Differences in Treating a Child or Adolescent Discussion Assignment

Differences in Treating a Child or Adolescent Discussion Assignment

Client Description 

The adult client is a 22 year old Caucasian male who lives with his mother, father, and younger brother while attending a local community college.  He was brought to the emergency department by his parents after they found a suicide note which included detailed funeral plans.  Client was transferred to the inpatient psychiatric unit where he disclosed suicidal ideation with a plan, expressing depression with feelings of hopelessness and loneliness.  He described difficulty with sleeping, poor concentration, feelings of anhedonia, diminished energy levels, and depressed mood almost every day, for the past eight months.  The client believes this is due in part to poor grades at school, damaged vehicle from an automobile accident, and loss of close friends who have moved several hours away. Differences in Treating a Child or Adolescent Discussion Assignment

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            His past medical history is negative except for a tonsillectomy as a child.  This is his first psychiatric inpatient experience.  His psychiatric history is negative, denies use of substances to include alcohol, and he does not take any medications.  Following interview, PHQ-9 score was 19.  Client was placed on M1 hold.

 Differences in Treating a Child or Adolescent

             There are distinctions when caring for the child or adolescent client with suicidality, or any other psychiatric diagnosis, when compared to the adult client.  Questioning must be simplistic and age appropriate.  If questions are understood, chances for the provider to obtain meaningful information is significantly greater.  Portraying a nonjudgmental attitude that displays empathy is particularly important when caring for this population.  Under these conditions, they are more likely to open up, translating to an accurate psychiatric assessment (Carandang, Gray, Marval-Ospino, & MacPhee, 2012). Differences in Treating a Child or Adolescent Discussion Assignment

Families are a vital part of the psychiatric evaluation for children and adolescents, communicating large amounts of pertinent information that includes personal and family history.  Regarding treatment, parent and guardian understanding, compliance, and support directly translates to outcomes of the child or adolescent (Sadock, Sadock, & Ruiz, 2014).  The adult client mentioned was able to provide a complete biopsychosocial history and triggers of his depression, something an adolescent or child is typically not developmentally capable of. Differences in Treating a Child or Adolescent Discussion Assignment

Input from teachers and counselors is unique to children and adolescents.  Their insight can point to potential problems with functioning in school and correlates to depression (Gerson & Havens, 2015).  Likewise, primary caregivers often describe transitional occurrences or concerning behaviors that children cannot verbalize, whereas adults are able to readily identify problem areas and associated responses (Carandang et al., 2012).  As a provider, caring for the child or adolescent with depression means recognizing symptomology differences from adults. For example, depression in the child or adolescent often presents as irritability or with behavioral problems (American Psychiatric Association [APA], 2013).  In the mentioned case study, the adult male client readily verbalized feelings of depression and described his associated symptoms. Differences in Treating a Child or Adolescent Discussion Assignment

 Child or Adolescent Psychiatric Emergencies: Legal/Ethical Issues

             Children and adolescents are minors who are largely dependent on others for decision making and providing fundamental necessities.  If this does not occur, referrals, that may include legal action, must be made.  The objective is for this vulnerable population to live in a safe environment with people who provide basic needs so that the individual can grow and thrive (Sondheimer & Rey, 2012). Differences in Treating a Child or Adolescent Discussion Assignment

A provider is responsible to render care that upholds principles of beneficence, nonmaleficence, autonomy, and justice, but specific to the best interest of the child.  Opinions of caregivers cannot be ignored and ultimately, they approve treatment.  Thorough education allows for informed consent practices, however in cases with child and adolescents, it may be a delicate balance between parent wishes and recommendations of the healthcare team (Sondheimer & Rey, 2012). Differences in Treating a Child or Adolescent Discussion Assignment

 

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

(5th ed.). Washington, DC: Author.

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. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions. Retrieved from http://iacapap.org/wp-content/uploads/J.1-EMERGENCIES-072012.pdf

Gerson, R. & Havens, J. (2015). The child and adolescent psychiatric emergency: A public

health challenge. Psychiatric Times, 31(11), 20. Differences in Treating a Child or Adolescent Discussion Assignment

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.

Sondheimer, A. & Rey, J. M. (2012). Ethics and international child and adolescent psychiatry. In

  1. M. Rey (Ed), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions. Retrieved from http://iacapap.org/wp-content/uploads/A.1-ETHICS-072012.pdf

Differences in Treating a Child or Adolescent Discussion Assignment