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Comprehensive Integrated Psychiatric Assessment

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.” Comprehensive Integrated Psychiatric Assessment.
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.
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Note: The approximate length of this media piece is 2 minutes.
 

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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. Comprehensive Integrated Psychiatric Assessment.
This week, you explore in depth the elements of the comprehensive integrated psychiatric assessment and diagnostic process.
Photo Credit: sbrogan / iStock / Getty Images Plus

Comprehensive Integrated Psychiatric Assessment 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.

“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. Comprehensive Integrated Psychiatric Assessment.
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 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.
Comprehensive Integrated Psychiatric Assessment 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! Comprehensive Integrated Psychiatric Assessment.
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?
Comprehensive Integrated Psychiatric Assessment

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. Comprehensive Integrated Psychiatric Assessment.
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. Comprehensive Integrated Psychiatric Assessment.

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.
Comprehensive Integrated Psychiatric Assessment

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. 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.
Comprehensive Integrated Psychiatric Assessment.

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