NRNP 6660 Comprehensive Integrated Psychiatric Assessment Paper

NRNP 6660 Comprehensive Integrated Psychiatric Assessment Paper

When performing an initial assessment with child or adolescent patients, gathering information and building a positive rapport can be a challenging process. In the video provided by YMH Boston, the clinician is presented with an adolescent who has been dropped off by his mother for a mental health evaluation due to his supposed problems with anger management.

NRNP 6660 Comprehensive Integrated Psychiatric Assessment Paper

Some of the methods that the practitioner did well was establishing confidentiality and privacy with the patient. The practitioner also was able to relax the patient from being guarded, related to being taken for an evaluation, into offering information more willingly. By speaking to the patient casually about his life, in order to make him feel more relaxed, the practitioner was able to segue into speaking about why he felt like he was brought to the clinic and was able to establish what was lacking in communication between the patient and his mother. By asking the patient open-ended questions and enabling the patient to expand on his thoughts, the practitioner was able to discover the core of the patient’s problems with his mother and can now address the issue appropriately.

While the practitioner did many things well in this assessment, there are factors which could be improved. The mistake, in my opinion, was a subtle one which was created by stereotyping roles between the mother and the patient and created a compelling concern which will need to be addressed. “Stereotyping can be a subtle cognitive phenomenon resulting from virtually universal social categorization processes, it also occurs, often unconsciously, among people who strongly endorse egalitarian principles and truly believe that they are not prejudiced” (Pumariega, et al., 2013).

The practitioner reinforced the patient’s view about how teenagers dislike speaking to their mothers and how his mother should “kinda’ be real, not be a parent” (YMH Boston, 2013). The practitioner needed to be more unbiased in his stance by not taking sides when empathizing with the patient. While empathizing with the patient about the communication problems with his mother can be a useful tool, the practitioner needs to accomplish this in a way which does not criticize one party over the other (AACAP, 2012).

The patient certainly had his own emotional views about why he believes his mother thinks he needs anger management. “Emotional reactions are not necessarily wrong, but not acknowledging them and factoring them in rationally can be misleading” (Kaplan, 2017). The practitioner will need to recover from the criticizing stance against the mother. It was subtle mistake during an act of developing a rapport with the patient, but the interaction could have been approached in a more productive way.

I believe my next question would be addressing his communication with his mother: “How do you feel about having a conversation with your mother concerning how you would prefer to speak to someone who is willing to listen and support you rather than making you feel pressured or constantly nagged?”

I would ask this question in order to gather information about whether the patient has attempted to speak about his issues with his mother and to allow the patient to elaborate on how he views communicating with her. By having the patient expand on how he feels about discussing these issues with his mother and his stance on the viability of the approach, he may open up about more underlying concerns or problems which are causing his anger and barrier in communication.

References for NRNP 6660 Comprehensive Integrated Psychiatric Assessment Paper

American Academy of Child & Adolescent Psychiatry (AACAP). (2012). Practice parameter for cultural competence in child and adolescent psychiatric practice. Journal of the American Academy of Child & Adolescent Psychiatry, 51(5), 541-557. Retrieved from http://www.jaacap.com/article/S0890-8567(12)00141-4/pdf

Kaplan, C. (2017). Ethical dilemmas. Advanced Healthcare Network. Retrieved from https://web.archive.org/web/20160416180027/http://nurse-practitioners-and-physician- assisstants.advanceweb.com/Article/Ethical-Dilemmas-2.aspx.

Pumariega, A.J., Rothe, E., Mian, A., Carlisle, L., Toppelberg, C., Harris, T., …Smith, J. (2013). Practice parameter for cultural competence in child and adolescent psychiatric practice. Journal of the American Academy of Child & Adolescent Psychiatry, 52(10), 1101-1115. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00479-6/pdf.

YMH Boston. (2013c, May 22). Vignette 4 – Introduction to a mental health assessment [Video file]. Retrieved from https://www.youtube.com/watch?v=JCJOXQa9wcE

NRNP 6660 Comprehensive Integrated Psychiatric Assessment Paper Instructions

Watch the YMH Boston Vignette 5 video and take notes; you will use this video as the basis for your Discussion post.
By Day 3 of 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.

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