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Supportive Psychotherapy Versus Interpersonal Psychotherapy

Introduction

Psychotherapy is a treatment approach that targets mental and psychiatric wellbeing. In fact, it involves engaging the professional services of a psychiatrist who applies talk therapy to direct the patient in developing a personalize solution to address the exiting problem. At the conclusion of the therapy, the patient is either considered to be healed having developed healthier habits or approaches to address the problem. In case the patient is not considered treated at the end of the treatment, then other treatment approaches can be recommended (Acton, 2013). The present paper discusses the similarities and differences between supportive psychotherapy (SP) and interpersonal psychotherapy (IP) as aspects of psychotherapy Supportive Psychotherapy Versus Interpersonal Psychotherapy.

Discussion

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Part 1.

There are similarities between SP and IP. Firstly, they apply talk therapy to engage patients in identifying and discussing the existing problem, before developing personalized solutions. Secondly, they require active participation of the patients who must be willing to be treated after noting the presence of the problem, as seen in the requirement that patients be honest in their expression. Finally, the patients must be willing to apply the developed solution and offer feedback that allows for the initial solution to be evaluated and revised as the actual situation demands. Overall, there is a need for the patient to actively participate in the treatment when using either one of the two therapies (Wheeler, 2014). Supportive Psychotherapy Versus Interpersonal Psychotherapy.

Part 2.

Even though SP and IP have three similarities, the two are distinctive therapeutic approaches with three differences. The first difference is the role of the therapist in the treatment process. SP requires that the therapist take on an active role in directing the patient on how to address the existing problem. This implies that the patient takes on a passive role in developing the solution, and an active role in applying the solution as presented. In contrast, IP requires that the patient take on an active role in developing the solution, with the therapist taking on a passive role in helping the patient to identify the problem and solution. The second difference is that SP confines the therapeutic relationship between the therapist and patient within the treatment sessions Supportive Psychotherapy Versus Interpersonal Psychotherapy. In contrast, IP requires that the therapeutic relationship exceed the confines of scheduled therapy sessions with the therapist capable of intervening when called upon irrespective of the time and place. The final difference is that SP has the therapist acting as a model of the ideal while IP has the therapist acting as a guide who helps the client in interpreting what constitutes the ideal (Wheeler, 2014).

Part 3.

As a therapist, I would prefer using IP as opposed to SP. That is because IP is a comprehensive treatment approach that allows the patient to apply a personalized treatment. This is preferable to SP that has the therapist develop a solution that is not guaranteed to work. By incorporating the patient’s perspective, IP ensures that the solution is personalized. In addition, IP does not restrict treatment to the therapy sessions so that the therapist is always available to address the patient’s needs irrespective of place or time. This ensures that the patient receives help from the therapist when required (Cautin & Lilienfeld, 2015). Supportive Psychotherapy Versus Interpersonal Psychotherapy.

Conclusion

One must accept that psychotherapy is a tool for addressing mental needs. In addition, one must acknowledge that there are different psychotherapy approaches to include SP and IP. Although the two are psychotherapy approaches, they share similarities and differences that limit the situations in which they can be used.

References

Acton, A. (2013).
Major depressive disorders: new insights for the healthcare professional
. Atlanta, GA: Scholarly Editions.

Cautin, R. & Lilienfeld, S. (2015).
The encyclopedia of clinical psychology, volume II Cli-E
. Hoboken, NJ: John Wiley & Sons. Supportive Psychotherapy Versus Interpersonal Psychotherapy

Wheeler, K. (Eds.). (2014).
Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
(2
nd
ed.). New York, NY: Springer Publishing Company.

 

Assignment 1: Supportive Psychotherapy Versus Interpersonal Psychotherapy

Although supportive psychotherapy and interpersonal psychotherapy share some similarities, these therapeutic approaches have many differences. When assessing clients and selecting therapies, it is important to recognize these differences and how they may impact your clients. For this Assignment, as you compare supportive and interpersonal psychotherapy, consider which therapeutic approach you might use with your clients. Supportive Psychotherapy Versus Interpersonal Psychotherapy.

Learning Objectives

Students will:

Compare supportive psychotherapy and interpersonal psychotherapy

Recommend therapeutic approaches for clients presenting for psychotherapy

To prepare:

Review the media in this week’s Learning Resources.

Reflect on supportive and interpersonal psychotherapeutic approaches.

The Assignment

In a 1- to 2-page paper, address the following:

Briefly describe how supportive and interpersonal psychotherapies are similar.

Explain at least three differences between these therapies. Include how these differences might impact your practice as a mental health counselor. Supportive Psychotherapy Versus Interpersonal Psychotherapy.

Explain which therapeutic approach you might use with clients and why. Support your approach with evidence-based literature.

Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://academicguides.waldenu.edu/writingcenter/templates ). All papers submitted must use this formatting. Supportive Psychotherapy Versus Interpersonal Psychotherapy.

Structural Family Therapy and Strategic Family Therapy Essay

Key Points

A psychologist named Salvador Minuchin discovered structural family therapy by discovering that family dysfunctions are not individual based but grounded on an entire family unit. Therefore, this model tends to analyze family rules that easily lead to patterns that are highly dysfunctional within families which are actualized through relations and family model systems (Williams, 2016). This therapeutic approach happens gradually and includes interventions that require meditation and self-analysis Structural Family Therapy and Strategic Family Therapy Essay.

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Strategic family therapy was discovered by Milton Erickson with an aim of influencing change. It does so through psychological reviews of the issues that individuals in a family face at individual level (Horigian, Anderson & Szapocznik, 2016).  Research suggests that strategic family therapy is more realistic and considerate when compared to structural family therapy. However, its success is highly dependent on collaboration between family members.

Comparison, Strengths and Weaknesses

Structural family therapy helps to re-build a family’s network and cohesion by changing dysfunctional patterns that exist within a family. In comparison, strategic family therapy lays a lot of emphasis on the processes, relationship patterns and hierarchy that exists in a family. A common similarity is that both therapeutic strategies aim at influencing positive change in a family unit through behavior modification, encouraging communication and altering patterns of hierarchy (Williams, 2016). A common strength of both therapies is that they make maximum use of external and internal family networks to develop sustainable solutions that can be used to resolve conflicts within families. One of the weaknesses of structural family therapy is that it eliminates past abuse and trauma incidences. According to Williams (2016), this can be major factors that contribute to current dysfunctional patterns within a family. Structural Family Therapy and Strategic Family Therapy Essay.

Reference

Horigian, V.E., Anderson, A. R., & Szapocznik, J. (2016). Taking Brief Strategic Family Therapy from Bench to Trench: Evidence Generation across Translational Phases.
Family Processes,
55(3), 529-542.

Williams, A. E. (2016). The Viability of Structural Family Therapy in the Twenty-first Century: An Analysis of Key Indicators
. Contemporary Family Therapy,
38(3), 225-2261 Structural Family Therapy and Strategic Family Therapy Essay.

Nurs 6640 Group Processes and Stages of Formation Essay

Introduction

Groups are tools that allow individuals to congregate so as to pursue the same or similar objectives. In this case, the group allows the individual members to have a common forum where they can explore their issues and collective present effective strategies for addressing the issues. For that matter, the group is formed with set objectives and ceases to exist once these objectives have been achieved. This is also true for psychotherapy, where individuals with similar psychiatric issues are congregated to explore these issues in a common forum and within a controlled environment (Wheeler, 2014). The present analysis explores the unique features of groups as they apply to an identified psychotherapy case Nurs 6640 Group Processes and Stages of Formation Essay.

