Week 1: Comprehensive Integrated Psychiatric Assessment

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 crucial process – engaging with empathy.

Laureate Education (Producer). (2017d). Working with Children and Adolescents [Video file]. Baltimore, MD: Author.

The comprehensive integrated psychiatric assessment is a fundamental component of the psychiatric-mental health nurse practitioner’s (PMHNP) skill set, enabling them to understand, diagnose, and create a treatment plan for Maria. The psychiatric interview is a delicate endeavor in which one person delves into another’s innermost thoughts, fears, emotions, and behaviors. “This task is akin to exploring a dimly lit room in an old Victorian house” (Shea, p. 3) with only a candle for illumination. As the PMHNP gains more insight into the client’s life, the picture becomes clearer.

This week, you will explore in-depth the elements of the comprehensive integrated psychiatric assessment and the diagnostic process.

Learning Resources for Comprehensive Integrated Psychiatric Assessment

Required Readings

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)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Introduction”
“Use of the Manual”
“Cultural Formulation”

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

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 Psychological Association. (2017). Code of Ethics. Retrieved from http://www.apa.org/ethics/code/

Document: Child and Adolescent Diagnostic Assessment Worksheet (Word document)

Document: Practicum Journal Template (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.

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.

Discussion: Comprehensive Integrated Psychiatric Assessment

The comprehensive integrated psychiatric assessment of a child or adolescent involves gathering information not only from the child but also from various sources, including family members, caregivers, and the child’s teacher or school counselor. This complexity introduces issues of confidentiality, privacy, and consent that must be addressed. Additionally, the PMHNP must consider the influence of culture on the child’s situation.

In this Discussion, you will review and critique the techniques and methods used by a mental health professional as they conduct a comprehensive integrated psychiatric assessment of an adolescent.

By Day 3

Based on the YMH Boston Vignette 4 video, post answers to the following questions:

What aspects did the practitioner handle effectively?
In which areas could the practitioner improve?
Do you have any significant concerns at this point in the clinical interview? If so, what are they?
What would be your next question, and what is the rationale behind it?

By Day 6

Respond to at least two of your colleagues by offering additional insights or alternative perspectives on their assessment or suggesting different follow-up questions and explaining your reasoning.
Submission and Grading Information
Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 1 Discussion

Assignment: Practicum Journal Entry: Analyzing an Ethical Decision

In your role as a PMHNP, you will encounter several situations that will require your ability to make sound judgments and practice decisions for the safety and well-being of individuals, families, and communities. There may not be a clear-cut answer to address the issue, but your ethical decision-making must be based on evidence-based practice and what is good, right, and beneficial for patients. You will encounter patients who do not share your values, but you must remain professional and unbiased in the care you provide to all patients, regardless of their socio-demographic and ethnic/racial background. You must be prepared to critically analyze ethical situations and develop an appropriate plan of action. In this Assignment, you will review the literature and discover the various ethical dilemmas that PMHNPs encounter and how these issues are typically addressed in your state. Comprehensive Integrated Psychiatric Assessment.

By Day 7 of Week 4

Submit your Assignment.

Looking Forward: Upcoming Didactic Assignments

This week, you delved into the comprehensive integrated psychiatric assessment and diagnostic process. As you move forward in your course, here’s a glimpse of what’s coming up in your didactic assignments:

– Week 3: You’ll collaborate in a group to create a “Parent Guide,” which will be a valuable educational resource for parents with children diagnosed with specific mental health disorders.

– Week 5: You’ll have the opportunity to evaluate a client in your practicum who isn’t progressing as expected according to clinical outcomes.

– Week 6: You’ll explore a scenario involving an adult client who experienced a psychiatric emergency and compare how you would assess a child or adolescent client facing a similar situation.

– Week 7: Once again, you’ll work in a group to develop a “Parent Guide,” this time focusing on parents with children diagnosed with specific mental health disorders.

– Week 10: In the final weeks of your course, you’ll engage in group work to create another “Parent Guide” aimed at supporting parents with children diagnosed with specific mental health disorders.

These assignments will provide you with valuable hands-on experience and opportunities to apply your knowledge in real-world scenarios. Stay engaged and continue to develop your skills as you progress through the course. Comprehensive Integrated Psychiatric Assessment.