In this Discussion, you review and critique the techniques and methods of a mental health professional as he or she completes a comprehensive integrated psychiatric assessment of an adolescent
Discussion: Comprehensive Integrated Psychiatric Assessment The comprehensive integrated psychiatric assessment of a child or adolescent consists of gathering information from not only the child but from several sources, most notably the family members, caregivers, and the child’s teacher or school counselor. Because of this, the diagnostic assessment becomes more complicated. Issues of confidentiality, privacy, and consent must be addressed. Also, the PMHNP must take into consideration the impact of culture on the child. In this Discussion, you review and critique the techniques and methods of a mental health professional as he or she completes a comprehensive integrated psychiatric assessment of an adolescent. Learning Objectives Students will: • Evaluate comprehensive integrated psychiatric assessment techniques • Recommend assessment questions To Prepare for the Discussion: • Review the Learning Resources concerning the comprehensive integrated psychiatric assessment. • Watch the Mental Status Examination video. • Watch the two YMH Bostonvideos. Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking Submit! By Day 3 Based on the YMH Boston Vignette 4 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? By Day 6 Respond to at least two of your colleagues by offering additional insights or alternative perspectives on their diagnosis or provide alternate next questions and why you selected those. Rubric Detail Select Grid View or List View to change the rubric’s layout. Name: NRNP_6660_Week1_Discussion_Rubric • Grid View • List View Show Descriptions Main Posting: Response to the discussion question is reflective with critical analysis and synthesis representive of knowledge gained from the course readings for the module and current credible sources.– Outstanding Performance 44 (44%) – 44 (44%) “* Thoroughly responds to the discussion question(s) * Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources * Supported by at least 3 current, credible sources ” Excellent Performance 40 (40%) – 43 (43%) “* Responds to the discussion question(s) * Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. * 75% of post has exceptional depth and breadth * Supported by at least three credible references” Competent Performance 35 (35%) – 39 (39%) “* Responds to most of the discussion question(s) * Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module * 50% of post has exceptional depth and breadth * Supported by at least three credible references” Proficient Performance 31 (31%) – 34 (34%) “* Responds to some of the discussion question(s) * One to two criteria are not addressed or are superficially addressed * Is somewhat lacking reflection and critical analysis and synthesis * Somewhat represents knowledge gained from the course readings for the module. * Post is cited with fewer than two credible references” Room for Improvement 0 (0%) – 30 (30%) “* Does not respond to the discussion question(s) * Lacks depth or superficially addresses criteria * Lacks reflection and critical analysis and synthesis * Does not represent knowledge gained from the course readings for the module * Contains only one or no credible references” Main Posting: Writing– Outstanding Performance 6 (6%) – 6 (6%) “* Written clearly and concisely * Contains no grammatical or spelling errors * Fully adheres to current APA manual writing rules and style” Excellent Performance 5.5 (5.5%) – 5.5 (5.5%) “* Written clearly and concisely * May contain one or no grammatical or spelling errors * Adheres to current APA manual writing rules and style” Competent Performance 5 (5%) – 5 (5%) “* Written concisely * May contain one to two grammatical or spelling errors * Adheres to current APA manual writing rules and style” Proficient Performance 4.5 (4.5%) – 4.5 (4.5%) “* Written somewhat concisely * May contain more than two spelling or grammatical errors * Contains some APA formatting errors” Room for Improvement 0 (0%) – 4 (4%) “* Not written clearly or concisely * Contains more than two spelling or grammatical errors * Does not adhere to current APA manual writing rules and style” Main Posting: Timely and full participation– Outstanding Performance 10 (10%) – 10 (10%) “* Meets requirements for timely and full participation * Posts main discussion by due date” Excellent Performance 0 (0%) – 0 (0%) Competent Performance 0 (0%) – 0 (0%) Proficient Performance 0 (0%) – 0 (0%) Room for Improvement 0 (0%) – 6 (6%) * Does not meet requirement for full participation First Response: Post to colleague’s main post that is reflective and justified with credible sources.