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Discussion

Explain the group’s processes and stage of formation.

The psychotherapy case involves a group that is comprised of members who are seeking psychiatric care. The members have similar psychiatric issues and have been enrolled into the same group. This is intended allow the members to use social interactions to draw on collective experiences so as to identify effective solutions (Psychotherapy.net, 2011). A review of the interaction between the group members at the session reveals that the group is at the storming stage of formation. In this case, the group has just been formed, the members are getting to know each other, and none of the treatment objectives are yet to be met. The members’ personalities conflict as they get familiar with each other. This is evident in the interaction between Philip and Pam whose personalities conflicted. Since the group is yet to achieve any of its set objectives, the members are not heavily invested in the group and could leave the group if the present conflict is not addressed. The group will move into the norming stage of formation should the conflict be addressed and cohesion improved (Wheeler, 2014).

Explain curative factors that occurred in the group. Include how these factors might impact client progress.

The formation of the group is a curative factor since it is an indication that the members acknowledge that they have an issue that is best addressed in consultative forums with others who have a similar issue. This implies that the group members are receptive to psychiatric treatment. Another curative factor is that the group members are openly interacting with each other, honestly expressing themselves even in the face of conflict. This is an indication that they are opening up and will remain honest in future group interactions. Yet another curative factor is the presence of the therapist who moderates and guides the interactions between the group members while ensuring that they are on the right track to address their treatment objectives (Allen & Spitzer, 2015). Nurs 6640 Group Processes and Stages of Formation Essay.

Explain intragroup conflict that occurred and recommend strategies for managing the conflict.

The interaction between Pam and Philip is an indication of intragroup conflict. The conflict begins with Pam and Philip but draws in other group members with the result that the group could break down (Psychotherapy.net, 2011). The conflict is best addressed through considering it as an opportunity for improving cohesion. This would require that the conflicting group members be taken through a conflict resolution program where they explore the conflict and how it can be addressed without breaking down the group. Resolving the conflict will improve interactions between group members, making them more cohesive, and allowing them to address the group objectives as a priority (Bitter, 2014).

Conclusion

Groups are important tools for psychotherapy, allowing for persons seeking treatment to have a common forum in which to explore their psychiatric issues. Nurs 6640 Group Processes and Stages of Formation Essay. In addition, one must acknowledge that groups go through different stages of formation that act as an evolution in the treatment process. Also, conflicts are not uncommon in the initial stages of a group being forms, and these conflicts should be addressed to improve cohesion between group members while enabling them to address the treatment objectives.

References

Allen, K. & Spitzer, W. (2015).
Social work practice in healthcare: advanced approaches and emerging trends
. Thousand Oaks, CA: SAGE Publications. Nurs 6640 Group Processes and Stages of Formation Essay

Bitter, J. (2014).
Theory and practice of family therapy and counseling
(2
nd
ed.). Belmont, CA: Brooks/Cole.

Psychotherapy.net (Producer). (2011).
Group therapy: a live demonstration
. [Video file]. Mill Valley, CA: Author.

Wheeler, K. (Eds.). (2014).
Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
(2
nd
ed.). New York, NY: Springer Publishing Company. Nurs 6640 Group Processes and Stages of Formation Essay

Psychotherapeutic Approaches to Group Therapy for Addiction Essay

Introduction

Identify the psychotherapeutic approach that the group facilitator is using, and explain why she might be using this approach.

Determine whether or not you would use the same psychotherapeutic approach if you were the counselor facilitating this group, and justify your decision.

Identify an alternative approach to group therapy for addiction, and explain why it is an appropriate option.

Support your position with evidence-based literature. Psychotherapeutic Approaches to Group Therapy for Addiction Essay.

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Resource:

Laureate Education (Producer). (2013d). Levy family: Sessions 1-7 [Video file]. Baltimore, MD; Author.

Psychotherapeutic approaches

Introduction

Psychotherapy is a tool that allows for psychiatric problems to be addressed. It is not surprising that psychotherapy is used to address addiction. The delivery of psychotherapy is not particular and can be applied in group settings where addicts are offered a controlled environment in which to address addiction as a social problem (Wheeler, 2014). The present paper discusses the use of psychotherapy in the management of addiction.

Discussion

Part 1.

Psychodynamic model is being applied in the group sessions. In this case, the model has been applied to clarify the clients’ development, growth and behavior. The counselor seems to be using the model to gain a contextual awareness of the clients and their psychological issues. Through using the approach, the counselor was able to evaluate the clients’ development, growth and behavior as social functions that provide an awareness of the unconscious motivations, energies, and efforts responsible for the addiction (Wheeler, 2014). Through using this approach, the counselor has been able to form an accepting, empathetic and understanding relationship with Levy family members thereby allowing them to be more confident and trusting. This allows the counselor to develop and apply a targeted approach that is particular to the family’s needs. Psychotherapeutic Approaches to Group Therapy for Addiction Essay.

Part 2.

The psychodynamic model focuses on subconscious thought, and is not a suitable approach for the present case. Although this approach applies logical sequential steps that move from initial awareness of the prevailing problem towards a fitting solution that would be presented as a non-problem state, it is not an ideal approach for this situation (Wheeler, 2014). The person-centered model focuses on conscious thought and would be a more suitable approach. That is because the main issue in the case appears to be PTSD with the addiction being a consequence. Mr. Levy suffers from PTSD owing to his experiences as a soldier. He developed depression and anxiety as a result of the PTSD, and turned to alcohol as a coping mechanism. Repeated alcohol consumption has caused him to develop an addiction. The person-centered approach is more suitable since it would address PTSD as the underlying problem thereby eliminating the cause of the addiction. In addition, the approach would allow the client to better adjust and identify other activities that would reduce the addiction thereby allowing Mr. Levy to become addiction-free. Psychotherapeutic Approaches to Group Therapy for Addiction Essay. Besides targeting Mr. Levy, the approach would also be suitable for helping the whole family to socially adjust to the changes with a focus on improving their intellectual, physical, social and moral capacities. To be more precise, it would allow the family members to share their problems and consult each other in developing solutions, especially if the problem and solution have an effect on interactions between family members (Thompson, 2016).

Part 3.

Other than group therapy, the medication should be used as an alternative approach. This would entail using chemical agents that modify brain chemistry to reduce the addiction. There are FDA approved medication that would be appropriate for the present case to address the addiction. These medications include naltrexone, disulfiram, acamprosate, and naltrexone (Gorski, 2016). Other medications handle the case include baclofen, quetiapine, aripiprazole, sertraline, topiramate, and ondansetron. Apart from prescribing medication for the addiction, there is a need to prescribe medication for the withdrawal symptoms that could become overbearing if left unaddressed. Also, medication can be prescribed for the PTSD, anxiety and depression (Rutan, Stone & Shay, 2014). Psychotherapeutic Approaches to Group Therapy for Addiction Essay.

References

Gorski, T. (2016).
Problem-solving group therapy: a group leader’s guide for developing and implementing group treatment plans
. New York, NY: BookBaby/Self-Help.

Rutan, S., Stone, W. & Shay, J. (2014).
Psychodynamic group psychotherapy
(5
th
ed.). New York, NY: Guilford Publications. Psychotherapeutic Approaches to Group Therapy for Addiction Essay.

Thompson, R. (2016).
Counseling techniques: improving relationships with others, ourselves, our families, and our environments
(3
rd
ed.). New York, NY: Routledge.

Wheeler, K. (Ed.). (2014).
Psychotherapy for the advanced practice psychiatric nurse: a how-to guide for evidence-based practice
. New York, NY: Springer. Psychotherapeutic Approaches to Group Therapy for Addiction Essay.

