Notethis Is Not My Case Scenario At All It Is Just How I Want My Dis ✓ Solved

NOTE* This is not my case scenario at all. It is just how I want my discussion formatted with headings. Stick to my instructions videos and rubric. Thank you. Shawn is a 16-year-old boy who has come to an outpatient clinic for a mental health assessment.

The appointment was not his idea, and he is not happy to be at the clinic. The provider utilizing positive techniques to engage him will make him feel worth keeping the appointment. The practitioner must help the patient get beyond his closed-off presentation and help the client talk about himself (YMH Boston, 2013c, May 22). The assessment serves as a platform of interrelated purposes to present the chief complaint, formulate a primary differential diagnosis, determine the cause of the issue, and identify the risk of suicidal and homicidal ideations and gather an individualized treatment plan (Mash & Hundsley, 2005). What did the practitioner did well?

In this scenario, the client is a 16-year-old white male whose mother wanted him to have counseling for potential anger management issues. The practitioner opened his session very well by first going over the session's privacy and confidentiality portion. Privacy and confidentiality are held in remarkedly high esteem and considered extremely vital for providing patient care. Confidence and privacy help create and develop trust and a healthy relationship between the clinician and the patient; thus, leading to a positive patient care result/outcome. The provider maintained good eye contact and listened attentively.

According to Sadock, Sadock &Ruiz, 2014, giving full attention to the patient shows that the clinician cares. In what areas can the practitioner improve? The practitioner could also work on his body language as he sat with his legs crossed, making the client feel as though the practitioner is tense, and the practitioner can smile a little (American Psychiatric Association, 2013). The practitioner could have encouraged Shawn to explain why "school sucks". The topic should have been explored more with the client.

The client also stated several times that he does not like school, but the provider did not ask questions as to why. There are many reasons why a young person might not be achieving academically, including bullying from other students, behavioral or emotional problems, school culture or environment, school workload, and poor relationship with the teacher and other students (Raising Children, 2017). The client seems to have had a difficult time communicating with his mother. The provider should have obtained more information about the client and his mother's relationship and offered a more effective communication method/strategy. The provider should have used open-ended questions instead of leading questions, making it appear the provider is taking sides.

Open-ended questions allow the client to explain his feelings in his own words (Smith, Duell & Martin, 2012). At this point in the clinical interview, do you have any compelling concerns? If so, what are they? Yes, I would be concerned about his behaviors when angry and during his outburst with his mom. Has he ever thought of harming her or physically hit her?

Does he destroy things, and how long does he display the behaviors. These questions will help the practitioner will identify any risk-taking behaviors he might be engaging himself in. I would be concerned for the mother's safety, what she does during his anger episodes, and afterward to cope with his outburst. What would be your next question, and why? The practitioner's next questions to Shawn will include if he has thoughts of suicide or homicide, substance use, and sexual practices.

As noted by Sadock et al. (2014), clinical interviews with adolescents should include exploration of suicidal thoughts, assaultive behaviors, psychotic symptoms, substance use, and use of safe sexual practices. References: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Arlington, Va: American Psychiatric Association. Mash, E.

J. & Hundsley, J. (2005). Special section: Developing guidelines for the evidence- based assessment of child and adolescent disorders. Journal of Child and Adolescent Psychology, 34: . Raising Children. (2017). School problems: Children 9-15 years.

Retrieved from Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

Smith, S. F., Duell, D., & Martin, B. C. (2012). Clinical nursing skills: Basic to advanced skills. Boston: Pearson.

YMH Boston. (2013, May 22). Vignette 4 – Introduction to a mental health assessment [Video file]. Retrieved from Response 2 Hi, Very well written and informative post. The therapist will endeavor to establish rules and regulations and reassure the client of his right to confidentiality during the visit. The practitioner should involve the client in the initial assessment to help develop a treatment plan that both of them are comfortable with.

Saddock, Saddock & Ruiz (2014), in their studies, emphasize the importance and the need for the client to increasingly feel that the evaluation is a joint effort and that the practitioner will honestly invest in their story. Many individuals lose it when it comes to controlling their anger (Tice, 2000). The client may be having many frustrations he is battling and exhibiting through anger. Because this client did not care for school, the frustration of not learning in the same way as his peers could have resulted in anger difficulties. According to Hammer (2015), children learn anger management from their role models-their parents.

When parents do not manage anger appropriately, children will often imitate the same behavior. The practitioner should endeavor to learn the client's background to arrive at an appropriate diagnosis and help treat the behavior. According to Tarvis (2012), when parents are too strict and use physical punishment, the child tends to develop low self-esteem and anger difficulties. References: Sadock, B. J., Sadock, V.

A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer. Hammer, D. (2015). Living with our genes.

New York: Doubleday. Tarvis, C. (2012). Anger: The misunderstood emotion, 2nd Edition. New York: Touchstone. Tice, D. (2000).

131 creative strategies for reaching children with anger problems . Chapin, S. C.: Youthlight, inc. Criteria A Level Superior Criterion Score ORGANIZATION, LOGICAL FLOW, REQUIRED COMPONENTS 1 point The paper is superiorly well-organized and easy to follow. It contains all the required components as outlined in the writing assignment requirements.

