PMHNP Care Across the Lifespan I

Directions
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.
Video Link: https://www.youtube.com/watch?v=Gm3FLGxb2ZU

Discussion Post
The NP seemed to ask good questions during the interview. However, I feel as though she could improve by continuing with a more in-depth assessment. It is important to do a thorough assessment. Compelling concerns during the interview involves the patient addressing his suicidal ideations. I would want to go further and ask the patient more questions. Questions would include, how often are you having suicidal ideations? Do you have a plan? How long do these thoughts last? Would he ever consider acting on these thoughts? Is there anything that stops you from following through with these thoughts?

It is important to do a thorough psychiatric assessment. While assessing child and adolescent one should consider that the patient may not have good insight of their mental health due to the age. There are many different scales that can be used to score this age group on different mental health concerns. The Strengths and Difficulties Questionnaire (SDQ) is a self-managed behavioral questionnaire that screens children/ adolescents using 25 items on five scales: emotional problems, conduct problems, hyperactivity and inattention, peer relationships, and prosocial behaviors (Wong, Wai, Chan, Leung, & Leung, 2021). The teacher, parent, and patient fill out the questionnaire to see the improvements of the patient from multiple informants. The Spence Children’s Anxiety Scale (SCAS) is a self-administered, 44-item tool used to screen anxiety. Categories such as generalized anxiety, panic/agoraphobia, social phobia, and separation anxiety are assessed (Ferdinand, Alexander, & Jörg, 2021). The role of the parent during an assessment is important. It is important that the parent gives the psychiatrist insight on concerns they may have. The parent should also communicate between the child and their teachers to address and evaluate progress (Undheim, Lydersen, & Kayed, 2016).

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Solution

PMHNP Care Across the Lifespan: Discussion Response

Your discussion post offers an informative analysis of the interview. I like that you identify the practitioner as asking good questions that explore the issues affecting the client. In addition, I like that you identify the need for more in-depth questions for a more thorough assessment. Besides that, I like that you note the client’s suicidal ideation as a compelling concern since he is likely to act on them if left unaddressed. Also, I like that your suggested questions to ask the client when going forward revolve around the suicidal ideation. Furthermore, I like that you identify and explore the use of Strengths and Difficulties Questionnaire (SDQ) and Spence Children’s Anxiety Scale (SCAS) among children and adolescents. Additionally, I like that you explore the role of parents during an assessment, noting that they can present concerns they identified and help evaluate progress made. While your discussion post is well presented, I feel that it can be improved. Firstly, there are notable areas in which the practitioner did well, to include choice of venue, attention to the client, and professional demeanor (dressing and posture). These are important for creating the right professional setting for the interview from the get go. Secondly, the practitioner could improve on the introduction by easing the client to the interaction so that the client opens up and offers the required case details (Novalis, Singer & Peele, 2020). Thirdly, there is a need to ask the client questions about the break up and why he appears to have developed the suicidal ideation after the breakup. The break up was ignored in much of the interview and yet it should have been at the core. Fourthly, there is a need to present psychiatric treatment options for children, such as play therapy (Collarhide & Lemberger-Truelove, 2019). Overall, I feel that your discussion post has been well presented, but could be improved by including the four suggested details.

References

Collarhide, C. T., & Lemberger-Truelove, M. E. (Eds.) (2019). Theories of School Counseling Delivery for the 21st Century. Oxford University Press.

Novalis, P. N., Singer, V., & Peele, R. (2020). Clinical Manual of Supportive Psychotherapy (2nd ed.). American Psychiatric Association Publishing.

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