Comprehensive Integrated Psychiatric Assessment Discussion

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.” Comprehensive Integrated Psychiatric Assessment Discussion

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.

ORDER A CUSTOM-WRITTEN PAPER NOW

Note: The approximate length of this media piece is 2 minutes.

–Downloads–
Download Video w/CC
Download Audio
Download 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. Comprehensive Integrated Psychiatric Assessment Discussion

Photo Credit: sbrogan / iStock / Getty Images Plus

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

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. Comprehensive Integrated Psychiatric Assessment Discussion

“Introduction”

“Use of the Manual”

“Cultural Formulation”

Note: You will access this book from the Walden Library databases.

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. Comprehensive Integrated Psychiatric Assessment Discussion

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 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.

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 of how to address the issue, but your ethical decision making must be based on evidenced-based practice and what is good, right, and beneficial for patients. You will encounter patients who do not hold 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. For this Assignment, you review the literature and discover the various ethical dilemmas PMHNPs encounter and how these issues are typically addressed in your state.

Learning Objectives

Students will:

Analyze salient ethical issues in psychiatric mental health practice
Compare ethical dilemmas with state health laws and regulations
Analyze ethical decision-making processes

To prepare:

Review literature for moral/ethical issues encountered by a PMHNP.
Select one of the articles you found that was published within the last 5 years to use as a focus for this assignment.

Write a 2-page paper in which you do the following:

Summarize the moral/ethical issue in the article (no more than 1 paragraph).
Describe the moral and ethical dilemmas surrounding the issue.
Analyze the ethical issue and compare them to the state health laws and regulations in your state.
Outline the process of ethical decision making you would use to address this ethical dilemma.

Note: Be sure to use the Practicum Journal Template, located in this week’s Learning Resources.

By Day 7 of Week 4

Submit your Assignment.

Making Connections

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

Next week, you explore the many different psychiatric assessment tools and begin to explore treatment options. You also begin developing your resume and portfolio.

Looking Ahead 1: Didactic Assignments

Week 3: You will work in a group to develop a “Parent Guide,” which will serve as a teaching tool for parents with children who have been diagnosed with a specific mental health disorder.
Week 5: You will assess one of the clients in your practicum who you do not think is adequately progressing according to expected clinical outcomes. Comprehensive Integrated Psychiatric Assessment Discussion
Week 6: You will use one of your adult clients who had a psychiatric emergency as an example as you compare how you would assess a child or adolescent client who had a psychiatric emergency.
Week 7: You will work in a group to develop a “Parent Guide,” which will serve as a teaching tool for parents with children who have been diagnosed with a specific mental health disorder.
Week 10: You will work in a group to develop a “Parent Guide,” which will serve as a teaching tool for parents with children who have been diagnosed with a specific mental health disorder. Comprehensive Integrated Psychiatric Assessment Discussion

Looking Ahead 2: Practicum Assignments

Each week, you will complete practicum-related assignments. It is highly recommended that you review the practicum assignments for Weeks 2–11 before Day 7 of Week 1. This will give you time to meet with your preceptor so that you can fulfill the requirements of each practicum assignment.

Week 2: You begin working on your cover letter, resume, and portfolio. (Assignment to be submitted by Day 7 of Week 10.)
Week 3: You will complete a Decision Tree including the diagnosis and treatment of a pediatric client. (Assignment to be submitted by Day 7 of Week 4.)
Week 5: You will complete a Decision Tree including the diagnosis and treatment of a pediatric client. (Assignment to be submitted by Day 7 of Week 7.) Comprehensive Integrated Psychiatric Assessment Discussion
Week 6: You will write a reflection on your practicum experiences involving group therapy sessions. (Assignment to be submitted by Day 7 of Week 7.)
Week 7: You will write a journal entry concerning voluntary and involuntary commitment. (Assignment to be submitted by Day 7 of Week 7.)
Week 9: You will complete a Decision Tree including the diagnosis and treatment of a pediatric client. (Assignment to be submitted by Day 7 of Week 10.)
Week 10: You will write about two clients you observed or counseled during a group therapy session for children and adolescents. (Assignment to be submitted by Day 7 of Week 10.)
Week 10: You will complete and submit your cover letter, resume, and portfolio. (Assignment to be submitted by Day 7 of Week 10.) Comprehensive Integrated Psychiatric Assessment Discussion

Refer to Weeks 2–10 for additional guidance.

NURS_6660_Week1_Discussion_Rubric

	Outstanding Performance	Excellent Performance	Competent Performance	Proficient Performance	Room for Improvement
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.	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 “	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” Comprehensive Integrated Psychiatric Assessment Discussion	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”	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”	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	6 (6%) – 6 (6%) “* Written clearly and concisely * Contains no grammatical or spelling errors * Fully adheres to current APA manual writing rules and style”	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” Comprehensive Integrated Psychiatric Assessment Discussion	5 (5%) – 5 (5%) “* Written concisely * May contain one to two grammatical or spelling errors * Adheres to current APA manual writing rules and style”	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”	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	10 (10%) – 10 (10%) “* Meets requirements for timely and full participation * Posts main discussion by due date”	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)	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.	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”	8.5 (8.5%) – 8.5 (8.5%) * Response exhibits critical thinking and application to practice settings	7.5 (7.5%) – 8 (8%) * Response has some depth and may exhibit critical thinking or application to practice setting	6.5 (6.5%) – 7 (7%) * Response is on topic and may have some depth	0 (0%) – 6 (6%) * Response may not be on topic and lacks depth
First Response: Writing	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”	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”	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”	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 “	0 (0%) – 4 (4%) “* Responses posted in the discussion lack effective professional communication * Response to faculty questions are missing * No credible sources are cited”. Comprehensive Integrated Psychiatric Assessment Discussion
First Response: Timely and full participation	5 (5%) – 5 (5%) “* Meets requirements for timely and full participation * Posts by due date”	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)	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.	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”	8.5 (8.5%) – 8.5 (8.5%) * Response exhibits critical thinking and application to practice settings	7.5 (7.5%) – 8 (8%) * Response has some depth and may exhibit critical thinking or application to practice setting	6.5 (6.5%) – 7 (7%) * Response is on topic, may have some depth. Comprehensive Integrated Psychiatric Assessment Discussion	0 (0%) – 6 (6%) * Response may not be on topic, lacks depth
Second Response: Writing	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”	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”	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”	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 “	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	5 (5%) – 5 (5%) “* Meets requirements for timely and full participation * Posts by due date”	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)	0 (0%) – 0 (0%) * Does not meet requirement for full participation. Comprehensive Integrated Psychiatric Assessment Discussion