Assignment: 

Read a selection of your colleagues’ responses.

Respond to at least two of your colleagues by comparing your assessment tool to theirs. APA Format with at least two references in each responses no more than five years old

  

Response Post #1

Main Post – Brief Psychiatric Rating Scale

Week 2 Discussion – Assessment and Diagnosis in Psychotherapy

Main Post

Assessment Tools

It is paramount as health care professionals to be skillful in assessing clients to be able to diagnose, plan, and produce optimal care yielding full or partial recovery of the clients.  Various assessment and measuring tools are available for mental health providers to help measure illness, diagnose clients, and measure a client’s response to treatment that will help supplement data obtained from the clinical interview.  Though assessments usually span the entire treatment cycle, a thoughtfully constructed initial intake meeting can be a great tool to establish and reinforce the required therapeutic alliances between client and therapist, provide reassurance, ease anxiety, and enhance information gathering process required for an accurate diagnosis and suitable treatment plan (Wheeler, 2014). 

Brief Psychiatric Rating Scale

The Brief Psychiatric Rating Scale (BPRS) was developed in the sixties.  It is still one of the most popular behavioral rating scales/instruments use today by clinicians to quickly gather information about the possible presence and severity of various psychiatric symptoms and to assess changes in symptoms in response to medications (Zanello et al., 2013).  Originally, the BPRS was a 16-item scale, it was later extended to the standard 18-item version and currently expanded to a 24-item scale to measure additional aspects of schizophrenia symptoms thereby increasing its sensitivity to psychotic and affective disorders and to be used for patients living in the community (Shafer et al., 2017). 

The 18-item BPRS assess the following symptoms: somatic concern, anxiety, emotional withdrawal, conceptual disorganization, guilt feelings, tension, mannerisms and posturing, grandiosity, depressive mood, hostility, suspiciousness, hallucinatory behavior, motor retardation, uncooperativeness, unusual thought content, blunted affect, excitement, and disorientation (Yee et al., 2017).  The manual of administration of the 24-item BPRS offers a more detailed semi-structured interview with more probe questions for each symptom, and providing supplementary rules for the rating (e.g., delusions) including a well-defined anchor point (Zanello et al., 2013).  The recent analysis of the 24-item BPRS produced a four-factor solution: Negative Symptoms, Positive Symptoms, Manic-hostility, and Anxiety–Depression (Zanello et al., 2013).  The current BPRS is rated on a seven-point Likert-type scale.  A rating of “1” indicates the absence of symptoms, ratings of “2–3” indicate “very mild” to “mild” symptoms that are considered to have nonpathological intensity, and ratings of “6–7” indicate “severe” or “extremely severe” symptoms associated with significant distress or impairment (Zanello et al., 2013). 

The BPRS 18 has been studied extensively and has been proven to be reliable, valid, and reliable in many languages such as German, Portuguese, Dutch, based on score correlations with other rating scales and longitudinal sensitivity to changes in psychiatric symptoms (Yee et al., 2017).  When the psychometric properties of validity, sensitivity, and reliability of BPRS were explored, various factor solutions were found due to the heterogeneity of psychiatric diseases (Yee et al., 2017).  Clinicians/therapists must pay close attention to the clients they interact with, instilling hope in them, making sure they are comfortable, maintaining security, privacy, and safety to ensure their return for follow-up care (Wheeler, 2014).

Response Post #2

Quality of Life in Depression Scale

           According to Kennedy, Eisfeld, and Cooke (2001, p. 23), the concept of quality of life serves to evaluate the efficacy of treatment intervention from the patient’s perspective and how they influence a person’s overall sense of well-being and satisfaction with life. The theoretical foundation of the Quality of Life in Depression Scale (QLDS) is that quality of life derives from the patient’s own aptitude and capacity to fulfill their individual needs (Kennedy et al. 2001, p. 25).

