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Thorough Psychiatric Assessment, Symptom Rating Scales, and Treatment Options for Children and Adole

Importance of Thorough Psychiatric Assessment

Respond to the two post 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. POST 1BK What did the practitioner do well? In what areas can the practitioner improve?

The practitioner in the interview did well in interviewing the patient. One of the main aspects that I witnessed from watching the video is that she presented a calm and easy demeanour. She provided the patient with a summary of responses that he was giving which was an indication that she was listening. Nonetheless, she kept offering the patient leading questions which indicates that she did not give the patient a chance to elaborate more on what he was going through or how he was feeling.

This was an aspect in the interview that might have led to the patient not providing further answers and explanations on his experiences. The other aspect that came from the interview is the fact that the practitioner asked questions without giving the patient a chance to answer. This includes the fact that she only gave him room for yes and no answers. The practitioner should have maybe asked and inquired more from the patient about his feeling, especially with the suicidal tendencies which he described briefly. Through this elaboration, she would have been able to come up with better ways to provide assistance to the patient. At this point in the clinical interview, do you have any compelling concerns?

If so, what are they? I definitely have a compelling concern which in this case is the anger displayed by the patient and particularly in association with the triggers that lead to the anger. I would be concerned with how he will be able to manage and avoid these anger triggers. The client also described severe symptoms of depression and suicidal tendencies which would also have adverse effects on the patient and presents a patient safety concern for me. What would be your next question, and why? The next question that I would ask the patient is what he intended to do concerning the suicidal tendencies he has presented. This would be significant to ask because I will be able to get a chance to assist him to remove the suicidal tendencies. Explain why a thorough psychiatric assessment of a child/adolescent is important.

Suitable Symptom Rating Scales for Children and Adolescents

The thorough psychiatric assessment of a child or an adolescent is important because there are many factors that contribute to a child’s emotional state and at the same time the child in question might not be aware of the need to share the aspects they are going through and also might not trust other people for them to present the problems they are faced with. Through a thorough assessment, the health practitioner will be able to have a clear understanding of the problem that the children are faced with and therefore offer them assistance. An example of these psychiatric issues that children are likely to go through include neurological, pathological or physical undertone, which in case the health practitioner did not conduct a thorough examination might on the history, physical and psychiatric evaluation might lead to misdiagnosis and also poor patient results.

Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent. There are two major symptoms rating scales that are used by health practitioners when assessing a child or an adolescent. The rating scale is The Behaviours Assessment System for Children (BASC) is used for the assessment of emotional disorders, personality components and behavioural problems in individuals that are between the age of 2 to 21 years (Schmidt et al., 2021). Schmidt et al. (2021) have indicated that the BASC evaluates the patient's behaviours through self-reporting beginning at 8 years of age. The other rating scale that is used by health practitioners is the Children’s Depression Inventory (CDI) which is considered to be a modification of the Beck Depression Inventory (BDI) for adults (Stumper et al., 2019). CDI mainly evaluates patients that are between the ages of 7 and 17 years (Stumper et al., 2019).

According to the authors, CDI is one of the most commonly used scales for evaluating children’s and adolescent psychiatric positions. Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults. The two psychiatric treatment that is used on children and adolescents but not on adults are; Abilify (Aripiprazole) is used for treating bipolar, Schizophrenia and Tourette syndrome. The second treatment option that is used is Prozac (Fluoxetine) which is an SSRI option for the treatment of depression in kids and adolescents which is compared to Zoloft and Celexa is used to commonly treat depression in adults. Explain the role parents/guardians play in assessment.

Treatment Options for Children and Adolescents

Parents play an important role in the assessment of children and adolescents because they may offer the health practitioners information concerning the children and therefore promote the kid’s mental wellbeing. According to the Clinical practice guidelines (2019), it has been suggested that children might not want to present their problems to other people through reliance on multiple sources such as parents and guardians or people that they look up to such as their teachers who may assist in assisting the child earlier rather than later in life when the psychiatric disorders have had a toll on their lives.

Parents are of significance because they have the legal obligation to take care of the children which include paying for and looking for suitable treatment when they are not feeling well which includes taking them to the hospital for assessment. 

These mental illnesses should require thorough assessment since children and adolescents are naïve, may fear expressing themselves, or think it is abnormal to experience mental imbalances. Psychiatrists, psychiatric nurses, parents, and guardians should collaborate to guarantee patient safety and wellness. In the YMH Boston Vignette 5 video, the pediatric patient Tony has been referred to a social worker by his medical provider after manifesting symptoms of anxiety and depression. The social worker possesses top-notch communication skills. She accompanies her words with appropriate facial expressions and body gestures. After asking him a few questions, he states that he feels angry at times and lacks the energy to do things that he loves, such as playing basketball. She seems to sympathize with him, and from her facial expressions, she wants to know more about Tony. The practitioner can improve by creating rapport with her patients to create a less tense mood to be more open and relaxed. At the start of the session, Tony was not settled, and he seemed unable to answer some of the questions posed to him. Therefore the social worker should improve on creating a rapport with her psychiatric patients.

Tony states that he is an alcoholic and takes beer with his friends. He further says that he started experiencing symptoms of anxiety and depression after he broke up with his girlfriend. The compelling concern is whether he takes beer with his friends for fun or to cushion his feelings of depression. Another matter is whether Tony bothered to inquire why she broke up with him from her ex-girlfriend. She might have broken up with him due to some behavior she never liked about him or due to some other reasons such as too much drinking. The social worker did not go into much deeper details which might yield the solution to Tony's psychiatric challenges. My next question would be to ask Tony whether he has shared his day-to-day experiences with his friends, parents, and guardians. I would ask this question because he stated that he had thoughts hurting himself. It would enable me to know how to coordinate with those close to him and put appropriate measures to prevent him from actualizing the thoughts of hurting himself. A thorough psychiatric assessment of children and adolescents is essential to guarantee patient safety. The comprehensive evaluation enables the psychiatrists to understand the patients deeper and administer the most effective intervention. The psychiatrist can point out emotional, psychological, behavioral, and developmental challenges in the life of the young adults and prevent any further mental imbalances.

There are several symptom rating scales to assess the mental state of children and adolescents. They include a 41-50 scale whereby the patient manifests a significant number of signs that suggest that the patient's mental condition is greatly affected and needs immediate and intense care (Zimmerman et al., 2018). There is the 51-60 scale whereby the patient manifests medium symptoms; hence the psychiatric condition is not severely damaged and can be managed easily. The scales are essential to determine the level of management required for different sets of patients. Psychiatric disorders among children and adolescents are handled differently compared to adults. Psychiatrists use play therapy sessions to monitor the coordination of the brain and other body parts, for example, legs and hands. The young children play with toys and dolls while the adolescents play games such as ball games and computer games. Concentration, interest, and signs of low energy are observed (Doran & Newland, 2021). Conclusion: parent-child interaction therapy is a standard measure to create and establish strong bonds between children and their parents and guardians. Parents and guardians play an essential role in the psychiatric assessment of children and adolescents. They ensure that their children attend therapy sessions and heed the appointments.

They also ensure that the children and adolescents appropriately take their medication. They take care of all transport costs and the costs of medicine. Therefore psychiatric assessment among children and adults should be given priority to avoid instances of mental cases going unnoticed. 

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