CBT in group and family settings

Post an explanation of how the use of CBT in groups compares to its use in family settings. Provide specific examples from your own practicum experiences. Then, explain at least two challenges counselors might encounter when using CBT in the group setting. Support your response with specific examples from this week’s media.

CBT in Group and Family Settings

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Introduction

Cognitive behavioral therapy (CBT) uses cognitive restructuring to change the maladaptive negative thinking pattern and behavior into a positive thinking pattern. CBT hypothesizes that an individual can be vulnerable to maladaptive thinking pattern of self, surrounding and the world in general. The focus of this discussion on the use of CBT in family and group settings (Thimm & Liss, 2014) CBT in group and family settings.

CBT in a group setting focuses on providing therapy to a number of people undergoing similar problems to change their maladaptive thinking patterns a more adaptive thinking pattern. The therapist focuses on the relationship between him/herself, the group, as well as the individual members of the group. Team members benefit from group therapy by sharing their challenges with other group members who might be having similar challenges (Wheeler, 2014). The group through members are a source of support and morale to each other since all members experience similar problems and challenges. CBT in group and family settings. In addition, by attending numerous individuals at once, the therapist can provide help to more individuals simultaneously (Thimm & Liss, 2014). During the practicum, I handled a group of members who all had a diagnosis of major depressive disorder.

CBT in a family setting hypothesizes that feelings, emotions, and behaviors are mutually influencing among family members. It, therefore, focuses on providing support to the members of the family to alter their thinking into more adaptive thinking and to ensure family members make better decisions and improve the atmosphere of the family setting (Wheeler, 2014). An example is a family where the husband was having an alcohol use disorder and both the wife and husband were involved in the therapy. CBT in group and family settings.

Some challenges counselors encounter while using the group setting include difficulties in restructuring the thinking pattern of people at the same time. Secondly, issues of privacy and confidentiality may present a challenge in a group setting (Ringle et al, 2015). CBT in group and family settings.

References

Ringle, V. A., Read, K. L., Edmunds, J. M., Brodman, D. M., Kendall, P. C., Barg, F., & Beidas, R. S. (2015). Barriers to and Facilitators in the Implementation of Cognitive-Behavioral Therapy for Youth Anxiety in the Community. 
Psychiatric services (Washington, D.C.)
. 
66
(9), 938-45.

Thimm J & Liss A. (2014). Effectiveness of cognitive behavioral group therapy for depression in routine practice.
BMC Psychiatry
. 14(292).

Wheeler, K. (Ed.). (2014).
Psychotherapy for the advanced practice psychiatric nurse: A how-to

       guide for evidence-based practice
. New York, NY: Springer. CBT in group and family settings

Working With Children and Adolescents Versus Adults Essay Discussion

Discussion: Working with Children and Adolescents versus Adults

Importance of Developmental Assessments

Developmental assessment in children is used to evaluate different facets of the child’s functioning like behavior, social interaction, cognition, communication, sensory abilities, motor abilities, as well as adaptive skills (Sadock, et al, 2014). Developmental assessment entails conducting accurate evaluations to determine the ability of a child to meet the essential developmental milestones and objectives. Working With Children and Adolescents Versus Adults Essay Discussion. In addition, it examines the performance and the ability of the child to perform common daily activities and tasks. Therefore, developmental assessment can help in identifying potential developmental problems and the need for more diagnostic examination; provides an objective account of the child’s deficits and abilities; and also helps in planning for suitable interventions (Thapar et al, 2015). In children diagnosed with or with suspected autism, all developmental domains should be assessed.

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Assessment Instruments to Evaluate Children and adolescents

The Modified Checklist for Autism in Toddlers (M-CHAT) instrument: This tool is utilized to evaluate children aged 16 months to 2 years and a half to examine their risk for autism. The tool has a set of 23 questions and it can be administered and scored as a component of well-child review and can also be utilized by specialists and other healthcare providers to assess a child’s risk to autism spectrum disorders.  The main aim of this instrument is to make the most of sensitivity and hence identify a high number of children with autism (Kleinman et al, 2013). Children who fail more than three items are supposed to be referred for diagnostic assessment by a specialist. Working With Children and Adolescents Versus Adults Essay Discussion.

Pediatric Symptom Checklist-17 (PSC-17): This is a brief questionnaire that is used to identify and evaluate for any emotional and behavioral changes and problems in children. This tool covers numerous behavioral and psychological problems. It is purposely used to examine the psychosocial functioning of the child. The tool has 35-item parent-reported questions as well as a youth self-report, a graphic version as well as a shorter 17-item version for parents and children (Murphy et al, 2016).

Treatment Options for Children and Adolescents

Floortime: This treatment entails the parent lying on the floor with the child and playing and performing the activities the childlike playing. Therapist and the parents engage the child through the activities preferred and enjoyed by the child and follow the child’s lead while playing. Floortime intervention aims at supporting the child’s emotional and cognitive development by assisting the child to learn emotional and communication skills (Mercer, 2015).

Kapvay: This is a non-stimulant and a long-acting clonidine used to treat AD/HD in children/adolescents aged between 6 to 17 years. The medication is normally prescribed two times a day and it is normally started at 0.1 mg and can be increased up to 0.2 mg two times a day.

The Parents’ Role

Parents play an important role in the assessment and treatment of children. First, parents have the duty of giving consent when children are being assessed and treated because minors are not supposed to give consent to their treatment. Secondly, during assessment parents act as informants and providing important information that may facilitate making an accurate diagnosis. Lastly, parents play a key role in ensuring that their children adhere to the treatment regimen (Sadock, et al, 2014). Working With Children and Adolescents Versus Adults Essay Discussion.

References

Kleinman J, Robins D, Ventola P, Juhi P, Hilarly B, Esser E, Wilson L et al. (2013). The Modified Checklist for Autism in Toddlers: A Follow-up Study Investigating the Early Detection of Autism Spectrum Disorders.
J Autism Dev Disord
. 38(5), 827–839.

Mercer J. (2015). Examining DIR/Floortime™ as a Treatment for Children With Autism Spectrum Disorders: A Review of Research and Theory.
SAGE Journals
. 27(5), 625-635

Murphy M, Paul B, Chiang C, Sturner R, Howard B, Abel M & Michael J. (2016). The PSC-17: Subscale Scores, Reliability, and Factor Structure in a New National Sample.
Pediatrics
. 138(3), e20160038.

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.

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. Working With Children and Adolescents Versus Adults Essay Discussion.

 

 

Discussion: Working With Children and Adolescents Versus Adults

Infant, childhood, and adolescent development are a continual interplay between nature (genetic or biologic predisposition) and nurture (environmental experiences). The nature/nurture continuum and debate will always be a part of your career as a PMHNP. Knowing common developmental milestone is important in the role as a child provider. Not only is it essential to the diagnostic process, but it is also important to the interdisciplinary interactions with other mental health professionals. The study of normal developmental processes, however, is only one tool that allows the mental health professional to understand the child being evaluated. There are many different assessment instruments and interviewing techniques that PMHNPs can have in their toolkit when working with children and adolescents.

In this Discussion, you examine the differences in assessing and treating children and adolescents versus adults. You take into consideration your own clinical experiences, as well as your experiences in your clinical rotation, and the information from the readings thus far.

Learning Objectives

Students will:

•Analyze the importance of developmental assessments

•Analyze assessment instruments used for evaluating children and adolescents

•Analyze treatment options used for children and adolescents

•Analyze roles parents play in assessment and treatment

To Prepare for the Discussion

•Review the Learning Resources concerning psychiatric assessments and assessment tools.

