Discussion: Comprehensive Integrated Psychiatric

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Discussion: Comprehensive Integrated Psychiatric

Discussion: Comprehensive Integrated Psychiatric

Discussion: Comprehensive Integrated Psychiatric Assessment

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In this Discussion, you review and critique the techniques and methods of a mental health professional as he or she completes a comprehensive integrated psychiatric assessment of an adolescent.

The comprehensive integrated psychiatric assessment of a child or adolescent consists of gathering information from not only the child but from several sources, most notably the family members, caregivers, and the child’s teacher or school counselor. Because of this, the diagnostic assessment becomes more complicated. Issues of confidentiality, privacy, and consent must be addressed. Also, the PMHNP must take into consideration the impact of culture on the child.

Discussion: Comprehensive Integrated Psychiatric Assessment

Introduction

What is a comprehensive integrated psychiatric assessment? A comprehensive integrated psychiatric assessment is the method of psychiatric assessment that consists of data collection, history, mental status examination, neurological examination, and educational and developmental testing (Sadock, Sadock & Ruiz, 2014).

The assessment should be comprehensive and exhaustive using all available current methods and instrumentation. In the case of a child or adolescent, it consists of collecting information from the child or the adolescent, the parents or the guardian, and the school teacher. The aims and objectives of comprehensive integrated psychiatric assessment in a child or adolescent are to help diagnose any number of emotional, behavioral, or developmental disorders and to make an evidence-based treatment plan in collaboration with the child and the parents. Each client’s assessment is different as each child’s and behaviors are different (Sadock, Sadock & Ruiz, 2014).

What the Nurse Practitioner Did Well

In the Vignette 4 video introduction to a mental health assessment, the nurse practitioner started well by telling the young client that the assessment and the discussion are confidential. The ethical principle of confidentiality requires that information shared by this young client with the nurse practitioner in the course of the comprehensive integrated psychiatric assessment is not shared with others. The only time the nurse practitioner can breach confidentiality is when the client is contemplating suicide, or he is having homicidal ideation (APA, 2017).

The nurse practitioner did well by asking open-ended questions from this young client. An open-ended interview is one of the best ways of gathering information from people. This open-ended question format prompted the young client to answer the questions put to him by the

nurse practitioner (Bright Education Service & Testing, 2015). The practitioner asked questions about the school and how he is doing in his academics. For many students, the genesis of their emotional problems emanates due to pressure from their school workload and peer pressure. Another good question asked by the practitioner is about his activities outside of school, this will give further insight into the causes of his psychological problem (YMH Boston, 2013).

The nurse practitioner also asked why the mother of the young man sent him for psychiatric evaluation and the young man said it was due to the anger management problem. The practitioner also asked the client to express his thoughts on his anger management problems. This question on anger and other background information collected will help the practitioner to arrive at the right diagnosis and treatment plan. The practitioner lastly asked another good question from his client on whom he is comfortable talking to. The young man mentioned his girlfriend and his coach. It is very important during the psychiatric assessment to ask clients for their support persons. In all the above mentioned the nurse practitioner did extremely well (YMH Boston, 2013).

In What Areas Can the Practitioner Improve?

There is a need for the nurse practitioner to introduce himself to his client by mentioning his name and his designation or title. When meeting a client for the first time it is very important to make eye contact and extend one’s hand when appropriate for a handshake. If family members are in the room they must be acknowledged as well (Jacques, 2012).

The nurse practitioner needs to ask questions on alcohol and drug abuse. Most teenagers nowadays indulge in alcohol and drug abuse. Substance abuse can induce psychosis and there is a great correlation between substance abuse and anger, aggressive behavior and emotional disorders (Ray, 2017).

The practitioner also ought to ask this young client if he smokes cigarettes because any exposure to nicotine is a great concern. The adolescent brain is still developing, and nicotine has effects on the brain’s reward system and brain regions involved in emotional and cognitive functions. Lastly, the time is too short to get a comprehensive and integrated psychiatric assessment, the practitioner needs to spend more time with the client (Mortensen, 2017).

Compelling Concerns

The compelling concern is this young client ready to attend anger management therapy? Anger management therapy will focus on helping this young client overcome an emotional block. The aims and objectives are to help him identify and overcome emotional stressors, especially stressors that cause hyperemotional reactions such as anger (Wheeler, 2014).

Next Question and Why

What is the diagnosis and when is the therapy going to start? After an assessment, the practitioner ought to come forth with a diagnosis based on his finding and assessment (APA, 2013).