DEMONSTRATION OF KNOWLEDGE APPLICATION 1 point It superiorly demonstrates a thorough understanding of discipline theories and concepts presented in the course, and relevant to the assignment criteria. Exhibits a superior ability to apply theories to the context of the assignment. Superiorly demonstrates integration of current learning with prior learning to evidencing a comprehensive understanding of the subject. It superiorly demonstrates ability to analyze and synthesize communication and/or conflict resolution concepts to expand understanding or create new knowledge. LITERATURE REVIEW 4 points Literature Review is superior and consists of at least of eight (8) sources from outside the assigned readings providing a full supporting background for the Discussion of the assigned Conflict Management Topics.

The Literature Review superiorly complies with following stated requirement “the The focus of your literature review should be in keeping with paragraph 3, the first two bullets, of the website webpage above.†DISCUSSION 4 points Discussion superbly addresses each of the three areas listed below and provides excellent and consistently germane support from the literature review: o Define and discuss conflict management styles - focusing on managing conflicts within a group situation. o Identify and discuss at least three (3) difference conflict management styles used within groups. o Define and discuss decision-making. Paper does not elaborate on the higher-level topic of problem-solving (decision-making is a process within problem-solving).

FINDINGS/CONCLUSIONS & OTHER ITEMS 2 points Findings/Conclusions are logical and appropriate, and more than superiorly address how conflict management styles influence or affect a group's decision-making and as specified in the requirements document. Paper superiorly follows all format guidelines as stated in writing assignment guidance. Paper has few to no grammatical or spelling errors. Entire paper meets APA guidelines. Week 7 Provides an introduction to several skills that are important to an effective project manager, which are: 1) group argumentation, including structuring and presenting an argument.

2) negotiation, and 3) leadership and motivation through the power of acknowledgment. The purpose of this writing assignment is to explore the effects of conflict management styles on the effectiveness of group decision making or the group decision-making process. Review the Individual Assignments Guidance and prepare a response to the assignment prompt. NRNP 6665- Open Discussion wk1 Discussion: 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. 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. THE DISCUSSION. In about 3-4 pages.

To Prepare/ RUBRIC · 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. 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.

Videos YMH Video below Ref /Readings Symptom Media. (2014). Mental status exam B-6 . [Video]. Western Australian Clinical Training Network. (2016, August 4). Simulation scenario-adolescent risk assessment [Video]. YouTube.

YMH Boston. (2013, May 22). Vignette 5 - Assessing for depression in a mental health appointment [Video] . YouTube. Sadock, B. J., Sadock, V.

A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer. · Chapter 31, “Child Psychiatry†Learning Resources Required Readings (click to expand/reduce) Hilt, R. J., & Nussbaum, A. M. (2016).

DSM-5 pocket guide for child and adolescent mental health . 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 adolescents. Indian Journal of Psychiatry, 61 (2), 158–175. 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 (click to expand/reduce) Symptom Media. (2014). Mental status exam B-6 . [Video].

Paper for above instructions

Introduction

The assessment of a 16-year-old boy, referred to as Shawn, who presents at an outpatient clinic for mental health evaluation, provides a crucial opportunity to explore effective techniques in engaging adolescent patients. The scenario underscores the importance of establishing trust and rapport, which can significantly impact the outcomes of mental health interventions (YMH Boston, 2013c). This paper evaluates the clinician's strengths, areas for improvement, potential concerns arising from the clinical interview, and suggests appropriate next steps. Through this analysis, we emphasize the significance of a thorough psychiatric assessment tailored for children and adolescents.

Strengths of the Practitioner

The practitioner demonstrated several effective techniques throughout the assessment. One of the foremost strengths was the emphasis on confidentiality and privacy. Ensuring these factors helps build a trustworthy relationship with the patient, crucial in mental health settings (Mash & Hundsley, 2005). The provider’s straightforward and transparent communication regarding the purpose of the assessment likely made Shawn feel safer and more understood, which is vital for a successful engagement (Sadock, Sadock & Ruiz, 2014).
Maintaining eye contact and attentive listening were also good practices evidenced by the clinician. These elements are central to creating an atmosphere where the patient feels valued and heard. As articulated by Sadock et al. (2014), providers' non-verbal communication significantly contributes to patient comfort and encourages open dialogue, crucial for effective assessment.

Areas for Improvement

Despite the strengths shown, opportunities for improvement exist. The practitioner’s body language may have inadvertently created a barrier to open communication; sitting with crossed legs may have communicated tension or discomfort (American Psychiatric Association, 2013). A more open and relaxed posture, along with a warm smile, could facilitate a more inviting environment for Shawn to express himself.
Additionally, the provider missed an opportunity to delve deeper into the context of Shawn's complaints about school. As noted, adolescents often face myriad challenges that may create academic disinterest, ranging from bullying to emotional issues (Raising Children, 2017). By not exploring why Shawn believes "school sucks," the practitioner may have overlooked critical factors contributing to his disengagement and potential anger management issues.
The practitioner also failed to assess the dynamics of Shawn's relationship with his mother more comprehensively. Understanding family dynamics is essential, as they can considerably influence a child's behavior and mental health outcomes. Employing open-ended questions, as recommended by Smith, Duell, and Martin (2012), would allow Shawn to articulate his feelings without the provider appearing to take sides.

