YMH Boston Vignette 4 Video Questions Discussion example
Comprehensive, integrated psychiatric assessment with adolescents is essential as it provides information that can be utilized in the development of appropriate intervention (AACAP, 2012a). Similarly, the practitioner has the opportunity to learn more about nature, consequences, and correlates the adolescent’s mental health problems using behavior changes (Gajbhare, 2014). Besides, the assessment also provides the practitioner with the extent to which the adolescent’s family can be involved not only in the comprehensive assessment but also in potential subsequent interventions (American Psychiatric Association, 2013). Further, the YMH Boston Vignette 4 Video Questions Discussion example assessment begins the process of responding creatively to the adolescent’s denial and resistance as in the case of the vignette four video. This phase can be used as the initial stage of treatment experience. As such, is essential to examine the Vignette 4 video to determine the areas in which the practitioner did well and the areas that need improvement.
The Areas the Practitioner Did Well
From the Vignette 4 video on Introduction to a Mental Health Assessment, the practitioner did well in informing the 16-year old boy patient about his rights to confidentiality and privacy which is an essential part of every introductory medical and mental health appointment (YMH Boston., 2013c). He explained to the patient that the information he will provide will be kept confidential and that he will not reveal anything to his parents except when the information indicates that he is likely to cause harm to himself or other people. In an interview with adolescents, it is essential to recognize that confidentiality is the cornerstone of the therapeutic relationship. Without clarification of the limits of confidentiality, the practitioner may likely obtain incorrect or incomplete information during the history taking (YMH Boston, 2013a). Further, the practitioner did well in engaging the patient with open-ended questions about the problems he experiences at home and in school. YMH Boston Vignette 4 Video Questions Discussion example.
Areas that Need Improvement
From the video, it is clear that the practitioner needs to avoid the negative perception of his patients. It was clear that the practitioner’s facial expression and tone indicated that he was having some negative attitudes towards the patient when the teen said that his mother thinks he has anger management problem (American Psychological Association, 2017). Similarly, the practitioner needs to elicit strategies for the patient to communicate with his mother more effectively (YMH Boston., 2013c).
At this point of the clinical interview, there are various compelling concerns arising from the teenage-parent conflict. The patient presents as angry and disinterested (YMH Boston., 2013c). It is clear that the teen is going through a lot of stressful situations in his life. The teen seems to have anger management problem. However, this behavior could as a result of his developmental stage. At this stage, he wants to please his parents but at the same time wants to break away (Sadock, Sadock, & Ruiz, 2014). Similarly, the teen experiences a lot of peer pressure and peers are becoming more important at this stage in his life than his parents. The teen also experiences a lot of physiological and psychological changes in his life that he has to handle (Laureate Education, 2017). All these stressful situations result in a melting pot of teenage emotions which leads to anger. In most cases, the target of those emotions is often directed at parents, which explains why the parent feels that the boy has anger management problem. Similarly, teens often feel uncomfortable opening to their parents and find it awkward and annoying. The teens also do not like it when people push them around. They prefer to be around people who listen to them than those who command or order them around. YMH Boston Vignette 4 Video Questions Discussion example.
In this assessment, the next question to ask the boy would be: “How do you get along with your father? It is essential to ask this question because he has spent the entire session talking about his mother and other persons in school. The practitioner needs to know how the patient relates to his family members to determine the appropriate intervention. YMH Boston Vignette 4 Video Questions Discussion example.
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 Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. YMH Boston Vignette 4 Video Questions Discussion example.
American Psychological Association. (2017). Code of Ethics. Retrieved from http://www.apa.org/ethics/code/
Gajbhare, P. (2014). Mental status examination [Video file]. Retrieved from https://www.youtube.com/watch?v=VjWVYgf2UcU
Laureate Education (Producer). (2017d). Working with Children and Adolescents [Video file]. Baltimore, MD: Author.
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. YMH Boston Vignette 4 Video Questions Discussion example.
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
YMH Boston. (2013c, May 22). Vignette 4 – Introduction to a mental health assessment [Video file]. Retrieved from https://www.youtube.com/watch?v=JCJOXQa9wcE. YMH Boston Vignette 4 Video Questions Discussion example.
YMH Boston Vignette 4 Video Questions Discussion example