Conclusion

The importance of comprehensive integrated psychiatric assessment cannot be overestimated, and it is one of the most important fundamentals of the psychiatric-mental health nurse practitioner’s skill set to comprehend, diagnose, and develop a treatment plan for clients with psychiatric disorders. This method of assessment consists of data collection, history, mental status examination, neurological examination, educational and developmental testing (Sadock, Sadock & Ruiz, 2014).

In this Vignette 4 video, the nurse practitioner did a good assessment on this adolescent with anger management problems. With all the open-ended questions asked by the practitioner

this helped to shed light on the problems of this young adult (YMH Boston, 2013). As a psychiatric nurse practitioner, an all-inclusive integrated psychiatric assessment on a child or adolescent will help us make the right diagnosis and right evidence-based treatment plan in collaboration with the child and the parents (Sadock, Sadock & Ruiz, 2014).

                                                         References

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

American Psychological Association. (2017). Code of Ethics. Retrieved from http://www.apa.org/ethics/code/

Bright Education Service &Testing. (2015). Why are open-ended questions important? Retrieved from https://brighted.funeducation.com/News/Common-Core-State-Standards-News/why-are-open-ended-questions-important

Jacques, Sue. (2012). Proper Introductions at Your Practice Are Critical to Patient Relations. Retrieved www.physicianspractice.com/staff/proper-introductions-your-practice-are-critical-patient-relations

Mortensen Assia (2017). Dangers of Teenagers Smoking Cigarettes. Retrieved https://healthfully.com/211897-dangers-of-teenagers-smoking-cigarettes.html

Ray Linda (2017). What are the Dangers of Substance Abuse? Retrieved from https://healthfully.com/17689-dangers-substance-abuse.html

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.

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.

YMH Boston. (2013). Vignette 4 – Introduction to a mental health assessment [Video file]. Retrieved from https://www.youtube.com/watch?v=JCJOXQa9wcE

Learning Objectives

Students will:

  • Evaluate comprehensive integrated psychiatric assessment techniques
  • Recommend assessment questions

To Prepare for the Discussion:

  • Review the Learning Resources concerning the comprehensive integrated psychiatric assessment.
  • Watch the Mental Status Examination video.
  • Watch the two YMH Bostonvideos.

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 of Discussion: Comprehensive Integrated Psychiatric Assessment

Based on the YMH Boston Vignette 4 video, post answers to the following questions:

  • What did the practitioner do well?
  • In what areas can the practitioner improve?
  • At this point in the clinical interview, do you have any compelling concerns? If so, what are they?
  • What would be your next question, and why?

By Day 6 of Discussion: Comprehensive Integrated Psychiatric Assessment

Respond to at least two of your colleagues by offering additional insights or alternative perspectives on their diagnosis or provide alternate next questions and why you selected those.

 

      The confidentiality law states that anyone with access to health information must protect the patient’s privacy (James & Laurence, 2013). The practitioner in the YMH Boston Vignette 4 video did a fairly good job addressing the extent and limits of confidentiality. However, some additional information should be given to the patient. (YMH Boston, 2013). The practitioner may want to extend his discussion to include medical privilege related to a court of law during testimony (James & Laurence, 2013). A practitioner can only disclose medical information with the permission of the patient, and a subpoena does not release the physician from testimonial privilege held by the patient. (James & Laurence ,2013). The practitioner also stated that he would not talk to the patient’s parents however he should have included that he would seek permission before discussing anything with his parents as family member and parents are great informants (Sadock, Sadock, & Ruiz, 2014).

The practitioner can improve by taking a less judgmental approach to the interview. The patient was asked why his mother believes that he has an anger management problem and then the practitioner replied that,” She must have a reason” (YMH Boston, 2013). The therapist must maintain neutrality so as not to hinder the professional relationship. At the initial interview, it is vital to establish rapport so that patients will be more forthcoming in providing histories to diagnose accurately and treat clients (American Academy of Child & Adolescent Psychiatry (AACAP, 2012). The use of reinforcement is a technique that could have been used in this situation (Sadock, Sadock, & Ruiz, 2014). Reinforcement is useful during patient self-disclosure (Sadock, Sadock, & Ruiz, 2014). It utilizes terms such as “I see” and “Tell me more” ( Sadock, Sadock, & Ruiz, 2014).

