Comprehensive Integrated Psychiatric Assessment

YMH Boston Vignette 5 Video

Engaging with clients to ensure that they effectively communicate is critical during therapy sessions. In the YMH Boston Vignette 4 video, the practitioner did well in several aspects. First, he was able to establish rapport with Sean. For Sean, he created a cozy, tranquil setting. He explained Sean’s privacy rights while also outlining the entire counseling process to him (YMH Boston, 2013). Using this method when working with teenagers will make them feel relaxed and at ease, making them more receptive to therapy. Teenagers prefer that their affairs be personal and kept secret. A strong therapeutic partnership is built on the anonymity of the client, and the therapist has a legal and ethical duty to maintain the confidentiality and safety of his or her clients (Geldard, Geldard & Foo, 2019). He was also able to establish trust with the client. This allowed Sean to open up and be honest about how he was feeling during the process of assessment. The mental health practitioner also provided Sean with questions that enabled him to talk about the problems he was experiencing before providing him with feedback. Besides, the practitioner helped Sean reveal his perspective of what he was experiencing such as the reason why he was feeling angry and suicidal.

One of my compelling concerns at this point of the interview is the client’s anger towards his mother. Since the practitioner already knows that Sean has a lot of anger toward his mother, he should have tried to find the basis of his anger (YMH Boston, 2013). The practitioner ought to have inquired as to whether Sean’s mother was aware of this deep-seated resentment and why, rather than disregarding the question because she was aware that a lot of adolescents dislike confiding in or speaking to their mothers. Another compelling concern is Sean’s suicidal ideations. Sean explained to the practitioner that he does not feel alive. The client’s top priority is to tackle safety concerns and remove or minimize risk.

I would ask Sean questions like what are the causes of his anger and whether he feels like harming others or himself, his likes and dislikes, and what he likes doing apart from basketball. I would also ask him about the relationship he had with his girlfriend and what would have likely led to their breakup. Besides, I would want to know how his academic performance was and what made him hate school. Based on studies, adolescents may have anxiety, depression, or ADHD when they cannot concentrate in class (Løvgren et al., 2019). I would also gather critical data to narrow down Sean’s diagnosis. I would ask; Do you ever consider taking your own life? In such a case, are there any concrete plans?

Answers to the Prompts

A thorough psychiatric assessment is important to enable a practitioner to effectively make a diagnosis of a mental health issue and find out the need for additional medical care and diagnostic testing. The psychiatric assessment is the most important component of the assessment of all people with psychological issues, particularly kids and teenagers (Western Australian Clinical Training Network, 2016). Assessing adolescents comprehensively provides practitioners with a multidimensional comprehension of the biopsychosocial elements of a mental health disorder (Ryan & Oquendo, 2020). It also enables them to collect the most critical information to help them come up with a treatment plan that is patient-centered.

When assessing children, the most effective symptom rating scale is the child behavioral checklist (CBCL). This tool is often used in adolescents and children between the ages of six and eighteen. It helps in finding out their social competence and any behavioral issues (Grabowski et al., 2019). Another effective tool is the Children’s Depression Inventory (CDI). This is an effective rating scale modified from the Beck Depression Inventory for adults. This tool takes approximately 15 minutes to provide practitioners with results about a child’s behavior.

Several treatment options can only be used on children and adolescents. One of them is parent-child interaction therapy. It aids parents in interacting with their kids and regulating their behavior. It might also strengthen the link between parents and children. Using an earbud, parents using PCIT receive real-time guidance from a therapist. Irrespective of the number of sessions, the location, or the issue, PCIT greatly reduces parent and child-related tension. According to research, PCIT helps children and parents better control their emotions (Geldard, Geldard & Foo, 2019). Another option is child-centered play therapy. A play-based intervention is child-centered play therapy (CCPT). It makes use of the playhouse as a secure setting where kids can express their emotions using play and signs. The therapeutic alliance can promote recovery and growth, lessen harmful behaviors, and enhance overall functioning. Through the use of games and the play surroundings, CCPT enables kids to investigate problems and take charge of their healing process.

Parents or guardians play significant roles in assessments. They are the first people to see any behavioral issues in their children. As a result, they play a critical role in collecting data and noting the developmental issues and milestones that their children are experiencing. Parents and guardians assist practitioners by providing them with pertinent information concerning their child’s health (Western Australian Clinical Training Network, 2016). They collaborate with practitioners by assisting where necessary in establishing positive behavior in their children and providing ideas on how they can deliver patient-centered care. The adolescents’ parents or guardians may additionally motivate them to visit a doctor to discuss their persistent issues.

References

Geldard, K., Geldard, D., & Foo, R. Y. (2019). Counseling adolescents: The proactive approach for young people. New York: Sage.

Grabowski, K., Rynkiewicz, A., Lassalle, A., Baron‐Cohen, S., Schuller, B., Cummins, N., … & Łucka, I. (2019). Emotional expression in psychiatric conditions: New technology for clinicians. Psychiatry and clinical neurosciences, 73(2), 50-62. https://doi.org/10.1111/pcn.12799

Løvgren, A., Røssberg, J. I., Nilsen, L., Engebretsen, E., & Ulberg, R. (2019). How do adolescents with depression experience improvement in psychodynamic psychotherapy? A qualitative study. BMC Psychiatry, 19, 1-12. https://doi.org/10.1186/s12888-019-2080-0

Ryan, E. P., & Oquendo, M. A. (2020). Suicide risk assessment and prevention: challenges and opportunities. Focus, 18(2), 88-99. https://doi.org/10.1176/appi.focus.20200011

Western Australian Clinical Training Network. (2016). “Simulation Scenario – Adolescent Risk Assessment.” [You Tube]. https://www.youtube.com/watch?v=wNF1FIKHKEU

YMH Boston. (2013). “Vignette 5 – Assessing for Depression in a Mental Health Appointment.” [You Tube]. https://www.youtube.com/watch?v=Gm3FLGxb2ZU