Assignment: NRNP 6665 Week 1 Comprehensive Integrated Psychiatric Assessment

Assignment: NRNP 6665 Week 1 Comprehensive Integrated Psychiatric Assessment

Assignment: NRNP 6665 Week 1 Comprehensive Integrated Psychiatric Assessment

Comprehensive Integrated Psychiatric Assessment

Many assessment principles are the same for children and adults; however, unlike with adults/older adults, where consent for participation in the assessment comes from the actual client, with children it is the parents or guardians who must make the decision for treatment. Issues of confidentiality, privacy, and consent must be addressed. When working with children, it is not only important to be able to connect with the pediatric patient, but also to be able to collaborate effectively with the caregivers, other family members, teachers, and school counselors/psychologists, all of whom will be able to provide important context and details to aid in your assessment and treatment plans.

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Some children/adolescents may be more difficult to assess than adults, as they can be less psychologically minded. That is, they have less insights into themselves and their motivations than adults (although this is not universally true). The PMHNP must also take into consideration the child’s culture and environmental context. Additionally, with children/adolescents, there are lower rates of neurocognitive disorders superimposed on other clinical conditions, such as depression or anxiety, which create additional diagnostic challenges.

In this Discussion, you review and critique the techniques and methods of a mental health professional as the practitioner completes a comprehensive, integrated psychiatric assessment of an adolescent. You also identify rating scales and treatment options that are specifically appropriate for children/adolescents.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare

 

Review the Learning Resources and consider the insights they provide on comprehensive, integrated psychiatric assessment. Watch the Mental Status Examination B-6 and Simulation Scenario-Adolescent Risk Assessment videos.

Watch the YMH Boston Vignette 5 video and take notes; you will use this video as the basis for your Discussion post.

By Day 3 of Week 1

Based on the YMH Boston Vignette 5 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?

Then, address the following. Your answers to these prompts do not have to be tailored to the patient in the YMH Boston video.

Explain why a thorough psychiatric assessment of a child/adolescent is important.

Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent.

Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.

Explain the role parents/guardians play in assessment.

Support your response with at least three peer-reviewed, evidence-based sources and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

Upload a copy of your discussion writing to the draft Turnitin for plagiarism check. Your faculty holds the academic freedom to not accept your work and grade at a zero if your work is not uploaded as a draft submission to Turnitin as instructed.

Read a selection of your colleagues’ responses.

By Day 6 of Week 1

Respond to at least two of your colleagues on 2 different days by offering additional insights or alternative perspectives on their analysis of the video, other rating scales that may be used with children, or other treatment options for children not yet mentioned. Be specific and provide a rationale with evidence.

MICHELLE

Hello Classmates

Based on this week’s provided video segment, my responses to the questions are here.

1. What did the practitioner do well?

The practitioner followed up on some of the client’s responses to gain more details, such as asking Tony to tell more about having thoughts of not wanting to be alive.

2. In what areas can the practitioner improve?

The practitioner could work on developing a better rapport with the client. For example, they introduce themselves and explain their roles warmly and empathetically to make Tony feel more at ease opening up. Trust is essential between adolescents and their healthcare providers. Trust may become increasingly important as teenagers study relativity and develop skepticism (Hardin et al., 2021).

3. At this point in the clinical interview, do you have any compelling concerns? If so, what are they?

When the client states he does not want to be alive, this is a significant concern as it indicates suicidal ideation.

4. What would be your next question, and why?

My next question would be: “Do you feel like hurting yourself now, and do you have a plan?” It is important to address his safety directly and determine if he needs a higher level of care, such as hospitalization.

A thorough psychiatric assessment of a child/adolescent is important to:

Establish a baseline of functioning and identify any developmental, medical, psychiatric, or psychosocial issues impacting the child.

Determine an appropriate diagnosis or diagnoses based on symptoms.

