Assessing for depression in a mental health appointment. – REPLY 3 Madeleine Frias

THE ASSIGNMENT  –  Week 1 Discussion – REPLY 2

PLEASE REPLY TO THE FOLLOWING DISCUSSION POST:
Madeleine Frias Hinojosa
Nov 25 10:53am 
What strengths can be identified with the practitioner? 
 Some of the strengths observed in the practitioner during the clinical interview were the following. First, they supported the development of a positive, trusting relationship by demonstrating friendly and non-judgmental body language, and vocal tone, as well as repeating the teenage client’s emotions in discussion. This approach helps build rapport and as a result, patient has to be more forthcoming with information, important in assessment of teenagers. He also did not use the language that was critical, something that is quite important for adolescents since they always Sterile and permissive approach improves patient’s interactions during the psychiatric interviews with children and adolescents according to Breslin et al. Further, the practitioner adopted good eye contact and open body postures that made the gesture looks more of attention and welcoming.
 In which areas is the practitioner lacks knowledge? 
 The practitioner stated some of the communication skills which include the following: During the interview, the practitioner was in speaking order, but he fails to organize the interview questions in a way that would help elicit more information. They could have posed further specific queries more relevant to the adolescent’s daily function such as academic, peer and family relations. Developmental questions relevant are crucial more so to adolescents because they may not be articulate to express their worries. In addition, starting with more restrictions on confidentiality may have helped to calm the adolescent about the session and his/her statements since privacy is crucial when the youth feels comfortable to open and share certain information (Levinson et al., 2023). 
 At this stage of the clinical interview, do any strong feelings come up? 
 Indeed, there are several persuasive reasons at this stage of the interview. A change in mood, lacking interest in activities the adolescent usually enjoys or possible feelings of hopelessness should sound a warning bell for depression or anxiety. However, any client presenting sign of any self-harm, suicidal thoughts or substance use should be offered crisis intervention since s/he presents serious level of risk. Adolescents are especially susceptible to internalising disorders that do not always indicate issues, so these areas should not be excluded from detailed examination (Breslin et al., 2022). 
 What would be your next question, and why could it be the next? 
 My next question would be, “……How have you feel in the last weeks at home and school?” This may be the most important question because it lets the adolescent explain much about his or her feelings and functioning in two important contexts. It also enables the parent/guardian to also see possible sources of stress like familial problems or school related issues; which are most of the times causes of the teenage mental health woes. Tackling these areas allows the clinician to build a much better understanding of the teenager’s overall status and subsequent actions (Levinson et al., 2023). 
 Why comprehensive psychological evaluation of a child/adolescent is necessary?
  A developmental psychiatric evaluation of children and adolescents is particularly crucial because the disorders are differently expressed across the developmental age. In contrast to adults, children can show the signs of psychological distress through behaviour, that consist of becoming irritable or getting worse in school, instead of verbally vocalizing it. Confirmation of these disorders at an early stage is important in arresting the development of certain disorders that may compromise subsequent lifestyle functions like social interaction and academic achievements. Furthermore, an effective evaluation contemplates the bio psychosocial perspective as this is especially important during adolescent due to the effects of home and peer pressure. 
 Two Symptom Rating Scales for Children/Adolescents

Patient Health Questionnaire for Adolescents (PHQ-A): 

 The PHQ-A is a self-administered instrument that is intended for adolescents twelve to seventeen years of age and which is solely to be used as a screening tool for diagnosing depression. It even quantifies intensity of such signs as low temper, fatigue, and paucity of interest which help in diagnosing depression as well as evaluating its response to treatment. The short administration time and low cost make it particularly suitable for use in clinical settings. Studies attests its reliability and validity in screening depression on adolescents (Levinson et al., 2023). 
 Child Behavior Checklist (CBCL):

The CBCL is a parent-report general behavior profile for children between 6 and 18 years old. It reviews internalizing conditions, which include anxiety and depression, and externalizing behaviors, including aggression. This scale is especially helpful to gain insight from the caregiver’s view, for children sometimes may not express all their worries well. The CBCL has shown both internal and external reliability and is considered an important part of modern clinical practice (Breslin et al., 2022). 


 Two Psychiatric Treatment Options for Children and Adolescents

Play Therapy: 

 Play therapy is an age appropriate method of treatment that seeks to mirror how children handle their concerns, as the children do through play. This therapeutic modality allows the overall formation of a disease-free interaction between patient and clinician by going to the root of what is not spoken. Scientific practice indicates that play therapy can be used for children who may not understand normal talk therapy at their young age (Levinson et al., 2023).

Parent-Child Interaction Therapy (PCIT):

PCIT is a behaviorally oriented treatment that enhances the parent child interactions while managing child behavioral concerns. This one entails consulting parents with instructions of how they can use to shape good behavior and modify improper ones. PCIT has been effective in reducing externalizing behavior and changing of parent-child communication patterns, and is well-suited for younger children (Breslin et al., 2022). 


 Role of Parents/Guardians in Assessment

The psychiatric assessment of children and adolescents cannot be complete without parents and guardians. It comes with essential historical as well as contextual data like developmental, as well as past trauma history and report of changes in forms of behavior. Their evaluation guarantees a comprehensive observation of functioning of the child across the contexts, which is so vital in the diagnostic and assessment encounters. In addition, their parent’s cooperation and support are essential for compliance with therapeutic suggestions, especially for children (Levinson et al., 2023).

 

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