At this point in the clinical interview, there is a compelling concern related to the patient’s temperament.  The patient stated that his mother thinks that he has an anger management problem and that he “loses his temper” (YMH Boston, 2013). As a practitioner, I would not transition so quickly and would seek clarification. I would like to know what it looks like when he loses his temper. How often it occurs and what happens to measure adaptive resilience (AACAP,2012).

My next question would be aimed at finding the reasons why the patient dislikes school. For example, you state that you hate school and that it sucks, can you tell me more? What precisely about school do you dislike? Gathering a further explanation will assist in determining if the issue is social or academic. Establishing the cause will help in the implementation of the therapeutic intervention and if collaboration is necessary with teachers. Further exploration is needed as studies show that approximately half of all mental health disorders start at the age that the patient appears to be (American Nurses Association,2014).

References

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

James W., J., & Laurence B., M. (2013). Limits of confidentiality: To disclose or not to disclose. Journal of Vascular Surgery, (2), 521. 

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. (2013c, May 22). Vignette 4 – Introduction to a Mental Health Assessment [Video file]. Retrieved from https://www.youtube.com/watch?v=JCJOXQa9wcE

Comprehensive Integrated Psychiatric Assessment

A comprehensive psychiatric evaluation may be needed to diagnose emotional, behavioral, or developmental disorders. An evaluation of a child, adolescent, or adult is made based on behaviors present and in relation to physical, genetic, environmental, social, cognitive (thinking), emotional, and educational parts that may be affected as a result of these behaviors (Stewart & Hamza, 2017). Comprehensive psychiatric evaluations usually require a few hours over one or more office visits for the child and parents. With the parents’ permission, other significant people (such as the family physician, school personnel, or other relatives) may be contacted for additional information (Sadock, Sadock, & Ruiz, 2014).

What the Practitioner Did Well

The practitioner appropriately informed the client about his rights to confidentiality. It is vital that clinicians make it clear for older children and adolescents that they would not disclose anything that they discuss without their permission (Wade, 2015). Confidentiality is consistent with their development of maturity and autonomy without it some adolescent may be reluctant to disclose personal information or even forgo treatments (Sadock, Sadock, & Ruiz, 2014). The therapist also carefully made the client aware that in case that he learned that the patient is suspected having plan to hurt self or others his permission is not needed to inform either his parents or anyone and/or institution that should intervene. Moreover, the practitioner maintained a nonjudgmental nor punitive tone. That approach, obviously, helped the client open up the to the practitioner.

Areas that the Practitioner Can Improve

The practitioner tried to create a positive rapport with the client, but he should have done that in way not to make the client believe that he is right and her mother is wrong. Additionally, the practitioner took a posture that made him look like an authority figure. He crossed his leg seat back. Bennett et al. (2017) explained that, generally, teens have been found to be more likely to speak to “informal sources”, such as family or friends, as opposed to more authoritative figures (i.e., teachers, counselors, doctors). Furthermore, teens tend to be uncomfortable talking with unfamiliar adults. These two factors authoritative figure and unfamiliar adult are often in play for a teen entering counseling.

Concern at this Point

The concern at this point is the ability of the practitioner to restructure the family. Apparently, the structure of the family has been broken. The practitioner should be able to work not only with the teenage client but also with his mother to help everyone recognize and play their role in the family.

The question that I would like to ask the client at this point is:  What are the goals you would like to accomplish by participating in this?

Discussion: Comprehensive Integrated Psychiatric Assessment References

Bennett, E. D., Le, K., Lindahl, K., Wharton, S., & Mak, T. W. (2017). Five Out of the Box Techniques for Encouraging Teenagers to Engage in Counseling . Vistas, 3. Retrieved from https://www.counseling.org/docs/default-source/vistas/encouraging-teenagers.pdf

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.

Stewart, S. L., & Hamza, C. A. (2017, January 26). The Child and Youth Mental Health Assessment (ChYMH): An examination of the psychometric properties of an integrated assessment developed for clinically referred children and youth. 17. doi:10.1186/s12913-016-1970-9

Wade, M. E. (2015, September). Confidentiality concerns with minors. Counseling Today, 11. Retrieved from https://www.counseling.org/docs/default-source/ethics/ethics-columns/ethics_september_2015_confidentiality-minors.pdf?sfvrsn=1624522c_4

Comprehensive Integrated Psychiatric Assessment

A comprehensive psychiatric evaluation may be needed to diagnose emotional, behavioral, or developmental disorders. An evaluation of a child, adolescent, or adult is made based on behaviors present and in relation to physical, genetic, environmental, social, cognitive (thinking), emotional, and educational parts that may be affected as a result of these behaviors (Stewart & Hamza, 2017). Comprehensive psychiatric evaluations usually require a few hours over one or more office visits for the child and parents. With the parents’ permission, other significant people (such as the family physician, school personnel, or other relatives) may be contacted for additional information (Sadock, Sadock, & Ruiz, 2014).