Inform treatment planning and identify the most appropriate interventions. Monitor the response to treatment and make adjustments over time. Educate parents/guardians on the child’s needs and empower them to participate in treatment.

Multidisciplinary evaluation and treatment are typical. Information can be acquired gradually to avoid overwhelming the young person and their family. Professionals caring for the child and family must share information (Srinath et al., 2019).

Two appropriate symptom rating scales include:

Designed to assess children aged 6 to 12 years’ degree of depression symptoms, the Children’s Depression Rating Scale-Revised (CDRS-R) is a 17-item scale (Isa et al., 2014).

Designed to offer effective and practical diagnosis aid, the Vanderbilt Attention Deficit/Hyperactive Disorder Parent Rating Scale (VADPRS) is an ADHD rating scale. The 55-item VADPRS assesses 18 DSM-IV ADHD symptoms on a 4-point scale of frequency. It also has subscales that look for 8 ODD behaviors, 14 CD behaviors, and 7 anxiety or depression behaviors. Eight items on a 5-point scale—1 = above average performance, 5 = problematic performance—examining academic performance and relationships help determine whether a child meets the diagnostic criteria for ADHD (Anderson et al., 2022).

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Two treatment options that are more applicable to youth include:

Family therapy is centered around enhancing parenting techniques and the family unit’s overall functioning. Initial phase of therapy The dropout rates among adolescents and young adults vary from 28% to 75%, which exposes them to a higher likelihood of experiencing unfavorable consequences. Research conducted by Berry et al. (2023) has established a correlation between family involvement in treatment and reduced rates of treatment discontinuation, as well as increased attendance in face-to-face outpatient treatment sessions.

Medication management: Although psychotropic medications should be used cautiously in young individuals, certain conditions like ADHD and depression may require pharmacological treatment, which should be closely monitored by a healthcare professional.

The role parents/guardians play in assessment is significant, as supported by the following sources:

Parents are the historians of the child’s development and can provide critical background information. Collaboration with parents is essential for establishing goals, engaging family support, and ensuring appropriate follow-through of recommendations outside of sessions. Parents also act as reporters on the child’s symptoms and functional status to inform diagnosis and track treatment progress.

References

Anderson, N. P., Feldman, J. A., Kolko, D. J., Pilkonis, P. A., & Lindhiem, O. (2022). National Norms for the Vanderbilt ADHD Diagnostic Parent Rating Scale in Children. Journal of Pediatric Psychology, 47(6), 652-661. https://doi.org/10.1093/jpepsy/jsab132

Links to an external site.

Berry, K. R., Gliske, K., Schmidt, C., Ballard, J., Killian, M., & Fenkel, C. (2023). The Impact of Family Therapy Participation on Youths and Young Adult Engagement and Retention in a Telehealth Intensive Outpatient Program: Quality Improvement Analysis. JMIR Formative Research, 7. https://doi.org/10.2196/45305

Links to an external site.

Hardin, H. K., Bender, A. E., Hermann, C. P., & Speck, B. J. (2021). An Integrative Review of Adolescent Trust in the Healthcare Provider Relationship. Journal of Advanced Nursing, 77(4), 1645. https://doi.org/10.1111/jan.14674

Links to an external site.

Isa, A., Bernstein, I., Trivedi, M., Mayes, T., Kennard, B., & Emslie, G. (2014). Childhood Depression Subscales Using Repeated Sessions on Children’s Depression Rating Scale—Revised (CDRS-R) Scores. Journal of Child and Adolescent Psychopharmacology, 24(6), 318-324. https://doi.org/10.1089/cap.2013.0127

Links to an external site.

Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical Practice Guidelines for Assessment of Children and Adolescents. Indian Journal of Psychiatry, 61(Suppl 2), 158-175. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_580_18

Links to an external site.

YMH Boston. (2013, May 22). Vignette 5 – Assessing for depression in a mental health appointment

Links to an external site.Links to an external site. Links to an external site.

