Psychiatric Assessment and Treatment


Many assessment principles are the same for children and adults; however, unlike with adults/older adults, where consent for participation in the assessment comes from the actual client, with children it is the parents or guardians who must make the decision for treatment. Issues of confidentiality, privacy, and consent must be addressed. When working with children, it is not only important to be able to connect with the pediatric patient, but also to be able to collaborate effectively with the caregivers, other family members, teachers, and school counselors/psychologists, all of whom will be able to provide important context and details to aid in your assessment and treatment plans.
Some children/adolescents may be more difficult to assess than adults, as they can be less psychologically minded. That is, they have less insights into themselves and their motivations than adults (although this is not universally true). The PMHNP must also take into consideration the child’s culture and environmental context. Additionally, with children/adolescents, there are lower rates of neurocognitive disorders superimposed on other clinical conditions, such as depression or anxiety, which create additional diagnostic challenges.
In this Discussion, you review and critique the techniques and methods of a mental health professional as the practitioner completes a comprehensive, integrated psychiatric assessment of an adolescent. You also identify rating scales and treatment options that are specifically appropriate for children/adolescents.
Required Readings
• Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental healthLinks to an external site.. American Psychiatric Association Publishing.
o Chapter 1, “Introduction”
o Chapter 4, “The 15-Minute Pediatric Diagnostic Interview”
o Chapter 5, “The 30-Minute Pediatric Diagnostic Interview”
o Chapter 6, “DSM-5 Pediatric Diagnostic Interview”
o Chapter 9, “The Mental Status Examination: A Psychiatric Glossary”
o Chapter 13, “Mental Health Treatment Planning”
• Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescentsLinks to an external site.. Indian Journal of Psychiatry, 61(2), 158–175.
• 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.). Wiley Blackwell.
o Chapter 32, “Clinical assessment and diagnostic formulation”
Required Media
• Symptom Media. (2014). Mental status exam B-6Links to an external site.. [Video].
• Western Australian Clinical Training Network. (2016, August 4). Simulation scenario-adolescent risk assessmentLinks to an external site. [Video]. YouTube. to an external site.
• YMH Boston. (2013, May 22). Vignette 5 – Assessing for depression in a mental health appointmentLinks to an external site. [Video]. YouTube.
Optional Resources
• Boland, R. Verdiun, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.
o Chapter 1, “Examination and Diagnosis of the Psychiatric Patient”
 Section 1.2, “Children and Adolescents” (pp. 74-87)
• Review the Learning Resources and consider the insights they provide on comprehensive, integrated psychiatric assessment. Watch the Mental Status Examination B-6 and Simulation Scenario-Adolescent Risk Assessment videos.
• Watch the YMH Boston Vignette 5 video and take notes; you will use this video as the basis for your Discussion post.
Based on the YMH Boston Vignette 5 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?
Then, address the following. Your answers to these prompts do not have to be tailored to the patient in the YMH Boston video.
• Explain why a thorough psychiatric assessment of a child/adolescent is important.
• Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent.
• Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.
• Explain the role parents/guardians play in assessment.
Support your response with at least three peer-reviewed, evidence-based sources and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

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