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!

By Day 3

Post your answers to the following:

•Explain why a developmental assessment of children and adolescents is important.

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

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

•Explain the role parents play in assessment and treatment. Working With Children and Adolescents Versus Adults Essay Discussion

 

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 2, “Contributions of the Psychosocial Sciences” (pp. 93–130)

•Chapter 6, “Classification in Psychiatry” (pp. 290–299)

•Chapter 31, “Child Psychiatry” (pp. 1107–1152)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

•“Neurodevelopmental Disorders”

•“Intellectual Disabilities”

•“Communication Disorders”

Note: You will access this book from the Walden Library databases.

Resume, Portfolio, and Cover Letter Resources

CoverLetter.us. (2017). Nurse practitioner cover letter sample 1. Retrieved from http://www.coverletter.us/nurse-practitioner-cover-letter/ Working With Children and Adolescents Versus Adults Essay Discussion

Dahring, R. (2013). Cover letter caveats. Retrieved from https://web.archive.org/web/20161117160433/http://nurse-practitioners-and-physician-assistants.advanceweb.com:80/Columns/Career-Coach/Cover-Letter-Caveats.aspx

Porche, D. J., & Danna, D. (2015). Cover letter & resume preparation: Every detail is important when applying for a job. Advance Healthcare Network for NPs & PAs. Retrieved from https://web.archive.org/web/20160818183515/http://nurse-practitioners-and-physician-assistants.advanceweb.com:80/Features/Articles/Cover-Letter-Resume-Preparation.aspx

Walden University Career Services Center. (2017). Resumes & CVs: Home. Retrieved from http://academicguides.waldenu.edu/careerservices/resumesandcvs

Document: Cover Letter, Resume, and Portfolio Assignment Guide (PDF)

Optional Resources

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.

•Chapter 2, “Diagnosis, Diagnostic Formulations, and Classification” (pp. 17–30) Working With Children and Adolescents Versus Adults Essay Discussion

Conduct Disorder Parent Guide

Introduction

Conduct disorder is classified among disorders of disruptive behavior which are often comorbid with other defiant disorders. Conduct disorder is characterized by a pattern of behaviors which demonstrate a violation of rights and aggression. It has a complex etiology which is as a result of the interaction of several psychosocial and biological factors. Biologically, a low level of p5-hydroxy indole acetic acid levels in CSF tends to correlate with violence and aggression among children and adolescents Conduct Disorder Parent Guide. A family which lacks structure and supervision with occasional conflicts between parents and siblings results to maladaptive behaviors. This paper discusses the Conduct disorder including its signs and symptoms, pathophysiology, diagnosis, and currently available treatment options.

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Signs and Symptoms

The signs and symptoms of conduct disorder vary with age and are highly dependent on whether the condition is moderate, mild or severe. The first sign is aggressive behavior which may result in physical harm. Aggressive behavior may be in the form of fighting, bullying, forced sexual activity and cruelty to animals or others. Children may also display destructive behavior where they intentionally destroy and vandalize property (Blair, Leibenluft & Pine, 2014). Other children may display deceitful behavior where they repeatedly lie, break into cars or homes to steal or even shoplift. The last sign is that of violating rules such that, a child frequently goes against societal accepted rules or even engage in behaviors which are not appropriate for the child’s age (Blair, Leibenluft & Pine, 2014). Key examples of such behaviors may include sexual activity at a very young age, running away and skipping school Conduct Disorder Parent Guide.

Pathophysiology

 

Behaviors which are a problematic result from a child’s temperamental characteristics and environmental influences that shape the child’s temperament. As young as 2 years, the signs of irritability, inattentiveness, impulsivity, and compliance can result in behavioral patterns which negatively influence conduct in later ages (Sadock, Sadock & Ruiz, 2014). Due to difficulties with a child’s temperament, even parents with good intentions get involved in a negative cycle and can even isolate themselves from communal and family support. As a child advances, those with problems in conduct progressively display aggression and impulsivity with peers since they lack the skills for socializing (Sadock, Sadock & Ruiz, 2014). By the time they reach adolescence, most of them experience anger episodes and resort to being aggressive rather than responses that are verbally mediated.

Diagnosis of Conduct Disorder

Based on the DSM-V criteria for diagnosing mental health disorders, conduct disorder is diagnosed among individuals with a positive history of habitually violating the rights of other people such that, he/she fails to confirm individual behaviors to social norms that are appropriate for age. Besides, an individual ought to have at least four of the signs and symptoms in the categories of being aggressive to animals and people, destroying property, theft and deceit and serious violation of rules (American Psychiatric Association, 2013).   Some of the behaviors may include: using a weapon to harm others, frequent physical confrontations with others, aggressive behavior towards animals or others, destroying property with arson or other means, an incident of forcibly influencing another to engage in sex, engaging in economic crimes and running away from home at least twice(American Psychiatric Association, 2013).  The behaviors should also have significant impairment on the physical, social and mental functioning of the individual who should either be an adolescent or a child.  The child or adolescent may also have limited prosocial emotions such as lack of empathy, guilt or remorse, not concerned about his/her performance and a deficient effect.

Treatment Options

           
Treatment for conduct disorder aims at decreasing or eliminating behavioral problems in the short term while working towards the long-term goal of preventing the behavioral problems of children from worsening with time. Multiple modalities of treatment have proven to be highly effective in treatment especially the combination of psychotherapy with medications. The most effective psychotherapeutic approach is cognitive behavioral therapy (Sadock, Sadock & Ruiz, 2014). In this case, CBT is used in the context that behavioral which are not appropriate can be unlearned and replaced with pro-social ones which are more meaningful.  This is done through a systematic manipulation of consequences and rewards which promote behaviors which are pro-social and discourage those that are antisocial. Majority of the parents with children who have conduct disorder tend to blame themselves for creating a number of problems in a child’s life(Sadock, Sadock & Ruiz, 2014). Therefore, Family therapy can also be used to improve the interactions and communication among family members by addressing family conflict. For instance, parent management training can be used to teach parents how to positively change the behavior of a child at home.

Medications that have proven to be effective in the management of conduct disorder aim at reducing a child’s distressing symptoms such as aggression, impulse and other underlying mental illnesses that may be in existence. Generally, atypical antipsychotics such as risperidone are indicated for the management of mood lability (Pringsheim et al., 2015).  Clonidine, a beta blocker may also be used to control aggression and impulsivity. Anticonvulsants such as lithium have also proven to be effective in managing aggression and symptoms of mood disorders. Fluoxetine, which is a selective serotonin reuptake inhibitor, has proven to benefit patients with rigid, depressive aggressive behaviors (Pringsheim et al., 2015).   Stimulants are also effective in managing aggressiveness and impulsivity but need close parental monitoring due to high street value and a high potential for abuse from peers.

 

 

References

.American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Blair, R. J. R., Leibenluft, E., & Pine, D. S. (2014). Conduct disorder and callous-unemotional traits in youth.
New England Journal of Medicine
, 
371
(23), 2207-2216.

Pringsheim, T., Hirsch, L., Gardner, D., & Gorman, D. A. (2015). The pharmacological management of oppositional behavior, conduct problems, and aggression in children and adolescents with attention-deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder: a systematic review and meta-analysis. Part 1: psychostimulants, alpha-2 agonists, and atomoxetine.
The Canadian Journal of Psychiatry
, 
60
(2), 42-51.

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 Conduct Disorder Parent Guide

 

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

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

•Standard 5E “Pharmacological, Biological and Integrative Therapies” (page 59)

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. Conduct Disorder Parent Guide.