CHIDINMA

MAIN POST

Comprehensive Integrated Psychiatric Assessment

A comprehensive, integrated psychiatric assessment for adolescents is a specialized evaluative process tailored to meet the unique developmental, emotional, and social needs of teenagers. This assessment is designed to capture a broad spectrum of information, including psychological, biological, and environmental factors, to fully understand the adolescent’s mental health status (Thapar et al., 2015). It encompasses a detailed examination of the adolescent’s behavior, mood, cognitive functioning, family dynamics, academic performance, peer relationships, and any substance use or abuse. By integrating information from various sources—self-reports, parental inputs, school reports, and possibly medical evaluations—mental health professionals aim to construct a nuanced profile of the adolescent’s mental health (Boland et al., 2022). This thorough approach enables the identification of specific psychiatric disorders, co-occurring conditions, and any underlying issues that might be affecting the adolescent’s well-being. The ultimate goal of a comprehensive, integrated psychiatric assessment for adolescents is to develop an individualized treatment plan that supports the young person’s mental, emotional, and social development, facilitating a path toward recovery and healthy adjustment.

YMH Boston Vignette 5 Video

Strengths of Practitioner’s Approach

In the interaction with Tony, the practitioner displayed several strengths in gathering information and establishing rapport. Notably, the practitioner asked open-ended questions, crucial in encouraging patients to share their feelings and experiences (Kwame & Petrucka, 2021). This technique allowed Tony to express his emotions and thoughts without feeling cornered or judged. Additionally, the practitioner showed empathy and a non-judgmental attitude, creating a safe space for Tony to discuss sensitive topics such as his mood, interest levels, academic performance, and substance use. By validating Tony’s feelings and showing genuine concern for his well-being, the practitioner fostered a sense of trust, which is essential in therapeutic relationships.

Areas for Improvement

While the practitioner demonstrated several commendable skills during the clinical interview with Tony, there are areas where improvements could enhance the effectiveness of the session. Firstly, an immediate and direct risk assessment for self-harm is critical, considering Tony expressed a desire not to live. This step is fundamental to ensure his safety and determine the necessary interventions (Micol et al., 2022). Secondly, a deeper exploration into Tony’s coping mechanisms could shed light on both the positive strategies he might be employing and the maladaptive ones, offering a pathway to address and modify these in therapy for better outcomes.

Additionally, the practitioner briefly touched on substance use; however, a more detailed inquiry into the frequency, quantity, and impact of Tony’s alcohol consumption is needed. This could clarify the role substance use plays in his mental health and whether it serves as a coping mechanism, thereby informing more targeted interventions (Magee & Connell, 2021). Furthermore, a more thorough exploration of Tony’s anger and aggression would be beneficial, including its triggers, frequency, and current management strategies. Understanding these aspects could help tailor interventions that address anger management more effectively.

Lastly, evaluating Tony’s support system, including friends, family, or others, is essential. This could provide valuable context about his social environment and highlight potential sources of support or stress, enriching the therapeutic approach. By addressing these areas for improvement, the thoroughness of the assessment could be enhanced, ensuring that immediate safety concerns are addressed and facilitating the development of a more targeted and effective treatment plan for Tony.

Compelling Concerns from the Clinical Interview

In the clinical interview with Tony, several critical issues were identified that demand immediate attention and careful consideration in his ongoing treatment. A paramount concern is Tony’s expressed desire not to be alive, signaling potential suicidal ideation or risk of self-harm. This alarming statement necessitates an urgent assessment to gauge these thoughts’ severity and devise appropriate safety measures. Moreover, Tony has reported significant mood changes, diminished interest in activities he once enjoyed, such as basketball, difficulties waking up, and a decline in academic performance. These symptoms strongly suggest the presence of depression, compounded by signs of considerable anxiety, particularly evidenced by his physical reactions when discussing the breakup with his girlfriend.

