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Within the context of YMH Boston Vignette 5, the mental examination that the practitioner carried out highlighted a number of admirable characteristics. In order to provide the child with a secure environment in which he could freely express himself, the physician kept his composure and remained objective. The therapist effectively used open-ended questions, enabling the adolescent to freely express his thoughts and emotions at his own pace. Through vocal affirmations and eye contact, the therapist demonstrated active listening, which is an essential component in establishing rapport with adolescents as its target audience. On the other hand, the practitioner could be able to develop their skills if they go deeper into delicate subjects such as suicidal thoughts or self-harm. Because these aspects were only studied on a surface level, it is required to conduct a more comprehensive risk assessment. This is especially true in situations in which the patient displays symptoms of distress or reports having problems with peers or experiencing feelings of isolation.

The fact that the adolescent has mentioned having issues with his family and friends, in addition to his feelings of isolation, are big concerns at this time in the therapy dialog in particular. Suicidal ideation, anxiety, or depression are all potential risk factors that may be associated with these. As can be seen from his hazy responses and nonverbal cues, the adolescent may be experiencing some level of discomfort when it comes to truly expressing his emotions. This gives rise to concerns over the possibility of underreporting symptoms, which is a regular occurrence in evaluations of adolescents.

"Have you ever considered hurting yourself or said that you don't want to be here?" is the following inquiry that I will direct to you. Due to the fact that determining a child's or adolescent's likelihood of committing suicide is an essential component of mental health evaluations, this inquiry is of utmost significance. Practitioners should approach patients directly about self-harm without fear, as recommended by the American Academy of Child and Adolescent Psychiatry (2020). This is done in order to uncover suicidal ideas at an early stage, which can be extremely important for survival.

It is essential to carry out a comprehensive psychiatric evaluation in order to acquire a comprehensive picture of how a child or teenager is functioning emotionally, intellectually, and behaviorally within the context of their social, cultural, and developmental environment. Children frequently have trouble expressing themselves, and without a comprehensive examination, it is possible that crucial problems may go unnoticed, which will postpone the arrival of vital care. Comprehensive evaluations, as stated by Bostic et al. (2021), are beneficial in that they aid in the early detection of mental difficulties, the development of tailored treatment programs, and the promotion of care coordination with families, schools, and other professionals.

Two helpful symptom rating measures can be utilized for the purpose of mental evaluation in this population. These instruments are the Child Behavior Checklist (CBCL) and the Revised Children's Anxiety and Depression Scale (RCADS). According to Achenbach and Rescorla (2001), the Child Behavior and Behavioral Assessment (CBCL) offers a multi-informant perspective on the child's symptoms by examining a wide range of behavioral and emotional difficulties concerning the kid. It is possible to find versions of the CBCL for both teachers and parents. By evaluating anxiety and depression symptoms by DSM criteria, the RCADS provides a methodical approach to monitoring the severity of symptoms over time for children between the ages of 8 and 18 (Chorpita et al., 2000). This method is especially useful for children who are experiencing symptoms of depression.

Play therapy and parent-child interaction therapy (PCIT), two types of mental health care, are utilized more frequently in the treatment of children and adolescents than they are in the treatment of adults. Play therapy has the potential to be a lifesaver for younger children, who may not yet be able to articulate the complexities of their feelings. According to Bratton et al. (2005), it is often used to address traumatic experiences, anxiety, and behavioral issues. Additionally, it encourages communication through the use of symbolic play. Parent-kid Interaction Therapy (PCIT) is a form of therapy that involves attending predetermined sessions with both the parent and the kid. The primary objectives of PCIT are to enhance the relationship between the parent and the child and to modify unfavorable behavioral patterns. These strategies, which are suitable for children of this age, are able to fulfill the emotional and cognitive requirements of young children.

Psychiatric evaluations are highly dependent on the participation of the patient's parents or guardians. In addition to providing the appropriate context, tracking behaviors in a variety of settings, and other similar functions, they are essential to the implementation of treatment plans. When they work together, they are able to accomplish more comprehensive therapy goals and guarantee that patients receive constant care. It is legally obliged to get treatment consent and disclose personal information, therefore their participation is crucial to the diagnostic and therapeutic process (Geller, 2019). Due to this requirement, their participation is essential.

The fact that all of the sources that were utilized in this discussion have been subjected to peer review and are founded on evidence ensures that the academic legitimacy and credibility of the discussion is guaranteed. It is well acknowledged that the Journal of the American Academy of Child and Adolescent Psychiatry is an indispensable resource for anyone working in the field of pediatric mental health. Assessment tools for young people have made extensive use of the research that has been published in the journal Child and Adolescent Mental Health, which is a peer-reviewed publication that offers clinical updates and research on mental health disorders that children and adolescents often experience. The inclusion of these sources within the realm of evidence-based psychiatry, the fact that they have been subjected to peer review, and the trustworthiness of the authors all contribute to the fact that these sources are being regarded as scholarly.

References:

Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms & profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.

Bratton, S. C., Ray, D., Rhine, T., & Jones, L. (2005). The efficacy of play therapy with children: A meta-analytic review of treatment outcomes. Professional Psychology: Research and Practice, 36(4), 376-390. https://doi.org/10.1037/0735-7028.36.4.376

Chorpita, B. F., Yim, L., Moffitt, C., Umemoto, L. A., & Francis, S. E. (2000). Assessment of symptoms of DSM-IV anxiety and depression in children: A revised child anxiety and depression scale. Behaviour Research and Therapy, 38(8), 835-855. https://doi.org/10.1016/S0005-7967(99)00130-8

Geller, B. (2019). Involving parents in child and adolescent psychiatric treatment. Child and Adolescent Psychiatric Clinics of North America, 28(1), 25-39. https://doi.org/10.1016/j.chc.2018.07.002

Bostic, J. Q., Rubin, D. H., & Godfrey, M. D. (2021). Comprehensive mental health services for children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 30(1), 1-15. https://doi.org/10.1016/j.chc.2020.08.001