•Chapter 3, “Contributions of the Sociocultural Sciences” (pp. 131–150)

•Chapter 31, “Child Psychiatry” (pp. 1152–1181, 1244–1253)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

•“Neurodevelopmental Disorders”

•“Intellectual Disabilities”

•“Communication Disorders”

•“Disruptive, Impulse-Control, and Conduct Disorders”

Note: You will access this book from the Walden Library databases.

Volkmar, F., Siegel, M., Woodbury-Smith, M., King, B., McCracken, J., & State, M. (2014). Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 53(2), 237–257. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00819-8/pdf Conduct Disorder Parent Guide

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Note: All Stahl resources can be accessed through the Walden Library using the link. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.

To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication. Conduct Disorder Parent Guide

Review the following medications:

Irritability in autism

Attention-deficit/hyperactivity disorder

aripiprazole

risperidone

armodafinil

amphetamine (d)

amphetamine (d,l)

atomoxetine

bupropion

chlorpromazine (hyperactivity)

clonidine

guanfacine

haloperidol (hyperactivity)

lisdexamfetamine

methylphenidate (d)

methylphenidate (d,l)

modafinil

reboxetine

Note: Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.”

Required Media

Laureate Education (Producer). (2017b). A young girl with difficulties in school [Multimedia file]. Baltimore, MD: Author. Conduct Disorder Parent Guide

Optional Resources

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.

•Chapter 51, “Autism Spectrum Disorder” (pp. 665–682)

Discussion: Parent Guide

Note: You and your group will use the wiki function to develop three Parent Guides (one in Week 3, one in Week 7, and one in Week 10). A wiki is a site that allows collaborative editing by all users. Each group will have its own place to communicate and collaborate on the assignments. Once your group has completed each assignment, one member should transfer the information to its final format and submit it through the group submission link in the Discussion. Do not delete the assignment from the wiki format, as your Instructor will review this area to determine each member’s participation.

Collaboration is essential to accurate diagnosis of the conditions under consideration in this week. For this week’s Discussion, you practice collaboration by working in a group on developing a “Parent Guide,” which will serve as a teaching tool for parents with children who have been diagnosed with a specific mental health disorder Conduct Disorder Parent Guide.

It is recommended that you make your project as attractive as possible and consider using the finished product as teaching tools for families that you will work with in your own practices.

Learning Objectives

Students will:

•Analyze signs and symptoms of neurodevelopmental disorders

•Analyze the pathophysiology of neurodevelopmental disorders

•Analyze diagnosis and treatment methods for neurodevelopmental disorders

•Evaluate Parent Guides Conduct Disorder Parent Guide

To Prepare for this Discussion:

•Your Instructor will assign you to a group and a disorder by Day 1 of Week 2.

•Review the resources concerning your assigned disorder.

•Review the Blackboard Help website concerning wikis.

•Use your group’s Discussion Board to design and develop the Parent Guide before posting to the group wiki. For further guidance, refer to the Accessing Group Discussions instructions below.

Using evidence-based research, design and develop a Parent Guide for your assigned disorder including:

•Signs and symptoms

•Pathophysiology

•How the disorder is diagnosed

•Treatment options

Provide a minimum of three academic references. Conduct Disorder Parent Guide

Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree

Assignment 1: Practicum: Decision Tree

Introduction

The focus of the assignment is on making three decisions regarding the diagnosis and treatment of a client, 8-year-old Caucasian female with school difficulties. The first decision will involve making a differential diagnosis for the client and providing a rationale for selecting the decision. The second decision will involve making a decision about the treatment pan psychotherapy and providing a rationale for the decision. The last decision will be about treatment plan psychopharmacology and justifying the decision. In addition, the co-morbid physical and mental factors that may affect the diagnosis and treatment of the client will be considered. Finally, the paper will discuss the ethical considerations that may influence the treatment plan and communication with the client and her family. Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree.

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Decision #1: Differential Diagnosis

The selected decision for the differential diagnosis of the client is 314.00 Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation. This decision was selected because the client meets the criterion for A1 (inattention) for ADHD.  According to American Psychiatric Association (2013) the DSM-5 criteria confirming diagnosis of ADHD inattention include: the person fails to be attentive to details or makes mistakes in work, classwork, and other activities; difficulties in maintaining attention in tasks or play activities; often seems like one is not listening when spoken to directly; fails to follow through on instructions, does not finish classwork, chore or workplace duties; experiences difficulties in tasks and activities organization; normally avoids, does not like or is unwilling to take part in activities or tasks that need sustained mental efforts such as classwork or homework; regularly misplaces things essential for activities or tasks such as pens, books, toys; gets easily diverted and distracted by unnecessary stimuli and is often forgetful in daily activities (Volkmar et al, 2014). The client meets most of the above symptoms as indicated by the scoring of the Conner’s Teacher Rating Scale, subjective data and mental status exam. The Conner’s Teacher Rating Scale indicated that the client is inattentive, gets distracted easily, makes careless mistakes in her classwork, forgetful about the already learned content, poor in arithmetic, spelling and reading, short attention span and has difficulties in peer interactions. Subjective data indicated that the client could not sit still during the interview, was interruptive and reported that her mind wanders during class Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree. The mental status exam revealed that the client’s attention and concentration were somehow limited.  Other standardized assessment instruments that might be essential in identifying symptoms of ADHD include
ACTeRS and the Vanderbilt Assessment Scale.
In addition, the
Child Behavior Checklist can be used to further assess the behavior of the client (Sadock et al, 2014).

By selecting this decision, the expectation was that the correct diagnosis for the client would facilitate appropriate prescribing of the treatment regimen for the client.

Decision #2: Treatment Plan for Psychotherapy

The selected decision is to begin Adderall XR 10 mg orally daily. Adderall is a branded combination of (75%) dextroamphetamine along with (25%) levoamphetamine salts. This decision was selected because Adderall is FDA approved for the treatment of ADHD. In addition, evidence shows that Adderall is a stimulant that is effective in improving and balancing neurotransmitters level within the brain. Adderall also has minimal side effects and has fewer rebound symptoms because the medication wears off gradually and it is typically a long-lasting medication (Lakhan & Kirchgessner, 2013). According to Lakhan & Kirchgessner (2013), Adderall is an extended-release formulation that has a duration action of about 10-12 hours. This is a notably longer duration of action when compared to the majority of other methylphenidate formulations whose duration of action is a maximum of 6 hours. In addition, studies show that Adderall is a neuro-enhancement medication that is effective in memory improvement, improving focus and attention span (Lakhan & Kirchgessner, 2013). Accordingly, Adderall would be effective in treating the symptoms and signs of ADHD for the client. Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree.

By choosing this decision, it was expected that symptoms and signs of ADHD for the client would improve since Adderall has been shown to be effective in improving symptoms such as attention span. Specifically, it was hoped that the client’s disruptive behavior would reduce as well as her ability to focus and pay attention. It was also hoped that the medication would improve the client’s episodic memory and hence reduce her forgetfulness. This is because a study conducted by Advokat & Mindy (2013) demonstrated that Adderall is a stimulant that has the ability to improve episodic memory in individuals with ADHD and also has some cognitive benefit.

