NRNP-6665 Week 1 Discussion
Questions based on the YMH Boston Vignette 5 video
1. The practitioner changed the interactional style to fit Tony and respond to his needs more effectively. At first, Tony had no answer to questions about sadness and crying, but the practitioner successfully changed the focus to anger and frustration, which would be more relevant to Tony (YMH Boston, 2013). Also, the practitioner helped Tony to acknowledge his feelings and encouraged him to share them with the practitioner. However, the practitioner could enhance the interview by not going through a series of questions and instead try to establish rapport with Tony, which might make the latter more responsive.
2. At this stage of the clinical interview, some serious questions arise about Tony’s mental state. He has reported the following symptoms: decline in academic achievement, loss of interest in hobbies he once enjoyed, difficulty waking up in the morning, and agitation or panic when considering the breakup (YMH Boston, 2013). More disturbingly, Tony reported having thoughts that he does not wish to live and having ideas about killing himself.
3. The next question should, therefore, be geared towards determining the extent and seriousness of Tony’s suicidal ideation. A suitable follow-up could be, “Have you made any plans to hurt yourself, or have you thought about how you would do it?” This is an essential question because it will tell you the level of risk and how soon the person needs to be seen. Determining whether or not Tony has a concrete plan signifies a greater level of danger.
Other Questions
1. Psychiatric evaluation is critical in children and adolescents because it gives the clinician a clear picture of their condition to be in a position to diagnose the child correctly and also to plan for the proper treatment. Young people are in a developmental period, and their symptoms may not be similar to those of adults. That is why the early diagnosis of mental disorders is crucial for stopping the further development of the disease, avoiding the appearance of other illnesses, and enhancing the prognosis.
2. The CBCL self-report is a suitable symptom measure for evaluating children and adolescents, where parents/caregivers complete a questionnaire that measures a broad range of emotional and behavioral difficulties in children (Mansolf et al., 2021). It helps offer information on how the child functions in different contexts. The next one is the RCADS, a self-report measure that measures anxiety and depression in children and adolescents (Becker et al., 2018). It has subscales for the various types of anxiety disorders and depression; this makes it easier for the clinician to pinpoint which area is problematic and whether there is improvement over time.
3. Play therapy employs play in facilitating the child’s emotions, thinking ability, and communication (Koukourikos et al., 2021). It is beneficial for children who are still developing their language skills and may not be able to express themselves adequately. PCIT entails direct guidance from parents as they do their business with the child, aiming to enhance the quality of the parent-child relationship and manage behavioral problems (Vess & Campbell, 2022).
4. Parents and guardians are crucial to the psychiatric assessment process for children and adolescents. They offer background data and a history of the child’s development, behavior, and family situation that the child may be unable to recount. Parents’ observations and ideas may be helpful to the clinician in identifying patterns and antecedents that may not be apparent during the assessment sessions.
References
Becker, S. P., Schindler, D. N., Holdaway, A. S., Tamm, L., Epstein, J. N., & Luebbe, A. M. (2018). The Revised Child Anxiety and Depression Scales (RCADS): Psychometric Evaluation in Children Evaluated for ADHD. Journal of Psychopathology and Behavioral Assessment, 41(1), 93–106. https://doi.org/10.1007/s10862-018-9702-6
Koukourikos, K., Tsaloglidou, A., Tzeha, L., Iliadis, C., Frantzana, A., Katsimbeli, A., & Kourkouta, L. (2021). An Overview of Play Therapy. Materia Socio Medica, 33(4), 293–297. https://doi.org/10.5455/msm.2021.33.293-297
Mansolf, M., Blackwell, C. K., Cummings, P., Choi, S., & Cella, D. (2021). Linking the Child Behavior Checklist to the Strengths and Difficulties Questionnaire. Psychological Assessment. https://doi.org/10.1037/pas0001083
Vess, S. F., & Campbell, J. M. (2022). Parent–child interaction therapy (PCIT) with families of children with autism spectrum disorder. Autism & Developmental Language Impairments, 7, 239694152211407. https://doi.org/10.1177/23969415221140707
YMH Boston. (2013). Vignette 5 – Assessing for Depression in a Mental Health Appointment. In YouTube. https://www.youtube.com/watch?v=Gm3FLGxb2ZU
Why the Sources are Considered Scholarly
• Becker et al. (2018): This article is published in the Journal of Psychopathology and Behavioral Assessment, a peer-reviewed academic journal, and it presents original research evaluating the psychometric properties of a clinical assessment tool, a hallmark of scholarly work.
• Koukourikos et al. (2021): Published in Materia Socio Medica, this peer-reviewed article provides a comprehensive overview of play therapy, including theoretical foundations and practical applications, typical of scholarly sources that aim to inform and advance clinical practice.
• Mansolf et al. (2021): This article appears in Psychological Assessment, a peer-reviewed journal known for publishing empirical research on assessment tools and methodologies, thereby contributing to the academic field of psychology.
• Vess & Campbell (2022): Published in Autism & Developmental Language Impairments, this peer-reviewed article discusses applying a specific therapeutic approach, PCIT, within a clinical population, reflecting the rigorous standards and contributions of scholarly research.