated Psychiatric Assessment Comprehensive Nursing Paper Example)

What would be your next question, and why?

You admit to having some thoughts about harming yourself. What is the ongoing nature of these thoughts, do you have a plan, what is the intent, and have you attempted to act on them?

Harris et al. (2019) opine that there is a strong connection between self-harm and the risk of future suicide. Statistics indicate that about half of teenagers who die by suicide have a previous history of self-harm.(Comprehensive Integrated Psychiatric Assessment Comprehensive Nursing Paper Example)

Part II of II

Explain why a thorough psychiatric assessment of a child/adolescent is essential.

A comprehensive psychiatric evaluation, especially of the integrated type, is instrumental in diagnosing behavioral, developmental, or emotional problems. Srinath et al. (2019) observe that the evaluation may include descriptions of present behaviors, symptoms, personal and family history of emotional, behavioral, or developmental disorders.(Comprehensive Integrated Psychiatric Assessment Comprehensive Nursing Paper Example)

Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent.

Kutcher Adolescent Depression Scale (KADS) – KADS is a self-report scale designed to diagnose and assess the severity of depression in adolescent patients. Depending on the provider, one may opt to use either the 16- item, an 11- Item, or an abbreviated 6- Item scale.(Comprehensive Integrated Psychiatric Assessment Comprehensive Nursing Paper Example)

Child Adolescent suicidal potential index CASPI- CASPI is a three-domain 30 item self-report measure of risk for suicide using anxious–impulsive depression, suicidal ideation and acts, and family discussion (Koutek et al., 2016). The subjects respond to the items using a Yes or no answer.(Comprehensive Integrated Psychiatric Assessment Comprehensive Nursing Paper Example)

Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.

Child-centered play therapy (CCPT) utilizes play as children’s language with a central tenet that all children possess an innate drive towards growth. Ray & Cheng (2018) opine that kids express themselves freely using toys, games, and other things. In CCPT, the child leads the way during this therapeutic process. In the case of diagnosing and treating ADHD, Leigh (2018) medications like guanfacine extended-release tablets 7mg PO once daily and clonidine hydrochloride extended-release tablets 0.4mg PO 1-2 times daily are approved for children but used as off label drugs in adult patients.(Comprehensive Integrated Psychiatric Assessment Comprehensive Nursing Paper Example)

Explain the role parents/guardians play in assessment.

Parents and guardians contribute to the child /adolescent patient psychiatric assessment by offering collaborative information regarding the patient’s symptoms and relevant emotional, behavioral, or developmental history. They also become chief informants in cases where the patient is severely psychotic or cannot express themselves fully. In conclusion, it is essential to acknowledge that interviews and examinations enable psychiatric-mental health nurse practitioners to initiate a process to help their patients.(Comprehensive Integrated Psychiatric Assessment Comprehensive Nursing Paper Example)

References

Harris, I. M., Beese, S., & Moore, D. (2019). Predicting future self-harm or suicide in adolescents: a systematic review of risk assessment scales/tools. BMJ Open, 9(9), e029311.

Koutek, J., Kocourkova, J., & Dudova, I. (2016). Suicidal behavior and self-harm in girls with eating disorders. Neuropsychiatric disease and treatment, 12, 787.(Comprehensive Integrated Psychiatric Assessment Comprehensive Nursing Paper Example)

Leahy, L. G. (2018). Diagnosis and treatment of ADHD in children vs. adults: What nurses should know. Archives of psychiatric nursing, 32(6), 890-895.

Ray, D., & Cheng, Y. (2018). Child-Centered Group Play Therapy Implementation Guide.

Samartzis, L., & Talias, M. A. (2020). Assessing and improving the quality of mental health services. International journal of environmental research and public health, 17(1), 249.

Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for the assessment of children and adolescents. Indian journal of psychiatry, 61(Suppl 2), 158.(Comprehensive Integrated Psychiatric Assessment Comprehensive Nursing Paper Example)

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