The emotional turmoil following the end of this relationship seems to be a critical factor affecting Tony’s mental health, with his intense anger and physical stress responses indicating a struggle to process the breakup healthily. Another area of concern is Tony’s substance use. While he mentions only occasional beer consumption, an understanding of the patterns and impact of his alcohol use is crucial, especially considering the possibility of substance use escalating as a coping mechanism.

Lastly, Tony’s anger to the extent of wanting to engage in fights underscores the importance of exploring anger management strategies and identifying the root causes of these feelings to prevent potential harm. Developing a comprehensive care plan for Tony involves prioritizing his safety, addressing the underlying causes of his symptoms through therapeutic interventions, and collaborating with his healthcare provider for a holistic approach to treatment. It may also include a referral to psychiatric services for medication evaluation and leveraging support systems to provide Tony with the necessary care and support.

Addressing Tony’s Suicidal Thoughts: A Crucial Conversation

Prompted by Tony’s concerning remark about not wanting to live, the essential next step is to ask, “Have you had thoughts about harming yourself or ending your life?” This direct question is crucial for several key reasons. First and foremost, it is vital to evaluate Tony’s safety, as his comment suggests possible suicidal thoughts. A clear understanding of whether he has contemplated self-harm or has specific plans for suicide is indispensable for crafting an effective safety plan tailored to his situation (Moscardini et al., 2020). Moreover, asking Tony openly about suicide signals to him that it is a safe space to discuss even his darkest thoughts and feelings. This openness is instrumental in challenging the stigma often associated with talking about suicide, encouraging him to be more forthcoming about his feelings and experiences. Such transparency is critical for determining the next steps in his care, which might include urgent interventions, a psychiatric evaluation, or an adjustment to his treatment strategy based on his needs and risk level.

Additionally, engaging in this challenging conversation demonstrates a deep level of support and readiness to address all aspects of Tony’s mental health. It shows a commitment to building a strong therapeutic relationship where Tony feels supported and understood without judgment. This approach is critical to ensuring Tony knows he is not alone and that help is available to navigate his challenges.

The Importance of Comprehensive Psychiatric Assessments in Child and Adolescent Mental Health

Conducting a thorough psychiatric assessment of a child or adolescent is a critical process in understanding and addressing the complex interplay of factors that contribute to their mental health status. Such assessments are comprehensive evaluations encompassing various domains, including psychological, developmental, and social aspects and family and educational environments. There are several reasons why these assessments are essential:

Firstly, children and adolescents undergo rapid developmental changes that can significantly impact their psychological well-being. A thorough psychiatric assessment helps identify any developmental delays or disorders that may not be apparent to parents or teachers but could significantly affect the child’s social and academic performance. The early detection of such issues is crucial as it allows for timely intervention, which is often more effective and can prevent the exacerbation of symptoms (Brown et al., 2020).

Secondly, psychiatric assessments for this age group can uncover underlying psychiatric disorders that might manifest through subtle or overt behavioral problems, emotional distress, or academic difficulties. Conditions such as anxiety disorders, depression, ADHD, and autism spectrum disorders often have their onset in childhood or adolescence. Early and accurate diagnosis through comprehensive assessment is critical to implementing effective treatment plans tailored to the child’s needs, thereby improving long-term outcomes (Merikangas et al., 2010).

Lastly, these assessments provide an opportunity to evaluate the impact of environmental factors on a child’s mental health. This includes family dynamics, peer relationships, and any exposure to trauma or stressors. Understanding the context in which the child or adolescent is developing is essential for a holistic approach to treatment, which focuses on the individual and considers modifying the environment to support their mental health (Bush et al., 2020)

A thorough psychiatric assessment of children and adolescents is pivotal for the early identification, accurate diagnosis, and effective treatment of mental health disorders. It considers the developmental, psychological, and environmental factors crucial in shaping a young person’s mental health. By providing a comprehensive view of the child or adolescent’s life, these assessments enable mental health professionals to develop personalized and effective treatment plans, laying the foundation for healthier future outcomes.