The result for this decision was that there was an improvement in signs and symptoms of ADHD for the client as manifested by the ability of the client to be more attentive at school and the ability to maintain attention throughout the morning classes. This outcome was consistent with the expected outcome. However, during the afternoon the client would “daydream” which means she was not able to maintain attention in the afternoon. The reason for the client being not able to maintain attention in the afternoon was that the medication dose administered had worn off and therefore the inattentive symptoms would begin manifesting again prior to the administration of the subsequent dose of Adderall (Advokat & Mindy, 2013).  It was also reported that the client started losing appetite after she started taking Adderall. The loss of appetite for the client can be attributed to the medication’s side effects. Appetite loss is a common side effect with this medication because it suppresses appetite (Sallee, 2015).

Decision #3: Treatment Plan for Psychopharmacology

The selected decision for the client’s treatment plan for psychopharmacology is the addition of a small dose of immediate release of Adderall in the early afternoon. This decision was selected because the client has been showing inattentiveness during the afternoon because by afternoon the medication wears off. Therefore, the addition of a small dose of Adderall in the afternoon for the client will ensure that the client will maintain attention in the afternoon as well. In addition, the addition of a small dose of immediate release of Adderall would help the client to maintain attention during early evening and hence she will be able to do any homework given at school (Heal et al, 2013).

The reason why the decision to assure the parents that weight loss is a common side effect with Adderall was not chosen is because this option will not assist the client in maintaining attention in the afternoon classes. Secondly, the option of augmenting the Adderall treatment with family therapy was not selected because the family therapy would not solve the issue of return of the return of inattentive symptoms during the afternoon classes (Heal et al, 2013). Accordingly, this justifies the decision to add a small dose of immediate release of Adderall in the early afternoon in order to enable the client to maintain attention even during the afternoon. Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree.

Ethical Considerations in Treatment Plan

It will be important to ensure that the professional legal obligations of ensuring optimal treatment for the client are met. Therefore, it should be ensured that the assessment and treatment of Katie is I accordance with the current professional guidelines (American Nurses Association, 2014). Informed consent should be sought from the parents of Katie while Katie should also be allowed to assent to the treatment. This is because any assessment or treatment without seeking informed consent involves a legal misdemeanor of battery. Accordingly, in this case, it will be important to seek consent from the client’s parents but at the same time try to take into account the views and wishes of Katie (Merman et al, 2017). The treatment process for the client will also involve respect for autonomy by obtaining suitable consent Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree. Moreover, the hyperactivity presents an ethical conflict between justice and beneficence/non‐maleficence. Other ethical aspects include the addictive effects of ADHD treatments and also evidence shows that ADHD treatment may have irreversible effects on the central nervous system. Accordingly, the healthcare practitioner should educate the client’s parents regarding the potential side effects of the proposed treatment to ensure the parents are fully informed before they consent into the treatment (Merman et al, 2017).

Conclusion

The selected decision for the differential diagnosis of the client is 314.00 Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation. This is because the client meets the criterion for A1 (inattention) for ADHD as per DSM-5. The selected decision for decision point two is to begin Adderall XR 10 mg orally daily. The rationale for selecting this decision is because Adderall has been shown to be effective in improving signs and symptoms of ADHD by improving and balancing neurotransmitters level within the brain. The selected decision for decision point three is to add a small dose of immediate release of Adderall in the early afternoon. The rationale for selecting this decision is to ensure that the client will be able to maintain attention even during the afternoon.  Finally, it will be important to seek consent from the parents of Katie and also integrate wishes and views of Katie in the treatment plan. It is also important to educate the parents about the possible side effects of the proposed treatment regimen.

 

 

References

Advokat C & Mindy S. (2013). Attention-deficit hyperactivity disorder (ADHD) stimulant medications as cognitive enhancers.
Front Neurosci
. 7(82).

American Nurses Association. (2014).
Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.)
. Washington, DC: Author.

American Psychiatric Association. (2013).
Diagnostic and statistical manual of mental disorders
(5th ed.). Washington, DC: Author.

Heal D, Smith S, Gosden  & Nutt D. (2013). Amphetamine, past and present – a pharmacological and clinical perspective.
J Psychopharmacology
. 27(6), 479–496.

Lakhan S & Kirchgessner A. (2013). Prescription stimulants in individuals with and without attention deficit hyperactivity disorder: misuse, cognitive impact, and adverse effects.
Brain Behav
. 2(5), 661–677.

Merman S, Laura B, Hans G & Frances A. (2017). ADHD: a critical update for educational professionals.
Int J Qual Stud Health Well-being
. 12(1): 1298267.

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014).
Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.)
. Philadelphia, PA: Wolters Kluwe

Sallee F. (2015). Early Morning Functioning in Stimulant-Treated Children and Adolescents with Attention-Deficit/Hyperactivity Disorder, and its Impact on Caregivers.
J Child Adolesc Psychopharmacol
. 25(7): 558–565.

Volkmar, F., Siegel, M., Woodbury-Smith, M., King, B., McCracken, J., & State, M. (2014). Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder.
Journal of the American Academy of Child & Adolescent Psychiatry
. 53(2), 237–257.

 

Week 3: Autism Spectrum Disorder, ADHD, ODD, and ICD

”I can’t believe I am sitting here talking to this lady. Mom thinks I am nuts just because I will not do what she asks. She does not care about me. She only cares about my little brother and that man that keeps coming around. I don’t care anything about her. Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree.  That is why I throw things and won’t do what she asks. I don’t care about anyone. Those kids at school who used to be my friends don’t know anything. I am so much smarter than they are.

Jacob, age 11”

There are many mental disorders that occur early in the life course. The DSM-5 describes neurodevelopmental disorders such as autism spectrum disorder and ADHD and disruptive, impulse-control, and conduct disorders, such as oppositional defiant disorder and conduct disorder. These disorders are examined together with a particular emphasis on comparing and contrasting presenting features. Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree. Diagnosis of these various conditions can rarely be made in a single office setting and often require a comprehensive approach involving multiple stakeholders, including the child, as well as his or her parents, teachers, and other significant figures in the child’s life and mental health professionals, such as psychologists who can conduct comprehensive neuropsychological testing.

The PMHNP must coordinate and integrate several sources of information to arrive at an accurate diagnosis of these disorders. Early and accurate diagnosis is essential to developing an effective treatment plan, which will have the potential to minimize the impact of these disorders on the child’s developmental trajectory. When one considers appropriate diagnosis from this perspective, the importance of diagnostic accuracy becomes quite apparent Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree.

This week, you begin exploring disorders that occur early in the life course by working with your group to develop a Parent Guide. You also examine a case to determine a differential diagnosis and treatment plan that incorporates both psychotherapy and psychopharmacology.

Photo Credit: Cultura/Seb Oliver / Cultura / Getty Images

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. Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree.

Required Readings

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

•Standard 5E “Pharmacological, Biological and Integrative Therapies” (page 59)

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 3, “Contributions of the Sociocultural Sciences” (pp. 131–150)

•Chapter 31, “Child Psychiatry” (pp. 1152–1181, 1244–1253) Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

•“Neurodevelopmental Disorders”

•“Intellectual Disabilities”

•“Communication Disorders”

•“Disruptive, Impulse-Control, and Conduct Disorders”

Note: You will access this book from the Walden Library databases.

Volkmar, F., Siegel, M., Woodbury-Smith, M., King, B., McCracken, J., & State, M. (2014). Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 53(2), 237–257. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00819-8/pdf Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree.

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Note: All Stahl resources can be accessed through the Walden Library using the link. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.

To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Review the following medications:

Irritability in autism

Attention-deficit/hyperactivity disorder

aripiprazole

risperidone

armodafinil

amphetamine (d)

amphetamine (d,l)

atomoxetine

bupropion

chlorpromazine (hyperactivity)

clonidine

guanfacine

haloperidol (hyperactivity)

lisdexamfetamine

methylphenidate (d)

methylphenidate (d,l)

modafinil

reboxetine

Note: Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.” Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree.

