Assignment Task:
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. Need Online Tutoring?
Comprehensive Integrated Psychiatric Assessment
A comprehensive psychiatric assessment is crucial for identifying the cause and history of a developmental or psychological disorder in a child. This evaluation relies on information from various providers and agencies, including social workers, babysitters, pediatricians, and teachers. The information should be aligned with the child's current behaviors to understand the disorder's onset and triggers. However, teenagers may be reluctant to express themselves, and assessing factors against environmental, cognitive, physical, and social components only partially solves the problem. During the evaluation, psychiatrists should establish rapport with the client, making them comfortable and willing to participate. Cooperation is essential in therapy for the correct diagnosis.
What did the Practitioner do well?
In clinical and research settings, the choice of symptom rating scales for children and teenagers depends on their purpose and psychometric properties. Psychiatrists must comprehensively understand multiple scales to ensure a sound selection process. HEADSS is a commonly used tool for adolescents to assess their home, education, activities, drug use, sexuality, and suicidal ideations.
GAPS, an acronym for Guidelines for Adolescent Preventive Services, are another rating tool that addresses the psychological issues of adolescents. Both parents and children complete the questionnaire separately before presenting it to the counselor.
In what areas can the practitioner improve?
When assessing minors for possible mental disorders, parents or guardians should be involved. First, they must authorize therapists to assess the child. Right from the start, they should ask any questions they have and provide input into the treatment selection and recommended support. Their role extends beyond simply understanding therapeutic interventions, as they should actively participate in developing the services. Clinicians must exercise caution when offering hope for problem resolution, as they frequently accommodate long-standing issues instead of addressing them. Before asking more sensitive questions, the interview should begin with a warm greeting and a question about the client's interests (Hilt & Nussbaum, 2016).
At this point in the clinical interview, do you have any compelling concerns? If so, what are they?
The provider conducted an assessment without the client's consent, causing concerns about the adolescent's potential mood instability, social isolation, and risk factors for self-harm or suicidal ideation. It is crucial to obtain consent from parents before the evaluation, as these areas need further exploration to assess safety risks and guide treatment planning (Roberson & Kjervik, 2012).
What would be your next question, and why?
My next question would be, "Have you ever felt so upset or overwhelmed that you thought about hurting yourself or ending your life?" This question is crucial for assessing current or past suicidal ideation, a critical component of the adolescent risk assessment. The client's self-harm plan should be evaluated, and if necessary, emergency evaluation and hospitalization may be necessary. Factors such as the history of suicide, firearm access, support systems, and reasons for not harming themselves should also be considered. "Suicide is the second leading cause of death for adolescents 15 to 19 years old" (Shain, 2017). Boys have a complete suicide rate 3 times higher than girls (Shain, 2017).
Explain why a thorough psychiatric assessment of a child/adolescent is important.
Early identification of unique developmental issues is crucial for effective treatment plans, as it allows for a comprehensive understanding of the unique factors influencing a child's behavior, thereby ensuring timely intervention and improved long-term outcomes. Clinical history-taking and interviews are crucial tools for child and adolescent mental health professionals to diagnose and manage their patients effectively (Sharma et al., 2019).
Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/ adolescent.
The Pediatric Symptom Checklist (PSC) and the Strengths and Difficulties Questionnaire (SDQ) are tools used to screen for emotional, behavioral, and academic issues in children aged 4-18. The PSC helps identify potential concerns for further evaluation, while the SDQ assesses emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship issues, and prosocial behavior.
Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.
1. Play Therapy: Often used with younger children, play therapy provides a safe space to express emotions and work through issues that may be difficult to verbalize.
2. Parent-Child Interaction Therapy (PCIT): This treatment focuses on improving the quality of the parent-child relationship and altering parent-child interaction patterns. It is particularly effective for young children with behavioral problems.
Explain the role parents/guardians play in assessment.
Parents/guardians play a crucial role in a child's mental health assessment by providing crucial insights into their developmental history, behavior, and environmental factors and ensuring the accuracy of the child's information. They also ensure the accuracy of assessments and support successful treatment programs. The best approach is to use selective paternalism when necessary, ensuring well-being and respecting the child's autonomy while prioritizing their best interests in shared decision-making (Sharma et al., 2019).
In conclusion, child and adolescent mental health is closely linked to other medical specialties and is influenced by the child's psychosocial environment. Assessment should be biopsychosocial, considering the child's lived experience, culture, and developmental capabilities. Clinical history-taking and interviews are essential for diagnosis and plan management. Multidisciplinary input is needed, and confidentiality and its limits must be discussed. Maintaining documentation is crucial for comprehensive clinical assessments and interventions.