Symptom Rating Scales for Child and Adolescent Psychiatric Evaluations

During the psychiatric assessment of children and adolescents, symptom rating scales play a crucial role in objectively evaluating the severity and presence of symptoms, aiding in the diagnosis and monitoring of treatment progress. Two widely recognized and validated scales appropriate for this purpose include the Child Behavior Checklist (CBCL) and the Strengths and Difficulties Questionnaire (SDQ).

The Child Behavior Checklist (CBCL) is a comprehensive tool used to assess a wide range of emotional and behavioral problems in children aged 6 to 18. Developed by Achenbach and Edelbrock (1983), the CBCL is parent-reported and consists of over 100 items measuring various aspects of behavior and emotional well-being, including internalizing and externalizing problems, social proficiency, and competencies. The CBCL has been extensively validated and recognized for its ability to differentiate between various psychiatric disorders, making it an essential tool in clinical and research settings (Biederman et al., 2020). Its broad scope and strong psychometric properties enable clinicians to capture a comprehensive snapshot of a child’s functioning across multiple domains.

The Strengths and Difficulties Questionnaire (SDQ) is another valuable tool designed to screen for psychosocial problems in children and adolescents aged 3 to 17. This instrument, developed by Goodman (1997), comprises 25 items divided into five subscales: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. The SDQ can be completed by parents, teachers, or young people, providing a multi-informant perspective on the child’s or adolescent’s difficulties and strengths. It has been validated in numerous studies across different cultures and settings, proving a reliable and efficient way to screen for various psychiatric conditions (Bryant et al., 2020; Hall et al., 2019).

Both the CBCL and the SDQ are supported by a substantial body of research that attests to their validity and reliability in assessing psychiatric symptoms in children and adolescents. These tools are instrumental in the diagnostic process and invaluable in guiding treatment decisions and evaluating the effectiveness of interventions over time.

Pediatric-Specific Psychiatric Treatment Modalities

In the realm of psychiatric care, treatment strategies for children and adolescents often differ from those employed for adults, reflecting the unique developmental, psychological, and physiological considerations of younger patients. Two notable treatment options specifically tailored for this demographic include Play Therapy and Parent-Child Interaction Therapy (PCIT).

Play Therapy

This is a psychotherapeutic approach that uses play, a child’s natural medium of expression, to help them explore their feelings, address unresolved trauma, and solve problems. Through play therapy, children can express themselves symbolically and work through complex emotions in a safe and therapeutic environment, which might be challenging to articulate through conventional verbal communication. Evidence supports play therapy as an effective treatment for a variety of psychological issues in children, including anxiety, depression, and behavioral problems (Bhide & Chakraborty, 2020; Ray et al., 2021). This modality leverages the therapeutic powers of play to facilitate communication, increase self-esteem, and promote psychological healing.

Parent-Child Interaction Therapy (PCIT)

This is another intervention uniquely suited to young children, typically between the ages of 2 and 7, and their caregivers. PCIT is an evidence-based treatment designed to improve parent-child relationships and alter interaction patterns that contribute to disruptive behavior disorders in children. The therapy is highly structured and involves live coaching of parents during interactions with their child, aiming to reinforce positive behavior, improve communication, and teach effective discipline techniques. Research has shown that PCIT effectively reduces externalizing behaviors in children, decreases parental stress, and enhances the quality of the parent-child relationship (Fongaro et al., 2022; Vess & Campbell, 2022).

These treatments, play therapy and PCIT, are distinguished by their emphasis on the child’s developmental stage and the pivotal role of family and environmental interactions in shaping behavior and emotional well-being. Unlike many treatments used in adult psychiatry, which may focus more on individual therapy and medication management, these pediatric-specific modalities engage the child’s natural modes of learning and relating and actively involve parents or caregivers in the therapeutic process to effect change.