– Outstanding Performance 9 (9%) – 9 (9%) “* Response exhibits critical thinking and application to practice settings * Responds to questions posed by faculty * The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives” Excellent Performance 8.5 (8.5%) – 8.5 (8.5%) * Response exhibits critical thinking and application to practice settings Competent Performance 7.5 (7.5%) – 8 (8%) * Response has some depth and may exhibit critical thinking or application to practice setting Proficient Performance 6.5 (6.5%) – 7 (7%) * Response is on topic and may have some depth Room for Improvement 0 (0%) – 6 (6%) * Response may not be on topic and lacks depth First Response: Writing– Outstanding Performance 6 (6%) – 6 (6%) “* Communication is professional and respectful to colleagues * Response to faculty questions are fully answered if posed * Provides clear, concise opinions and ideas that are supported by two or more credible sources * Response is effectively written in standard edited English” Excellent Performance 5.5 (5.5%) – 5.5 (5.5%) “* Communication is professional and respectful to colleagues * Response to faculty questions are answered if posed * Provides clear, concise opinions and ideas that are supported by two or more credible sources * Response is effectively written in standard edited English” Competent Performance 5 (5%) – 5 (5%) “* Communication is mostly professional and respectful to colleagues * Response to faculty questions are mostly answered if posed * Provides opinions and ideas that are supported by few credible sources * Response is written in standard edited English” Proficient Performance 4.5 (4.5%) – 4.5 (4.5%) “* Responses posted in the discussion may lack effective professional communication * Response to faculty questions are somewhat answered if posed * Few or no credible sources are cited ” Room for Improvement 0 (0%) – 4 (4%) “* Responses posted in the discussion lack effective professional communication * Response to faculty questions are missing * No credible sources are cited” First Response: Timely and full participation– Outstanding Performance 5 (5%) – 5 (5%) “* Meets requirements for timely and full participation * Posts by due date” Excellent Performance 0 (0%) – 0 (0%) Competent Performance 0 (0%) – 0 (0%) Proficient Performance 0 (0%) – 0 (0%) Room for Improvement 0 (0%) – 0 (0%) * Does not meet requirements for full participation Second Response: Post to colleague’s main post that is reflective and justified with credible sources.– Outstanding Performance 9 (9%) – 9 (9%) “* Response exhibits critical thinking and application to practice settings * Responds to questions posed by faculty * The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives” Excellent Performance 8.5 (8.5%) – 8.5 (8.5%) * Response exhibits critical thinking and application to practice settings Competent Performance 7.5 (7.5%) – 8 (8%) * Response has some depth and may exhibit critical thinking or application to practice setting Proficient Performance 6.5 (6.5%) – 7 (7%) * Response is on topic, may have some depth Room for Improvement 0 (0%) – 6 (6%) * Response may not be on topic, lacks depth Second Response: Writing– Outstanding Performance 6 (6%) – 6 (6%) “* Communication is professional and respectful to colleagues * Response to faculty questions are fully answered if posed * Provides clear, concise opinions and ideas that are supported by two or more credible sources * Response is effectively written in standard edited English” Excellent Performance 5.5 (5.5%) – 5.5 (5.5%) “* Communication is professional and respectful to colleagues * Response to faculty questions are answered if posed * Provides clear, concise opinions and ideas that are supported by two or more credible sources * Response is effectively written in standard edited English” Competent Performance 5 (5%) – 5 (5%) “* Communication is mostly professional and respectful to colleagues * Response to faculty questions are mostly answered if posed * Provides opinions and ideas that are supported by few credible sources * Response is written in standard edited English” Proficient Performance 4.5 (4.5%) – 4.5 (4.5%) “* Responses posted in the discussion may lack effective professional communication * Response to faculty questions are somewhat answered if posed * Few or no credible sources are cited ” Room for Improvement 0 (0%) – 4 (4%) “* Responses posted in the discussion lack effective professional communication * Response to faculty questions are missing * No credible