Compelling Concerns

Several compelling concerns arise from the interview. Chiefly, Shawn's expressions of anger and sentiment toward his mother raise questions about his coping mechanisms. It is crucial to inquire whether he has ever manifested harmful behaviors towards his mother during these outbursts or if he has considered self-harm or violence (Sadock et al., 2014). Such inquiries are essential in assessing risk factors effectively.
Concerns about the mother’s well-being must also be addressed. Inquiry about her strategies for managing Shawn's anger during episodes could provide valuable insights into the family's coping mechanisms and highlight areas necessitating support or intervention.

Next Steps

The next logical step in the assessment would involve direct inquiries about Shawn's thoughts on self-harm or harm towards others. It is vital to facilitate a space where he feels comfortable confiding these thoughts to the practitioner (Sadock et al., 2014). Exploring his substance use and sexual behaviors is also essential, as these are often areas that adolescents may struggle with and can further complicate psychiatric assessments.
Moreover, the practitioner should involve Shawn’s guardians (in this case, his mother) in the assessment process. Facilitating communication and collaboration can enhance the effectiveness of the intervention by ensuring that the treatment plan is comprehensive and addresses family dynamics.

Importance of a Thorough Assessment

Conducting a thorough psychiatric assessment for children and adolescents is paramount due to their unique developmental needs. Unlike adults, children may lack the insight to articulate their feelings and behaviors effectively, making it essential for practitioners to approach assessments with particular skills and strategies (Thapar et al., 2015). Comprehensive assessments can help identify undiagnosed conditions, guide treatment planning, and promote healthier coping strategies.

Symptom Rating Scales

For effective psychiatric evaluation in adolescents, symptom rating scales offer structured tools to gauge the severity of symptoms. Two commonly used scales include:
1. The Child Behavior Checklist (CBCL): This instrument assesses a wide range of emotional and behavioral problems in children, allowing practitioners to quantify Shawn’s behavior against normative data (Achenbach & Rescorla, 2001).
2. The Pediatric Symptom Checklist (PSC): This simple, brief questionnaire can identify psychosocial problems in children, enabling the provider to assess Shawn’s emotional well-being and social functioning (McCubbin et al., 1988).

Treatment Options Unique to Adolescents

Adolescents may necessitate treatment options that differ significantly from adults. Two notable methods include:
1. Family Therapy: This approach acknowledges familial influences on a child's behavior and promotes communication and problem-solving among family members, which can be pivotal in resolving familial conflicts (Gurman & Fraenkel, 2002).
2. Cognitive Behavioral Therapy (CBT) tailored for adolescents focuses on behavior modification and cognitive restructuring, which is widely regarded as effective for managing anger issues and other emotional difficulties in this age group (Hofmann et al., 2012).

Role of Parents/Guardians in Assessment

The involvement of parents or guardians is critical in psychiatric assessments for children and adolescents. They provide essential insight into the child’s behavior, developmental history, and family dynamics, which can influence mental health outcomes. Moreover, educating parents on how to support their child through therapy can strengthen the treatment process (Srinath et al., 2019).

Conclusion

The assessment of Shawn presents a compelling case study regarding the complexities of adolescent mental health evaluation. The importance of rapport-building, the need for comprehensive inquiry, and the unique challenges posed when working with this demographic cannot be understated. By refining their techniques and addressing areas for improvement, practitioners can enhance their approaches, ensuring that children and adolescents receive the most effective and empathetic care possible.

References

Achenbach, T. M. & Rescorla, L. A. (2001). Manual for the ASEBA School-Age Forms & Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth & Families.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Arlington, VA: American Psychiatric Association.
Gurman, A. S. & Fraenkel, P. (2002). The Handbook of Family Therapy. New York: Brunner-Routledge.
Hammer, D. (2015). Living with our genes. New York: Doubleday.
Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Meta-Analysis. Cognitive Therapy and Research, 36(5): 427-440.
Mash, E. J. & Hundsley, J. (2005). Developing guidelines for the evidence-based assessment of child and adolescent disorders. Journal of Child and Adolescent Psychology, 34: 1-12.
McCubbin, M. A., McCubbin, H. I., Thompson, A. I., & Thompson, E. A. (1988). The Effectiveness of Family Therapy 1974–1984: A Meta-Analysis. Family Relations, 37(1): 86-92.
Raising Children. (2017). School problems: Children 9-15 years. Retrieved from [insert link here].
Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian Journal of Psychiatry, 61(2), 158–175.
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
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.
YMH Boston. (2013, May 22). Vignette 4 – Introduction to a mental health assessment [Video file]. Retrieved from [insert link here].
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This paper aims to present a comprehensive understanding of conducting psychiatric assessments with adolescents, while addressing key aspects from the prompt based on the specific scenario about Shawn.