NURS 6660 Discussion: Comprehensive Integrated Psychiatric Assessment

NURS 6660 Discussion: Comprehensive Integrated Psychiatric Assessment

NURS 6660 Discussion: 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 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.

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. NURS 6660 Discussion: Comprehensive Integrated Psychiatric Assessment.

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

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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. NURS 6660 Discussion: Comprehensive Integrated Psychiatric Assessment.

  • “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]. NURS 6660 Discussion: Comprehensive Integrated Psychiatric AssessmentRetrieved 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. NURS 6660 Discussion: Comprehensive Integrated Psychiatric Assessment

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. NURS 6660 Discussion: Comprehensive Integrated Psychiatric Assessment

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. NURS 6660 Discussion: Comprehensive Integrated Psychiatric Assessment.

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. NURS 6660 Discussion: Comprehensive Integrated Psychiatric Assessment

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.
  • 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. NURS 6660 Discussion: Comprehensive Integrated Psychiatric Assessment.

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.)
  • 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.). NURS 6660 Discussion: Comprehensive Integrated Psychiatric Assessment.
  • 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.) NURS 6660 Discussion: Comprehensive Integrated Psychiatric Assessment

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