What the Practitioner Did Well

The practitioner appropriately informed the client about his rights to confidentiality. It is vital that clinicians make it clear for older children and adolescents that they would not disclose anything that they discuss without their permission (Wade, 2015). Confidentiality is consistent with their development of maturity and autonomy without it some adolescent may be reluctant to disclose personal information or even forgo treatments (Sadock, Sadock, & Ruiz, 2014). The therapist also carefully made the client aware that in case that he learned that the patient is suspected having plan to hurt self or others his permission is not needed to inform either his parents or anyone and/or institution that should intervene. Moreover, the practitioner maintained a nonjudgmental nor punitive tone. That approach, obviously, helped the client open up the to the practitioner.

Areas that the Practitioner Can Improve

The practitioner tried to create a positive rapport with the client, but he should have done that in way not to make the client believe that he is right and her mother is wrong. Additionally, the practitioner took a posture that made him look like an authority figure. He crossed his leg seat back. Bennett et al. (2017) explained that, generally, teens have been found to be more likely to speak to “informal sources”, such as family or friends, as opposed to more authoritative figures (i.e., teachers, counselors, doctors). Furthermore, teens tend to be uncomfortable talking with unfamiliar adults. These two factors authoritative figure and unfamiliar adult are often in play for a teen entering counseling.

Concern at this Point

The concern at this point is the ability of the practitioner to restructure the family. Apparently, the structure of the family has been broken. The practitioner should be able to work not only with the teenage client but also with his mother to help everyone recognize and play their role in the family.

The question that I would like to ask the client at this point is:  What are the goals you would like to accomplish by participating in this?


References

Bennett, E. D., Le, K., Lindahl, K., Wharton, S., & Mak, T. W. (2017). Five Out of the Box Techniques for Encouraging Teenagers to Engage in Counseling . Vistas, 3. Retrieved from https://www.counseling.org/docs/default-source/vistas/encouraging-teenagers.pdf

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.

Stewart, S. L., & Hamza, C. A. (2017, January 26). The Child and Youth Mental Health Assessment (ChYMH): An examination of the psychometric properties of an integrated assessment developed for clinically referred children and youth. 17. doi:10.1186/s12913-016-1970-9

Wade, M. E. (2015, September). Confidentiality concerns with minors. Counseling Today, 11. Retrieved from https://www.counseling.org/docs/default-source/ethics/ethics-columns/ethics_september_2015_confidentiality-minors.pdf?sfvrsn=1624522c_4

“We adopted Maria from an orphanage in Guatemala when she was 4 years old. We were hoping she would love us as much as we love her, but she is always so distant and will not let us get close. She continually bumps her head on the wall and screams when we try to make her stop. She is now 5, and we have tried everything to help her understand that we just want to love her and have her be part of our family.”

Jessica and Jason, Parents of 5-year-old Maria

The delicate dance—engagement and empathy.

Laureate Education (Producer). (2017d). Working with Children and Adolescents [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 2 minutes.

The comprehensive integrated psychiatric assessment is one of the most important elements of the psychiatric-mental health nurse practitioner’s (PMHNP) skill set to understand, diagnose, and develop a treatment plan for Maria. The psychiatric interview is a craft by which one human being becomes acquainted with another’s deepest thoughts, fears, emotions, and behavior. “This task is not unlike exploring a darkened room in an old Victorian house” (Shea, p. 3) with only a candle for illumination. As the PMHNP sees more of the client’s life unfold, the picture becomes clearer.

This week, you explore in depth the elements of the comprehensive integrated psychiatric assessment and diagnostic process.

Photo Credit: sbrogan / iStock / Getty Images Plus


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 for Discussion: Comprehensive Integrated Psychiatric Assessment

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

  • 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)
  • 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

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)

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.

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.


