NRNP 6665 Discussion: Comprehensive Integrated Psychiatric Assessment Discussion: Comprehensive Integrated Psychiatric Assessment

 
Assessment of children and adolescents, like adults, share some similarities, but overall will be somewhat different. The classical approach to making a comprehensive psychiatric evaluation will be age-dependent when it comes to younger age groups. Furthermore, the difficulty is enhanced when you take into consideration the contextual complexities including culture and environment. Therefore, with regard to the vignette 5 video, this post will attempt to highlight some of these aspects of a comprehensive integrated psychiatric assessment.

What The Practitioner Did Well
The practitioner is using nonverbal cues such as nodding and making eye contact with the patient at good measure. These are desirable traits for a psychiatric interview. Additionally, she practices active listening. This is seen when she gives a summary of the pertinent findings from the patient history back to the patient to help them both in breaking down the situation.

What The Practitioner Can Improve Upon
The provider starts off with the wrong line of questioning when you consider the patient’s age and gender. Males have been considered to be more likely to relate to questions concerning rage and irritability as opposed to sadness and hopelessness as symptomatic of depression. In addition, the interview could benefit from better rapport cultivated by the provider as this does not seem to be the case with the patient on close observation.

Compelling Concerns and The Next Question
Suicidality and the risk of self-harm appear to be the most compelling issues in the patient with a background of anxiety and depressive symptomatology. The next question to be asked would therefore assess the risk of follow-through. It would be pertinent to know if there have been any suicide attempts and if so, how many. This is extremely helpful in determining an appropriate management plan (Oquendo & Bernanke, 2017).

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