Week 1 Discussion: Comprehensive Integrated Psychiatric Assessment/NRNP 6665

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.

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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.

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.

RESOURCES

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

LEARNING RESOURCES

Required Readings

Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental healthLinks to an external site.. American Psychiatric Association Publishing.

Chapter 1, “Introduction”

Chapter 4, “The 15-Minute Pediatric Diagnostic Interview”

Chapter 5, “The 30-Minute Pediatric Diagnostic Interview”

Chapter 6, “DSM-5 Pediatric Diagnostic Interview”

Chapter 9, “The Mental Status Examination: A Psychiatric Glossary”

Chapter 13, “Mental Health Treatment Planning”

Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescentsLinks to an external site.. Indian Journal of Psychiatry, 61(2), 158–175. http://doi.org/10.4103/psychiatry.IndianJPsychiatry_580_18

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.

Chapter 32, “Clinical assessment and diagnostic formulation”

Required Media

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

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

Optional Resources

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.

Chapter 31, “Child Psychiatry”

TO PREPARE

Review the Learning Resources and consider the insights they provide on comprehensive, integrated psychiatric assessment. Watch the Mental Status Examination B-6 and Simulation Scenario-Adolescent Risk Assessment videos.

Watch the YMH Boston Vignette 5 video and take notes; you will use this video as the basis for your Discussion post.

BY DAY 3 OF WEEK 1

Based on the YMH Boston Vignette 5 video, post answers to the following questions:

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

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

What would be your next question, and why?

Then, address the following. Your answers to these prompts do not have to be tailored to the patient in the YMH Boston video.

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

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

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

Explain the role parents/guardians play in assessment.

Support your response with at least three peer-reviewed, evidence-based sources and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

Read a selection of your colleagues’ responses.

BY DAY 6 OF WEEK 1

Respond to at least two of your colleagues on 2 different days by offering additional insights or alternative perspectives on their analysis of the video, other rating scales that may be used with children, or other treatment options for children not yet mentioned. Be specific and provide a rationale with evidence.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!

NRNP_6665_Week1_Discussion_Rubric

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeMain Posting:Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
44 to >39.0 pts

Excellent

Thoroughly responds to the Discussion question(s)… Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources… No less than 75% of post has exceptional depth and breadth… Supported by at least three current credible sources

39 to >34.0 pts

Good

Responds to most of the Discussion question(s)… Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module… 50% of the post has exceptional depth and breadth… Supported by at least three credible references

34 to >30.0 pts

Fair

Responds to some of the Discussion question(s)… One to two criteria are not addressed or are superficially addressed… Is somewhat lacking reflection and critical analysis and synthesis… Somewhat represents knowledge gained from the course readings for the module… Post is supported by fewer than two credible references

30 to >0 pts

Poor

Does not respond to the Discussion question(s)… Lacks depth or superficially addresses criteria… Lacks reflection and critical analysis and synthesis… Does not represent knowledge gained from the course readings for the module… Contains only one or no credible references
44 pts

This criterion is linked to a Learning OutcomeMain Posting:Writing
6 to >5.0 pts

Excellent

Written clearly and concisely… Contains no grammatical or spelling errors… Adheres to current APA manual writing rules and style

5 to >4.0 pts

Good

Written concisely… May contain one to two grammatical or spelling errors… Adheres to current APA manual writing rules and style with minor errors

4 to >3.0 pts

Fair

Written somewhat concisely… May contain more than two spelling or grammatical errors… Contains some APA formatting errors

3 to >0 pts

Poor

Not written clearly or concisely… Contains more than two spelling or grammatical errors… Does not adhere to current APA manual writing rules and style
6 pts

This criterion is linked to a Learning OutcomeMain Posting:Timely and full participation
10 to >8.0 pts

Excellent

Meets requirements for timely, full, and active participation… Posts main Discussion by due date

8 to >7.0 pts

Good

Posts main Discussion by due date… Meets requirements for full participation

7 to >6.0 pts

Fair

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Posts main Discussion by due date

6 to >0 pts

Poor

Does not meet requirements for full participation… Does not post main Discussion by due date

10 pts

This criterion is linked to a Learning OutcomeFirst Response:Post to colleague’s main post that is reflective and justified with credible sources
9 to >8.0 pts

Excellent

Response exhibits critical thinking and application to practice settings… Responds to questions posed by faculty… The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 to >7.0 pts

Good

Response has some depth and may exhibit critical thinking or application to practice setting.

7 to >6.0 pts

Fair

Response is on topic, may have some depth.

6 to >0 pts

Poor

Response may not be on topic, lacks depth.

9 pts

This criterion is linked to a Learning OutcomeFirst Response:Writing

6 to >5.0 pts

Excellent

Communication is professional and respectful to colleagues…. Response to faculty questions are fully answered, if posed…. Provides clear, concise opinions and ideas that are supported by two or more credible sources… Response is effectively written in standard, edited English.

5 to >4.0 pts

Good

Communication is mostly professional and respectful to colleagues…. Response to faculty questions are mostly answered, if posed…. Provides opinions and ideas that are supported by few credible sources… Response is written in standard, edited English.

4 to >3.0 pts

Fair

Response posted in the Discussion may lack effective professional communication…. Response to faculty questions are somewhat answered, if posed…. Few or no credible sources are cited.

3 to >0 pts

Poor

Responses posted in the Discussion lack effective communication…. Responses to faculty questions are missing…. No credible sources are cited.
6 pts

This criterion is linked to a Learning OutcomeFirst Response:Timely and full participation
5 to >4.0 pts

Excellent

Meets requirements for timely, full, and active participation… Posts by due date

4 to >3.0 pts

Good

Meets requirements for full participation… Posts by due date…

3 to >2.0 pts

Fair

Posts by due date

2 to >0 pts

Poor

Does not meet requirements for full participation… Does not post by due date

5 pts

This criterion is linked to a Learning OutcomeSecond Response:Post to colleague’s main post that is reflective and justified with credible sources
9 to >8.0 pts

Excellent

Response exhibits critical thinking and application to practice settings…. Responds to questions posed by faculty… The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 to >7.0 pts

Good

Response has some depth and may exhibit critical thinking or application to practice setting.

7 to >6.0 pts

Fair

Response is on topic, may have some depth.

6 to >0 pts

Poor

Response may not be on topic, lacks depth.9 pts

This criterion is linked to a Learning OutcomeSecond Response:Writing

6 to >5.0 pts

Excellent

5 to >4.0 pts

Good

4 to >3.0 pts

Fair

Response posed in the Discussion may lack effective professional communication…. Response to faculty questions are somewhat answered, if posed…. Few or no credible sources are cited.

3 to >0 pts

Poor

Responses posted in the Discussion lack effective communication…. Responses to faculty questions are missing…. No credible sources are cited.
6 pts

This criterion is linked to a Learning OutcomeSecond Response:Timely and full participation

5 to >4.0 pts

Excellent

Meets requirements for timely, full, and active participation… Posts by due date

4 to >3.0 pts

Good

Meets requirements for full participation… Posts by due date

3 to >2.0 pts

Fair

Posts by due date

2 to >0 pts

Poor

Does not meet requirements for full participation… Does not post by due date
5 pts

Total Points: 10

Week 1 Discussion: Comprehensive Integrated Psychiatric Assessment/NRNP 6665