Psychometric Properties of QLDS

           To create the QLDS, researchers conducted interviews with patients who had active or recent depression treated by psychotropic medication to discover how their depression affected their quality of life (Tuynman-Qua, Jonghe, and McKenna, 1997, p. 8). The interviewers extrapolated 75 general statements from the interviews and eventually winnowed the total number to 35 positive and negative statements about their quality of life (Tuynman-Qua, Jonghe, and McKenna, 1997, p. 8). The respondents who complete the QLDS respond either “true” or “not true” to these statements which include examples such as, “I feel as if I am not in control of my life” and “I look forward to things” (Tuynman-Qua, Jonghe, and McKenna, 1997, p. 8).

Appropriate Utilization of QLDS

           De Fruyt and Demyttenaere (2009, p. 214), discuss that health is not merely defined or measured as the absence of disease but a more holistic state of total well-being in the realms of physical, mental, and social health. This comprehensive understanding of health requires more than objective metrics like diagnostic imaging and blood tests to determine the absence of disease. Instead, implementation of a questionnaire such as the QLDS serves to gather essential data on the patient’s perception of their current state of well-being (Tuynman-Qua, Jonghe, and McKenna, 1997, p. 12). Tuynman-Qua, Jonghe, and McKenna (1997, p. 4), note that the presence of objectively identifiable symptoms and disease correlates less with health care utilization than the patient’s perception of feeling unwell. Additionally, patient perception of effect on well-being also correlates treatment compliance (Tuynman-Qua, Jonghe, and McKenna, 1997, p. 12). Therefore, it is appropriate to implement the QLDS before and after the implementation of a psychopharmacological intervention to understand the patient’s perception of benefit from treatment on their overall well-being  

           The QLDS is appropriate for use to evaluate the efficacy of psychopharmacologic medications. Per Fruyt and Demyttenaere (2009, p. 216), a Medline search for the utilization of the QLDS in Antidepressant trials found eight papers that used the QLDS. In one study on the efficacy of treatment of Major Depression (MD) with duloxetine in 40 to 55-year-old women, the study utilized the QLDS to capture the patient-perceived quality of life pre and post-treatment (Burt, Wohlreich, Mallinckrodt, Detke, Watkin, and Stewart, 2005, p. 345). The QLDS captured improved perception of quality of life consistent with improvements seen in both clinician-rated scales such as Hamilton Depression Scale and Clinician Global Impression as well as the patient-rated Patient Global Impression of Improvement Scale (Burt et al. 2005, p. 351).

Research public health issues on the “Climate Change” or “Topics and Issues” pages of the American Public Health Association (APHA) website. Investigate a public health issue related to an environmental issue within the U.S. health care delivery system and examine its effect on a specific population.

Write a 750-1,000-word policy brief that summarizes the issue, explains the effect on the population, and proposes a solution to the issue.

Follow this outline when writing the policy brief:

1. Describe the policy health issue. Include the following information: (a) what population is affected, (b) at what level does it occur (local, state, or national), and (c) evidence about the issues supported by resources.
2. Create a problem statement.
3. Provide suggestions for addressing the health issue caused by the current policy. Describe what steps are required to initiate policy change. Include necessary stakeholders (government officials, administrator) and budget or funding considerations, if applicable.
4. Discuss the impact on the health care delivery system.

Include three peer-reviewed sources and two other sources to support the policy brief.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

 

1) **********minimum 1 full page (cover or reference page not included)

2)¨**********APA norms  (All paragraphs must be narrative and cited in the text- each paragraphs)

3)********** It will be verified by Turnitin and SafeAssign 

4) References not older than 5 years

_______________________________________________________________

 

Part One

Reviewing the Nursing as Caring Theory, we come to understand that humans are intrinsically motivated to care for others. 

1) Based on this theory, how do you provide care for someone who is a criminal that needs care? (Example, a prisoner is brought to your unit for care, after being beaten for molesting a child).

Part Two

The transitions theory incorporates intervention and comprehension of what has taken place. 

