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Comprehensive Integrated Psychiatric Assessment (discussion)
Many assessment principles are
Jun 02, 2025
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ComprehensiveIntegratedPsychiatricAssessment.docx
Comprehensive Integrated Psychiatric Assessment (discussion)
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.
· Watch the
Mental Status Examination B-6 and
Simulation Scenario-Adolescent Risk Assessment videos.
·
TRANSCRIPT OF VIDEO FILE:
· 00:00:00______________________________________________________________________________
· 00:00:00BEGIN TRANSCRIPT:
· 00:00:00[sil.]
· 00:00:15SymptomMedia Mental Status Exam B-6
· 00:00:30OFF CAMERA What is your full name?
· 00:00:30DR. MASON Dr. Franklin Mason.
· 00:00:35OFF CAMERA What is the name of this building you're in right now?
· 00:00:40DR. MASON Fairview Hospital.
· 00:00:40OFF CAMERA What is the date?
· 00:00:40DR. MASON March 21st.
· 00:00:45OFF CAMERA Why are we here and what are we doing?
· 00:00:50DR. MASON We're here because they think I'm depressed, basically. (hmh)
· 00:00:55OFF CAMERA This is a concentration exercise. I'm going to ask you to subtract seven from 100 and then seven from that answer, and keep going as long as you can.
· 00:01:10DR. MASON Okay, so, 93, 85, 67, 60, 52, 45, 38, and... I lost track I think.
· 00:01:35OFF CAMERA Okay. It's all right. Can you subtract three from 100 and then three from that answer and keep going?
· 00:01:45DR. MASON 97, 94, 91, 88.
· 00:01:55OFF CAMERA That's good, thank you. Can you spell "world" forward?
· 00:02:05DR. MASON W-O-R-L-D.
· 00:02:05OFF CAMERA Now, can you spell "world" backwards?
· 00:02:10DR. MASON D-L-O. Oh, actually I messed that up, didn't I?
· 00:02:20OFF CAMERA That's alright, you can try again if you want.
· 00:02:20DR. MASON World, D-L-O-R-D-W? or W-D?
· 00:02:30OFF CAMERA That's alright.
· 00:02:30DR. MASON (laughing)
· 00:02:30OFF CAMERA Can you repeat and reverse these three digits: seven, two, five?
· 00:02:40DR. MASON Seven, two, five; five, two, seven.
· 00:02:50OFF CAMERA Can you repeat and reverse these four digits: eight, four, three, six?
· 00:03:00DR. MASON Eight, four, three, six; six, eight, three, four.
· 00:03:10OFF CAMERA Can you repeat and reverse these six digits: eight, four, five, two, nine, one?
· 00:03:25DR. MASON Eight, four, five, nine, two, one; one, two, eight, four, nine, five, four, one.
· 00:03:40OFF CAMERA Alright. I'm going to ask you to remember three things.
· 00:03:50DR. MASON Okay.
· 00:03:50OFF CAMERA You're going to repeat them now, and later on, I will ask you again if you can recall these three things.
· 00:03:55DR. MASON Okay.
· 00:03:55OFF CAMERA The three things are: apple, blue, and 408 Park Avenue. So, if you can repeat them now?
· 00:04:10DR. MASON Apple, blue, 408 Park Avenue.
· 00:04:10OFF CAMERA (mmhmm) And if you can recall them for later.
· 00:04:15DR. MASON Okay.
· 00:04:20OFF CAMERA What are some things you did in the past several days?
· 00:04:25DR. MASON I've just been working, basically, trying to rest when I can at the hospital.
· 00:04:40OFF CAMERA What are some things you did in the past few months?
· 00:04:45DR. MASON Drinking (hmh), working...That's really all that I do now.
· 00:04:55OFF CAMERA Who is the current President of the United States?
· 00:05:05DR. MASON Barack Obama.
· 00:05:05OFF CAMERA What are some recent news events?
· 00:05:10DR. MASON Well, we've had a plane go down mysteriously. We've had some issues in North Korea, and, I don't know, you know. I don't really keep up with the outside world.
· 00:05:40OFF CAMERA Can you name some recent past United States Presidents?
· 00:05:45DR. MASON Dwight D. Eisenhower, Bush, Regan, Clinton, Jefferson...
