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Comprehensive Integrated Psychiatric Assessment

Student Name

College Name

Course number: Course Title

Instructor’s Name

Assignment Due Date

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What did the practitioner do well and what areas can the practitioner improve?

The practitioner applies good communication skills where she is audible and clear,

maintains good eye contact with the patient, and maintains appropriate sitting arrangement where

she can be able to assess even the body language. She uses no medical jargon and her choice of

words is appropriate for the patient to understand and respond to (YMH Boston, 2013). She

sounds non-judgmental and uses an appropriate tone that does not intimidate the patient. The

conversation is kept brief and this is appropriate to avoid boring the patient due to their level of

concentration. She repeats the patient’s words to allow him to synthesize and prompt him more

(YMH Boston, 2013).

Here are some areas she would have improved, first, it is important to always start by

greeting and welcoming the patient. Secondly, she would have introduced herself to the patient

as well as reassured them of their confidentiality. These would help the practitioner to establish a

good rapport with the patient making them speak out all their problems. Lastly, during the

assessment, she would have formulated her questions before to avoid interrupting the patient

flow by posing other questions (YMH Boston, 2013).

At this point of the interview, do you have any compelling concerns? If so, what are they?

At this point of the interview, I have four compelling concerns, to begin with, is the

patient aware of their mental status, if they are, do they know about the causes of their state?

Secondly, the patient mentioned self-harm and at times wished that they were dead, from this, I

would like to know more about their suicidal ideations. Thirdly, the patient talks about hating

school, I would like to know the reason as to why they hate school. Lastly, the patient denies
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indulging in drug abuse and says that he drinks occasionally, from I would like to enquire more

about the family psychiatric history (YMH Boston, 2013).

What would be your next question, and why?

My next question would be; Are there any of your immediate family members with any

mental illness? This would help me rule out genetic conditions in the family and hence

concentrate on other possible causes of the psychiatric condition such as drug abuse and

alcoholism. This would lead to other questions about consent to do a toxicology test to rule out

drug-induced depression. It is important to ask about the social aspects of the patient that might

lead to depression (YMH Boston, 2013).

Explain why thorough psychiatric assessment of a child/adolescent is important

Thorough psychiatric assessment in children and adolescents is vital as justified by the reasons

below. To begin with, the developmental factors focus on the changes that occur during the

development of the person. It is important to note that the two cohorts are yet to reach their peak

in development and they experience developmental changes that may come along with

psychological effects that may be confused with psychiatric issues (Danielson et al., 2019).

Secondly, many psychiatric conditions have their onset during childhood or adolescent,

therefore, a thorough assessment should be done at this stage to formulate an early diagnosis and

initiate early intervention which may improve the prognosis of the patient (Danielson et al.,

2019).

Thirdly, children and adolescents are subjected to different environmental settings which

form their psychosocial environment and a thorough psychiatric assessment should be done to

fully understand the clients under this category. Lastly, it is important to do a thorough
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psychiatric assessment of children and adolescents because they are unable to explain their

symptoms well. This necessitates gathering information from multiple sources to obtain holistic

behavior of the client hence a thorough assessment is needed (Danielson et al., 2019)

Describe two different symptom rating scales that would be appropriate to use during the

psychiatric assessment of a child/adolescent.

Rating scale is a tool used to assess and quantify the degree of a particular presentation

by assigning it a numerical value or level to indicate the extent of expression of that trait

(Danielson et al., 2019). Discussed below are two rating scales used in pediatric/adolescent

psychiatric assessment; a child behavior checklist which consists well established questions

designed to assess a broad range of emotional and behavioral problems. The items are placed

into syndromes that present a category of symptoms such as attention problems which the

parents respond to rate their children over the past six months. It is used to gather information on

a child’s behavior hence identifying potential mental issues (Danielson et al., 2019).

Achenbach system of empirically based assessment refers to a parent report form where

emotional, behavioral, and social problems are screened. It classifies the symptoms into eight

classes the internalizing problems and the externalizing problems. It is mainly completed by

teachers, parents/guardians and another form is filled by the individual, the youth self-report, for

the adolescents hence generating a comprehensive assessment report (Danielson et al., 2019).
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Describe two psychiatric treatment options for children and adolescents that may not

be used when treating adults.

Children are not smaller adults hence have their own treatment modalities that best

addresses their needs holistically. Among them are two approaches outlined in this question. To

begin with the cognitive-behavior therapy, which focuses on changing the thoughts and emotions

that affect behavior. This works directly with the child and the therapist who helps the child

evaluate if feelings are illogical and then guide them through the process of changing thought

(CDC, 2019).

Family therapy involves working with the entire family to address the issue of solving

disputes, communication skills and strengthen family relationship. Adolescents with depression

responds this therapy as they learn how to handle problems (CDC, 2019).

Explain the role parents/guardians play in assessment

Parents/guardians play a crucial role in the assessment of children/adolescents with

mental conditions. They provide firsthand information about the behavior of the patient from the

onset of the symptoms and report on the behavior they observe. They also provide a family

history that the child/adolescent might not have, this defines their role as information providers.

Secondly, the parents/guardians provide support to the mental health professionals by helping

them obtain informed consent on therapeutic procedures, actively participate in decision-making

as well as help in follow-up and implementation of treatment plans (CDC, 2019).

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References

CDC. (2019, September 26). Therapy to Improve Children’s Mental Health. Centers for Disease

Control and Prevention. https://www.cdc.gov/childrensmentalhealth/parent-behavior-

therapy.html

Danielson, M., Månsdotter, A., Fransson, E., Dalsgaard, S., & Larsson, J-O. (2019). Clinicians’

attitudes toward standardized assessment and diagnosis within child and adolescent

psychiatry. Child and Adolescent Psychiatry and Mental Health, 13(1).

https://doi.org/10.1186/s13034-019-0269-0

YMH Boston. (2013). Vignette 5 - Assessing for Depression in a Mental Health Appointment. In

YouTube. https://www.youtube.com/watch?v=Gm3FLGxb2ZU