Discussion | NURS 6660 – Psychiatric Mental Health Nurse Practitioner Role I: Child and Adolescent | Walden University

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Explain why a developmental assessment of children and adolescents is important

According to the CDC (2020), a mentally healthy child who reaches his or her developmental and emotional milestones develops healthy social and coping skills when confronted with adverse situations. Mental health disorders among children as described as significant alterations in the way children learn, behave, or handle difficult and stressful emotions (CDC website, 2020). According to Saddock et al. (2014), the expression of psychopathology in children can be related to age and stage of development. To perform a thorough assessment of a child, the practitioner must have sufficient knowledge of the development stages of children of all ages (Saddock et al., 2014). Understanding children’s developmental stages and what is “normal” for any age is crucial in identifying psychopathology versus expected behavior and responses in this patient population (Saddock et al., 2014).

Describe two assessment instruments and explain why they are used for children and adolescents but not adults

CAPA: Child and Adolescent Psychiatric Assessment- The CAPA instrument is interview-based and used in children between the ages of 9 and 17 (Saddock et al., 2014). The CAPA covers disruptive disorders, mood disorders, somatization symptoms, tic disorders, PTSD, schizophrenia, substance use disorders, sleep disorders, anxiety disorders, elimination disorders, adaptive behavior disorders, and eating disorders (Saddock et al., 2014). The CAPA is available in a segmented form allowing for individual diagnostic units to be administered without conducting a full interview (Saddock et al., 2014). The CAPA takes about one hour to administer and focuses on symptoms occurring three months before the interview (Saddock et al., 2014). The CAPA provides ratings for both severity and presence of symptoms and can be used to formulate diagnoses in conjunction with the DSM-5 (Saddock et al., 2014). Training is required to administer the CAPA, and clinical judgment is required to interpret symptoms.

Dominic-R: The Dominic-R is a cartoon-like instrument designed to assess self-reported mental health in children ages 6-11 years of age (Bajeax et al., 2018). This instrument uses a picture of a child named Dominic, who is enduring the symptoms in question (Saddock et al., 2014). In the Dominic-R computerized version, “Dominic” is also available in Black, White, Asian, and Latino (Saddock et al., 2014). This tool demonstrates the “abstract emotional and behavioral content of diagnostic entities per the DSM-III, but information gathered with the use of this instrument can be applied to DSM-5 diagnostic criteria” (Saddock et al., p. 1111, 2014). With each picture, a sentence is read to the child about the emotion or situation the cartoon child is experiencing. The child is asked if they have experienced the same feeling (Saddock et al., 2014). Diagnoses covered by the Dominic-R include separation anxiety, depression, dysthymia, ADHD, ODD, conduct disorder, and specific phobias (Saddock et al., 2014). This assessment’s paper form takes approximately 20 minutes to administer, and the computer form takes about 15 minutes (Saddock et al., 2014).

Describe two treatment options for children and adolescents that may not be used when treating adults

Parent support– According to the National Institute of Mental Health (2020), parental support includes individual or group therapy that includes training. The opportunity to talk with other parents can provide new strategies for supporting a child and managing problematic behavior positively. The counselor can also guide parents on communicating with the child’s school (NIMH website, 2020).

Age-specific use of instruments– For example, the Dominic-R is explicitly used for children between the ages of six through 11. Instruments used with young children are designed to match their cognitive-developmental level and retain their attention (Bajeux et al., 2018). Several studies have demonstrated that the Dominic-R is quite sensitive in detecting differences in behavior that otherwise might not be detected by parent or teacher-reported questionnaires (Bajeux et al., 2018).

Explain the role parents play in assessment and treatment

According to Saddock et al. (2014), an interview with the parents and caretakers is crucial to obtain a chronological history of the child’s growth and development. A detailed developmental history and specifics of any stressors or significant events that may have influenced the child’s development must be identified (Saddock et al., 2014). The psychiatric history of the parents, family dynamics, marital status, and the parents’ emotional adjustments are also identified during the child’s treatment (Saddock et al., 2014). The child’s parents will often be the best informants of the child’s early developmental history, along with previous medical or psychiatric history (Saddock et al., 2014).

References

CDC website: What is children’s mental health (2020). Retrieved from https://www.cdc.gov/

childrensmentalhealth/basics.html

Bajeux, E., Klemanski, D., Husky, M., Leray, E., Chee, C., Shojaei, T., Fermanian, C., & Kovess-Masfety, V.

              (2018). Factors associated with parent-child discrepancies in reports of mental health disorders

              in young children. Child Psychiatry and Human Development. (49)1003-1010. Retrieved from

https://doi.org/10.1007/s10578-018-0815-7

National Institute of Mental Health website. (2020). Children and mental health. Retrieved from http://

www.nimh.nih.gov/health/publications/children-and-mental-health/index.shtml

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.

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