2) How do you apply the transitions theory to your current nursing practice?

Topic: IBS: diagnosis and treatment

Thesis statement needed???

You will need to determine the focus of inquiry and determine which approach to analysis you should take based on the topic you choose.

For this review, be sure to:

• Select three relevant and appropriate scholarly articles that address the topic you chose.
• Present a thorough literature review of the three articles by summarizing, synthesizing, and evaluating the materials.
• Incorporate citations into your body paragraphs; incorporate the essential and most relevant supporting evidence eloquently and appropriately.
• Present your writing in a clear, organized manner.
• Demonstrate understanding of the content presented in the articles.
• Use proper APA format with proper citations. Review APA Citations Here
• Paper should be 4 pages.

 

Respond to the post bellow  by comparing your assessment tool to theirs. 

NOTE: my assessment tool: The patient Health Questionnaire (PHQ-9

                                    Main Post

 

According  to the American Academy of Child and Adolescent Psychiatry (1995),  children and adolescents are evaluated due to psychiatric disorders that  impair emotional, cognitive, physical, and/or behavioral functioning.  The child or adolescent is evaluated in the context of the family,  school, community, and culture. The purpose and aims of the clinical  diagnostic assessment are to determine whether psychopathology is  present and, if so, to establish a differential diagnosis and tentative  diagnostic formulation, to develop a treatment recommendation and plan,  or to communicate the above findings in an appropriate fashion to the  parents and child. In addition, the aims of the assessment process are  to identify the stated reasons and factors leading to the referral, to  assess the nature and severity of the child’s behavioral difficulties,  functional impairments, subjective distress, and to identify individual,  family, or environmental factors that may potentially account for,  influence, or ameliorate these difficulties. When assessing children,  parents’ interviews and school functioning reports are necessary.

The  assessment tool I will discuss in this post is the Screen for Child  Anxiety Related Emotional Disorders (SCARED). Per the University of  Pittsburg (2019), SCARED is a child and parent self-report instrument  used to screen for childhood anxiety disorders including general anxiety  disorder, separation anxiety disorder, panic disorder, and social  phobia. In addition, it assesses symptoms related to school phobia. The  SCARED consists of 41 items and 5 factors that parallel the DSM-IV  classification of anxiety disorders. The child and parent versions of  the SCARED have moderate parent-child agreement and good internal  consistency, test-retest reliability, and discriminant validity, and it  is sensitive to treatment response

Target population: Children ages 8-18 years

Intended users: Clinicians and Psychiatrists

Time to Administer: 10 minutes

Completed by: Children and Parents

How to Use SCARED:  SCARED is a questionnaire with scales that describes how people feel.  Clients read each phrase and decide if it is “Not True or Hardly Ever  True” or “Somewhat True or Sometimes True” or “Very True or Often True”.  Then, for each sentence, they fill in one circle that corresponds to  the response that seems to describe them for the last 3 months. After  each phrase and circles, there are abbreviations of the various  disorders. Therefore,

a total score of >25 may indicate the presence of an Anxiety Disorder.  Scores higher than 40 are more specific.

A score of 7 for items 1, 6, 9, 12, 15, 18, 19, 22, 24, 27, 30, 34, 38 may indicate Panic Disorder or Significant Somatic Symptoms (PN).  

A score of 9 for items 5, 7, 14, 21, 23, 28, 33, 35, 37 may indicate Generalized Anxiety Disorder (GD).  

 A score of 5 for items 4, 8, 13, 16, 20, 25, 29, 31 may indicate Separation Anxiety Disorder (SP).  