Required Media

Laureate Education (Producer). (2017b). A young girl with difficulties in school [Multimedia file]. Baltimore, MD: Author.

Optional Resources

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.

•Chapter 51, “Autism Spectrum Disorder” (pp. 665–682)

Assignment 1: Practicum: Decision Tree

For this Assignment, you examine the client case study in this week’s Learning Resources. Consider how you might assess and treat pediatric clients presenting with symptoms noted in the case.

Note: This Assignment is the first of three assignments that are based on interactive client case studies. For these assignments, you will be required to make decisions about how to assess and treat clients. Each of your decisions will have a consequence. Some consequences will be insignificant, and others may be life altering. You are not expected to make the “right” decision every time; in fact, some scenarios may not have a “right” decision. You are, however, expected to learn from each decision you make and demonstrate the ability to weigh risks versus benefits to prescribe appropriate treatments for clients. Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree.

Learning Objectives

Students will:

•Evaluate clients for treatment of mental health disorders

•Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

The Assignment:

Examine Case 1. You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following:

•Decision #1: Differential Diagnosis

•Which Decision did you select?

•Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

•What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources. Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree

•Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?

•Decision #2: Treatment Plan for Psychotherapy

•Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

•What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

•Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?

•Decision #3: Treatment Plan for Psychopharmacology

•Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

•What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources. Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree.

•Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

•Also include how ethical considerations might impact your treatment plan and communication with clients and their families. Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree.

Analyzing an Ethical Decision Practicum Journal Entry Essay Assignment

Analyzing an Ethical Decision

Article: “Zhang S, Graham M, Brink J & Wang X. (2015). Involuntary admission and treatment of patients with mental disorder.
Neurosci Bull
. 31(1), 99–112”.

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Ethical Issue in the Article

Ethics involving involuntary treatment for people with mental illness revolve about protecting patients and other people and the ethical and legal aspects of balancing the autonomy and rights of the patient with the public rights (Sadock et al, 2014). Sometimes psychiatric patients do not consider themselves to be ill while other times they refuse to undergo treatment and therefore they may end up being forced to undergo treatment against their will (Zhang et al, 2015). Moreover, majority of voluntary psychiatric patients are coerced into accepting treatment maybe by the family, employer, friends or medical personnel. Accordingly, the involuntary treatment of psychiatric people brings in ethical issues in regard to autonomy and informed consent (Zhang et al, 2015). This is because involuntary treatment may be viewed to be violating the autonomy of the patient as well as the principle of informed consent. Analyzing an Ethical Decision Practicum Journal Entry Essay Assignment.

Moral and Ethical Dilemmas Surrounding the Issue

The moral and ethical dilemma surrounding the issue of voluntary vs. involuntary treatment occurs when the healthcare provider is forced to honor the autonomy of the patient and seek informed consent, and at the same time ensure that the patient gets the suitable treatment (Opsal et al, 2016). Mental illness can impair the patient’s judgment and their decision-making ability and hence such patients may not be able to make decisions regarding their treatment. Analyzing an Ethical Decision Practicum Journal Entry Essay Assignment. Accordingly, the healthcare provider has to make a decision between respecting the autonomy of the patient and being beneficent by providing treatment to be patient (Hustoft et al, 2018). The line separating the respect for the patient autonomy and beneficent care brings in moral and ethical dilemmas especially when handling individuals with severe mental illness. A healthcare provider should be able to justify and be heedful of any removal of the patient’s right and learn the responsibility of stripping a patient their freedom in order to provide the appropriate care (Hustoft et al, 2018).

Comparison to State Health Laws and Regulations in Missouri

Missouri has civil commitment laws that set out the procedure to determine when involuntary treatment is suitable for people with severe mental illness. Laws of Missouri permit the use of court-ordered treatment which is referred to as assisted outpatient treatment (AOT). For a person to be provided with the court-ordered treatment, the person must demonstrate probability of serious harm to self and other people, and show significant risk of physical harm that may result due to the inability of the individual to make treatment decisions because of the mental impairment (Lebenbaum et al, 2018) Analyzing an Ethical Decision Practicum Journal Entry Essay Assignment. Missouri laws also list the designated facilities acknowledged by the Department of Mental Health to offer involuntary detention services. Similarly, the principle of beneficence supports treatment for the best interests of the patient and if the patient is perceived to pose danger to self or other people, and is unwilling to get treatment (Lebenbaum et al, 2018). Analyzing an Ethical Decision Practicum Journal Entry Essay Assignment.

Process of Ethical Decision Making

The first step would be to recognize the ethical dilemma and gather the relevant factors about the dilemma. The second step would be to examine for the right-versus-wrong issues and test for right-versus-right paradigms. Finally, the organization policies regarding ethics and Missouri laws about involuntary treatment would be analyzed in order to make the appropriate ethical decisions (Brayley et al, 2015). Analyzing an Ethical Decision Practicum Journal Entry Essay Assignment.

References

Brayley J, Alston A & Rogers K. (2015). Legal criteria for involuntary mental health admission: clinician performance in recording grounds for decision.
Med J Aust
. 203 (8): 334.

Hustoft K, Larsen K et al. (2018). Voluntary or involuntary acute psychiatric hospitalization in Norway:A 24 h follow up study.
International Journal of Law and Psychiatry
. 56 (2018), 27-34

Lebenbaum M, Chiu M, Vigod S & Paul K. (2018). Prevalence and predictors of involuntary psychiatric hospital admissions in Ontario, Canada: a population-based linked administrative database study.
BJPsych Open
. 4(2), 31–38. Analyzing an Ethical Decision Practicum Journal Entry Essay Assignment.

Opsal A, Kare J & Clausen T. (2016). Perceived coercion to enter treatment among involuntarily and voluntarily admitted patients with substance use disorders.
BMC Health Serv Res
. 16(656).

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.

 

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

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author. Analyzing an Ethical Decision Practicum Journal Entry Essay Assignment.

•Standard 5D “Prescriptive Authority and Treatment” (page 58)

Note: Throughout the program you will be reading excerpts from the ANA’s Scope & Standards of Practice for Psychiatric-Mental Health Nursing. It is essential to your success on the ANCC board certification exam for Psychiatric/Mental Health Nurse Practitioners that you know the scope of practice of the advanced practice psychiatric/mental health nurse. You should also be able to differentiate between the generalist RN role in psychiatric/mental health nursing and the advanced practice nurse role.

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.

•“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 Analyzing an Ethical Decision Practicum Journal Entry Essay Assignment

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

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) Analyzing an Ethical Decision Practicum Journal Entry Essay Assignment

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. Analyzing an Ethical Decision Practicum Journal Entry Essay Assignment

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.

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.

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 Analyzing an Ethical Decision Practicum Journal Entry Essay Assignment

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.

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. Analyzing an Ethical Decision Practicum Journal Entry Essay Assignment

Treatment of Psychiatric Emergencies in Children Versus Adults Discussion Essay

Introduction

A psychiatric emergency is a disturbance of behaviour, mood, or thought which may lead to harm to the individual or others if untreated (Sadock, Sadock, & Ruiz, 2014).  In both pediatric and adult psychiatric emergencies, the clinician must ensure the safety of everyone involved.  A complete assessment should be performed.  Goals of the psychiatric emergency assessment are to determine whether client poses a risk of harm to self or others, confirm the presence of a psychiatric disorder, and determine factors that may have lead to the issue. It is also essential to determine how the illness has impaired the client’s normal level of functioning, identify the client’s strengths, target the problems for treatment, and determine the level of care the client requires (Carandang, Gray, Marval-Ospino, &MacPhee, 2012). Suicidal behaviours are one of the most common pediatric psychiatric emergencies. Treatment of Psychiatric Emergencies in Children Versus Adults Discussion Essay.