sources are cited” Second Response: Timely and full participation– Outstanding Performance 5 (5%) – 5 (5%) “* Meets requirements for timely and full participation * Posts by due date” Excellent Performance 0 (0%) – 0 (0%) Competent Performance 0 (0%) – 0 (0%) Proficient Performance 0 (0%) – 0 (0%) Room for Improvement 0 (0%) – 0 (0%) * Does not meet requirement for full participation Total Points: 100 Name: NRNP_6660_Week1_Discussion_Rubric Week 1: Comprehensive Integrated Psychiatric Assessment “We adopted Maria from an orphanage in Guatemala when she was 4 years old. We were hoping she would love us as much as we love her, but she is always so distant and will not let us get close. She continually bumps her head on the wall and screams when we try to make her stop. She is now 5, and we have tried everything to help her understand that we just want to love her and have her be part of our family.” Jessica and Jason, Parents of 5-year-old Maria The delicate dance—engagement and empathy. Laureate Education (Producer). (2017d). Working with Children and Adolescents [Video file]. Baltimore, MD: Author. Note: The approximate length of this media piece is 2 minutes. Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript The comprehensive integrated psychiatric assessment is one of the most important elements of the psychiatric-mental health nurse practitioner’s (PMHNP) skill set to understand, diagnose, and develop a treatment plan for Maria. The psychiatric interview is a craft by which one human being becomes acquainted with another’s deepest thoughts, fears, emotions, and behavior. “This task is not unlike exploring a darkened room in an old Victorian house” (Shea, p. 3) with only a candle for illumination. As the PMHNP sees more of the client’s life unfold, the picture becomes clearer. This week, you explore in depth the elements of the comprehensive integrated psychiatric assessment and diagnostic process. Learning Resources Required Readings American Academy of Child & Adolescent Psychiatry (AACAP). (2012a). Practice parameter for psychodynamic psychotherapy with children. 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 American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author. • Standard 5D “Prescriptive Authority and Treatment” (page 58) Note: Throughout the program you will be reading excerpts from the ANA’s Scope & Standards of Practice for Psychiatric-Mental Health Nursing. It is essential to your success on the ANCC board certification exam for Psychiatric/Mental Health Nurse Practitioners that you know the scope of practice of the advanced practice psychiatric/mental health nurse. You should also be able to differentiate between the generalist RN role in psychiatric/mental health nursing and the advanced practice nurse role. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. • “Introduction” • “Use of the Manual” • “Cultural Formulation” American Psychological Association. (2017). Code of Ethics. Retrieved from http://www.apa.org/ethics/code/ Kaplan, C. (2017). Ethical dilemmas. Advanced Healthcare Network. Retrieved from https://web.archive.org/web/20160416180027/http://nurse-practitioners-and-physician-assistants.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 Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer. • Chapter 5, “Examination and Diagnosis of the Psychiatric Patient” (pp. 192–289) • Chapter 31, “Child Psychiatry” (pp. 1082–1107) Document: Child and Adolescent Diagnostic Assessment Worksheet (Word document) Required Media Gajbhare, P. (2014, March 8). Mental status examination [Video file]. Retrieved from https://www.youtube.com/watch?v=VjWVYgf2UcU Note: The approximate length of this media piece is 36 minutes. Laureate Education (Producer). (2017d). Working with Children and Adolescents [Video file]. Baltimore, MD: Author. Note: The approximate length of this media piece is 2 minutes. YMH Boston. (2013a, May 22). Vignette 1 – Introduction to a preventive services visit [Video file]. Retrieved from https://www.youtube.com/watch?v=pQy-jwiu7gM Note: The approximate length of this media piece is 3 minutes. YMH Boston. (2013c, May 22). Vignette 4 – Introduction to a mental health assessment [Video file]. Retrieved from https://www.youtube.com/watch?v=JCJOXQa9wcE Note: The approximate length of this media piece is 4 minutes. Optional Resources Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer. • Chapter 1, “Neural Sciences” (pp. 1–92) • Chapter 31.2, “Assessment, Examination, and Psychological testing” (pp. 1107–1118) Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.
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