A score of 8 for items 3, 10, 26, 32, 39, 40, 41 may indicate Social Anxiety Disorder (SC) 

A score of 3 for items 2, 11, 17, 36 may indicate Significant School Avoidance (SN)

(see the attached document or link, it’s the SCARED assessment and how the score is calculated: source http://www.shared-care.ca/files/SCARED_Child_Updated_June_2015.pdf)

Psychometric Properties:  There are accumulating studies that have shown the SCARED to have good  psychometric properties for children and adolescents from various  cultures, so SCARED can be utilized in various countries as a  cross-cultural screening instrument for DSM-V anxiety disorders. The  psychometric properties of the SCARED are strong because females scored  significantly higher than males, and that age had a moderating effect on  male and female score differences. Studies have demonstrated that girls  run a higher risk of developing anxiety disorders than boys. The  moderating effect of age on anxiety symptoms, particularly generalized  anxiety disorder symptoms increases for older girls that may highlight  the importance of early interventions for them to help reduce the risk  for later developmental maladaptation (Crocetti et al., 2011)

Diagnosis for a Client Receiving Psychotherapy: Possible diagnoses for these clients under Anxiety Disorders are Panic Disorder and Agoraphobia (fear  of places and situations that might cause panic, helplessness, or  embarrassment), Separation Anxiety Disorder, Social Anxiety Disorder  (formerly Social Phobia), and Generalized Anxiety Disorder (American  Psychiatric Association, 2017).

Legal and Ethical Implications of Counseling Children: The four  ethical/ legal issues that arise when counseling children are counselor  competence, informed consent, confidentiality, and mandatory reporting  of child abuse. Counselor Competence–  that is knowledge and skills of the counselor (e.g. use of play  therapy), knowledge of mental disorders, understanding human  development, understanding family structure, culture/ diversity, and a  more talked about topic (transgender). Informed Consent–  It is formal permission that allows treatment. The counselor and client  fall under legal jurisdiction of contract law. Minors can only enter a  contract by parental / guardian consent, involuntary at parent’s  insistence, or ordered by juvenile court. Through informed consents,  clients are given voluntary knowledge of treatment, must understand  consequences of treatment, and if not obtained, counselors are held  responsible, and sued for battery, failure to gain consent, & child  enticement. Confidentiality  must be maintained so it will not cause lack of trust and  communication, child not seeking treatment, or early termination of  psychotherapy. Mandatory Reporting:  mental health professionals must report in all States. It’s the duty of  health care providers to report and failure to report breaches legal  and ethical standards (Garnsey, n.d.)

References

American Academy of Child and Adolescent Psychiatry (1995). 

            Practice Parameters for the Psychiatric Assessment of Children and Adolescents.

            Retrieved March 2, 2020, from 

https://www.aacap.org/App_Themes/AACAP/docs/practice_parameters/psychiatric_asse

American Psychiatric Association (2013). 

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 

Retrieved March 2, 2020, from 

https://dsm-psychiatryonline-org.ezp.waldenulibrary.org/doi/book/10.1176/appi.books.97

American Psychiatric Association (2017). What Are Anxiety Disorders?

            Retrieved March 3, 2020, from 

https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorder

Crocetti, E., Meeus, W. H. J., Raaijmakers, Q. A. W., William, W. H. (2011). 

            A meta-analysis of the cross-cultural psychometric properties of the Screen for Child

Anxiety Related Emotional Disorders (SCARED). Retrieved March 3, 2020, from

https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=3&sid=de03210f-a792-44d7-bb

Garnsey, E. (n.d.). Legal and Ethical Issues When Counseling Children. 

            Retrieved March 3, 2020, from

https://eportfolio.pace.edu/artefact/file/download.php?file=112508&view=76785

Screen for Child Anxiety Related Disorders (SCARED)- (2012). 

CHILD Version—Page 1 of 2 (to be filled out by the CHILD)

            Retrieved March 3, 2019, from 

http://www.shared-care.ca/files/SCARED_Child_Updated_June_2015.pdf

University of Pittsburg (2019). Instruments- Screen for Child Anxiety Related Emotional

            Disorders (SCARED). Retrieved March 2, 2020, from 

https://www.pediatricbipolar.pitt.edu/resources/instruments

SCARED_Child_Updated_June_2015.pdf