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Description of Adult Psychiatric Emergency Case

Working and doing my practicum in an acute psychiatric hospital, I have cared for many adults with psychiatric emergencies.  In my last rotation, a 30-year-old Caucasian female with suicidal ideations with a plan to overdose presented to the facility for evaluation.  She reported feeling overwhelmed due to (a) a recent separation from her husband, (b) becoming a single mother, and (c) struggling financially.  The client used a wheelchair due to a motor vehicle accident and felt she was a burden to her family.  A therapist assessed her, and the psychiatrist on call admitted the client with a diagnosis of major depressive disorder. Laboratory testing included a complete blood count, comprehensive metabolic panel, thyroid stimulating hormone level, magnesium level, phosphorous level, urine drug screen, urine pregnancy test, and pharmacogenetic testing for psychiatric medications.  After less than an hour on the adult unit, the client stated she wanted to go home and filled out paperwork requesting release. The client was placed on a 72-hour hold. Treatment of Psychiatric Emergencies in Children Versus Adults Discussion Essay.  An initial psychiatric evaluation was performed by the psychiatric mental health nurse practitioner later in the day, and the client was started on an antidepressant.  The client’s level of observation was downgraded to the line of sight after 24 hours then to every 15-minute checks the following day.  She received daily group psychotherapy, weekly individual psychotherapy, and evaluated by either a psychiatric mental health nurse practitioner or a psychiatrist daily.  Appointments for follow-up care were made, and the client was discharged home after 16 days in the facility. Treatment of Psychiatric Emergencies in Children Versus Adults Discussion Essay.

How a Child or Adolescent Would Be Treated Differently

If a pediatric client were to present with suicidal ideations with a plan, information would be gathered from both the parent or guardian and the child to form the diagnosis.  Laboratory testing would be the same as for the adult client except pregnancy testing; males and females below childbearing age would not require pregnancy testing (Lewandowski et al., 2013).  The psychiatric evaluation would be the same but may require the clinician to use simple words.  Children and adolescents would be asked about bullying at school or on social media and academic difficulties.  The child or adolescent would take part in family therapy sessions as a successful treatment of suicidality in the pediatric population is more likely to involve a family component (Lewandowski et al., 2013).  Selective serotonin reuptake inhibitors are the first-line medication for pediatric clients with moderate to severe depression. Treatment of Psychiatric Emergencies in Children Versus Adults Discussion Essay.

Ethical Issues

The treatment of children and adolescents requires the consent of their parents or guardians.  Each time a medication is changed, increased, or decreased consent from a parent or guardian must be obtained (Sadock, Sadock, & Ruiz, 2014).  Ethically, the clinician must recognize that children and adolescents must play a part in their treatment and obtain the assent of the minor whenever possible.

References

Carandang, C., Gray, C., Marval-Ospino, H., MacPhee, S. (2012). Child and adolescent psychiatric emergencies. In J. M. Rey (Ed.), 
IACAPAP e-textbook of child and adolescent mental health 
(pp.1-31). Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions. Retrieved from http://iacapap.org/wp-content/uploads/J.1-EMERGENCIES-072012.pdf

Lewandowski, R. E., Acri, M. C., Hoagwood, K. E., Olfson, M., Clarke, G., Gardner, W., …& Frank, S. (2013). Evidence for the management of adolescent depression. 
Pediatrics
, 
132
(4), e996-e1009. doi:10.1542/peds.2013-0600

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. Treatment of Psychiatric Emergencies in Children Versus Adults Discussion Essay.

 

Week 6: Emergency Psychiatric Care in Childhood and Adolescence

”I can’t believe I am not dead. I want to be dead, but those pills did not work as fast as I expected. Dad found me and called 911. I cannot go on living after what they said about me on the Internet. My life is ruined and I cannot go back to school or even show my face around here. They all think I am that way, but I am not. Dad thinks this was a mistake, but he is wrong. When I get out of here, I am going to try something different, and this time it will work.”

Jessica, age 13

When psychiatric emergencies arise, they can present many challenges to the PMHNP. While there are many approaches to emergencies that are similar, there are also significant differences when dealing with children and adolescents versus adults. This is particularly true with coordination of care, availability of resources, and legal implications of the psychiatric emergency. Treatment of Psychiatric Emergencies in Children Versus Adults Discussion Essay

This week, you examine psychiatric emergencies that arise during childhood and adolescence and compare how those emergencies are assessed and treated to those of adult clients.

Photo Credit: ijubaphoto / iStock / Getty Images Plus

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 23, “Emergency Psychiatric Medicine” (pp. 785–790)

Chapter 31, “Child Psychiatry” (pp. 1226–1253)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Bipolar and Related Disorders”

Note: You will access this book from the Walden Library databases.

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press. Treatment of Psychiatric Emergencies in Children Versus Adults Discussion Essay

Note: All Stahl resources can be accessed through the Walden Library using the link. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.

To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Review the following medications:

Reversal of benzodiazepine effects

flumazenil

Aggression

Behavioral problems

Cataplexy syndrome

clozapine

propranolol

zuclopenthixol

aripiprazole

asenapine

chlorpromazine

haloperidol

iloperidone

lurasidone

olanzapine

paliperidone

quetiapine

risperidone

ziprasidone

clomipramine

imipramine

sodium oxybate

Catatonia

Extrapyramidal side effects

Mania

alprazolam

chlordiazepoxide

clonazepam

clorazepate

diazepam

estazolam

flunitrazepam

flurazepam

loflazepate

lorazepam

midazolam

oxazepam

quazepam

temazepam

triazolam

benztropine

diphenhydramine

trihexyphenidyl

alprazolam (adjunct)

aripiprazole

asenapine

carbamazepine

chlorpromazine

clonazepam (adjunct)

iloperidone

lamotrigine

levetiracetam

lithium

lorazepam (adjunct)

lurasidone

olanzapine

quetiapine

risperidone

sertindole

valproate (divalproex)

ziprasidone

zotepine

Note: Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.” Treatment of Psychiatric Emergencies in Children Versus Adults Discussion Essay

Optional Resources

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.

Chapter 50, “Provision of Intensive Treatment: Intensive Outreach, Day Units, and In-Patient Units” (pp. 648–664)

Chapter 64, “Suicidal Behavior and Self-Harm” (pp. 893–912)

Discussion: Treatment of Psychiatric Emergencies in Children Versus Adults

The diagnosis of psychiatric emergencies can include a wide range of problems—from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations.

In this week’s Discussion, you compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients.

Learning Objectives

Students will:

Compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients

Analyze legal and ethical issues concerning treatment of child or adolescent psychiatric emergency clients

To Prepare:

Review the Learning Resources concerning emergency psychiatric medicine.

Consider a case where your adult client had a psychiatric emergency. (Note: If you have not had an adult client with a psychiatric emergency, ask your preceptor to describe one of their clients with a psychiatric emergency to use as an example for this Discussion.) Treatment of Psychiatric Emergencies in Children Versus Adults Discussion Essay

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!

By Day 3

Post:

Briefly describe the case you selected.

Explain how you would treat the client differently if he or she were a child or adolescent.

Explain any legal or ethical issues you would have to consider when working with a child or adolescent emergency case. Treatment of Psychiatric Emergencies in Children Versus Adults Discussion Essay