The comprehensive integrated psychiatric assessment of a child or adolescent consists of gathering information from not only the child but from several sources, most notably the family members, caregivers, and the child’s teacher or school counselor. Because of this, the diagnostic assessment becomes more complicated. Issues of confidentiality, privacy, and consent must be addressed. Also, the PMHNP must take into consideration the impact of culture on the child.

In this Discussion, you review and critique the techniques and methods of a mental health professional as he or she completes a comprehensive integrated psychiatric assessment of an adolescent.

Learning Objectives

Students will:
  • Evaluate comprehensive integrated psychiatric assessment techniques
  • Recommend assessment questions

To Prepare for the Discussion:

  • Review the Learning Resources concerning the comprehensive integrated psychiatric assessment.
  • Watch the Mental Status Examination video.
  • Watch the two YMH Bostonvideos.

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

Based on the YMH Boston Vignette 4 video, post answers to the following questions:

  • What did the practitioner do well?
  • In what areas can the practitioner improve?
  • At this point in the clinical interview, do you have any compelling concerns? If so, what are they?
  • What would be your next question, and why?

By Day 6

Respond to at least two of your colleagues by offering additional insights or alternative perspectives on their diagnosis or provide alternate next questions and why you selected those.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 1 Discussion


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

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.

Note: Be sure to use the Practicum Journal Template, located in this week’s Learning Resources.

By Day 7 of Week 4

Submit your Assignment.


This week, you explored in depth the elements of the comprehensive integrated psychiatric assessment and diagnostic process.

Next week, you explore the many different psychiatric assessment tools and begin to explore treatment options. You also begin developing your resume and portfolio.


  • Week 3: You will work in a group to develop a “Parent Guide,” which will serve as a teaching tool for parents with children who have been diagnosed with a specific mental health disorder.
  • Week 5: You will assess one of the clients in your practicum who you do not think is adequately progressing according to expected clinical outcomes.
  • Week 6: You will use one of your adult clients who had a psychiatric emergency as an example as you compare how you would assess a child or adolescent client who had a psychiatric emergency.
  • Week 7: You will work in a group to develop a “Parent Guide,” which will serve as a teaching tool for parents with children who have been diagnosed with a specific mental health disorder.
  • Week 10: You will work in a group to develop a “Parent Guide,” which will serve as a teaching tool for parents with children who have been diagnosed with a specific mental health disorder.

Each week, you will complete practicum-related assignments. It is highly recommended that you review the practicum assignments for Weeks 2–11 before Day 7 of Week 1. This will give you time to meet with your preceptor so that you can fulfill the requirements of each practicum assignment.

  • Week 2: You begin working on your cover letter, resume, and portfolio. (Assignment to be submitted by Day 7 of Week 10.)
  • Week 3: You will complete a Decision Tree including the diagnosis and treatment of a pediatric client. (Assignment to be submitted by Day 7 of Week 4.)
  • Week 5: You will complete a Decision Tree including the diagnosis and treatment of a pediatric client. (Assignment to be submitted by Day 7 of Week 7.)
  • Week 6:  You will write a reflection on your practicum experiences involving group therapy sessions. (Assignment to be submitted by Day 7 of Week 7.)
  • Week 7: You will write a journal entry concerning voluntary and involuntary commitment. (Assignment to be submitted by Day 7 of Week 7.)
  • Week 9:  You will complete a Decision Tree including the diagnosis and treatment of a pediatric client. (Assignment to be submitted by Day 7 of Week 10.)
  • Week 10:  You will write about two clients you observed or counseled during a group therapy session for children and adolescents. (Assignment to be submitted by Day 7 of Week 10.)
  • Week 10: You will complete and submit your cover letter, resume, and portfolio. (Assignment to be submitted by Day 7 of Week 10.)
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Customer 452483, July 9th, 2021
Healthcare Writing & Communications
Perfect! Thank you for also remembering to highlight the necessary words. Appreciate all of your help and hard work!
Customer 452483, November 7th, 2021
Sociology
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Customer 452483, November 8th, 2021
Microbiology
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Customer 452483, August 23rd, 2021
Communications
You're awesome! Thank you so much!
Customer 452483, July 27th, 2021
Classic English Literature
Great paper, thank you!
Customer 452591, May 5th, 2022
Sociology
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Customer 452483, November 14th, 2021
Mathematics
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Customer 452483, July 26th, 2021
Introduction to Sociology
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Customer 452483, October 15th, 2021
Microbiology
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Customer 452483, September 6th, 2021
Nursing
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Customer 452487, September 9th, 2021
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