· 00:06:05OFF CAMERA That's good, that's good. Can you name some famous historical events?
· 00:06:10DR. MASON Yeah, we have World War I and II... We have Vietnam, just different stuff like that.
· 00:06:25OFF CAMERA Mmhmm. What is the capital of the United States?
· 00:06:35DR. MASON The capital of the United States is Washington.
· 00:06:40OFF CAMERA What are the bodies of water bordering the United States?
· 00:06:50DR. MASON Pacific and Atlantic Ocean.
· 00:06:50OFF CAMERA What states border this current state that you're in right now; this state's border?
· 00:07:00DR. MASON Oregon, Nevada... and... that's all I know, I think.
· 00:07:20OFF CAMERA What causes rust?
· 00:07:20DR. MASON Rust?
· 00:07:20OFF CAMERA Mmhmm.
· 00:07:25DR. MASON I'd say time... time. Time equals rust basically. If you let something linger or hang out too long.
· 00:07:40OFF CAMERA What is the purpose of lungs?
· 00:07:45DR. MASON The purpose of lungs is to breathe life inside of you.
· 00:07:50OFF CAMERA We're going to make some comparisons. How are these objects similar? Orange and apple.
· 00:08:00DR. MASON They're both fruits.
· 00:08:05OFF CAMERA Desk and chair.
· 00:08:10DR. MASON They both are things you work on.
· 00:08:10OFF CAMERA Plane and truck.
· 00:08:15DR. MASON They both are things you ride in.
· 00:08:20OFF CAMERA Newspaper and radio.
· 00:08:20DR. MASON They're both things that display information.
· 00:08:30OFF CAMERA What do these old sayings mean to you in your own words? "The grass is greener on the other side of the fence."
· 00:08:45DR. MASON That there's always something better down the line if you're patient.
· 00:08:50OFF CAMERA "Don't cry over spilled milk."
· 00:09:00DR. MASON Basically, not whining or pining over what has happened already, just moving forward.
· 00:09:10OFF CAMERA "A rolling stone gathers no moss."
· 00:09:15DR. MASON I haven't even heard that one before...hmmm.
· 00:09:15(laughing)
· 00:09:20OFF CAMERA How about, "People who live in glass houses shouldn't "throw rocks"?
· 00:09:30DR. MASON I guess people who talk about somebody else, you look themselves first before they criticize.
· 00:09:40OFF CAMERA What is your mood today?
· 00:09:45DR. MASON It's normal, I feel okay.
· 00:09:50OFF CAMERA What is your mood usually over the past weeks or months?
· 00:09:55DR. MASON Pretty much the same, just not too up or not too down.
· 00:10:10OFF CAMERA Earlier, I asked you if you could recall three things. Can you remember what those three things were?
· 00:10:20DR. MASON Apple, blue, and Park Avenue.
· 00:10:20OFF CAMERA Now I'm going to ask you a few questions on judgement. Hypothetically, what would you do if you smelled smoke in a movie theater?
· 00:10:35DR. MASON I would report it... to the manager or whoever I see, I would report it.
· 00:10:45OFF CAMERA What would you do if you found an addressed, stamped envelope?
· 00:10:50DR. MASON Nothing, I would just leave it where it is. I don't like to touch other people's stuff.
· 00:11:00OFF CAMERA What would you do if you were lost in the woods?
· 00:11:05DR. MASON Try to find my way out.
· 00:11:10OFF CAMERA What would you do if you found a gun?
· 00:11:15DR. MASON I might keep it.
· 00:11:20OFF CAMERA Why are you here?
· 00:11:25DR. MASON Cuz' they think I'm depressed.
· 00:11:25OFF CAMERA What are three wishes you would make if they would come true?
· 00:11:35[sil.]
· 00:11:40DR. MASON Maybe... if I can be back with my wife. Maybe if I could take away the urge to drink so much. And, just... all the bad memories, I guess; take those away.
· 00:12:00END TRANSCRIPT
· Watch the YMH Boston
Vignette 5 video and take notes; you will use this video as the basis for your Discussion post.
· YMH Boston. (2013, May 22).
Vignette 5 - Assessing for depression in a mental health appointment
Links to an external site.
[Video]
. YouTube. https://www.youtube.com/watch?v=Gm3FLGxb2ZU
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.
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