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The Role of Parents/Guardians in the Assessment Process

Parents and guardians play a pivotal role in the psychiatric assessment of children and adolescents, acting as crucial sources of information, collaborators in treatment planning, and active participants in the therapeutic process. Their involvement is grounded in the understanding that family dynamics, parenting styles, and the home environment significantly influence a child’s mental health.

Firstly, parents often provide essential historical and developmental information that clinicians cannot obtain directly from the child. This includes observations of the child’s behavior across different settings, the onset and evolution of symptoms, and any family history of psychiatric conditions. Research underscores the importance of parental input in achieving accurate diagnoses (Srinath et al., 2019). Caqueo-Urízar et al. (2022) highlight that parents’ perspectives can reveal discrepancies with the child’s self-report, offering a more comprehensive view of the child’s functioning across various contexts.

Moreover, parents play a critical role in identifying and implementing interventions. Buka et al. (2022) emphasize that parents often apply behavioral strategies and support the child in practicing skills learned in therapy at home. This hands-on involvement is crucial for generalizing therapeutic gains beyond the clinical setting. Additionally, the assessment process itself can benefit the parent-child relationship. Kurzweil (2023) suggests that involving parents in their child’s psychiatric assessment can enhance their understanding of the child’s difficulties, improve parent-child communication, and increase parental engagement in the treatment process. This collaborative approach not only aids in the accurate identification of mental health issues but also fosters a supportive environment conducive to the child’s recovery.

Parents and guardians are indispensable allies in diagnosing children and adolescents. Their involvement enriches the assessment process, ensures diagnoses’ accuracy, and enhances interventions’ effectiveness. By providing critical information, supporting treatment implementation, and facilitating a deeper understanding of the child’s needs, parents contribute significantly to the success of psychiatric interventions for young individuals.

Supporting Sources

This discussion draws on a carefully selected set of sources, all peer-reviewed articles published within the last five years. The collection includes primary and secondary research articles by respected experts in their respective fields. These sources are considered scholarly because they undergo a rigorous review process by experts in the field before publication, ensuring the content’s accuracy, validity, and academic integrity. This peer review process is fundamental to academic scholarship because it helps maintain scientific standards and provides credibility to the research and findings reported. Additionally, our textbook has been crucial in deepening understanding of the subject matter. It has provided vital explanations and expanded perspectives on the themes discussed in the articles, serving as a fundamental component of this analysis.

References

Achenbach, T. M., & Edelbrock, C. (1983). Manual for the child behavior checklist and revised child behavior profile. University of Vermont, Department of Psychiatry.

Bhide, A., & Chakraborty, K. (2020). General principles for psychotherapeutic interventions in children and adolescents. Indian Journal of Psychiatry, 62(2), 299–318.

Biederman, J., DiSalvo, M., Vaudreuil, C., Wozniak, J., Uchida, M., Yvonne Woodworth, K., Green, A., & Faraone, S. V. (2020). Can the child behavior checklist (CBCL) help characterize the types of psychopathologic conditions driving child psychiatry referrals? Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 8(3),157–165

Boland, R. Verdiun, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer

Brown, K. A., Parikh, S., & Patel, D. R. (2020). Understanding basic concepts of developmental diagnosis in children. Translational Pediatrics, 9(1), 9–22.

Bryant, A., Guy, J., CALM Team, & Holmes, J. (2020). The Strengths and Difficulties Questionnaire predicts concurrent mental health difficulties in a transdiagnostic sample of struggling learners. Frontiers in Psychology, 11(4), 1–11.

Buka, S.L., Beers, L. S., Biel, M. G., Counts, N. Z., Hudziak, J., Parade, S. H., Paris, R., Seifer, R. & Drury, S. S. (2022). The family is the patient: Promoting early childhood mental health in pediatric care. Pediatrics,149(5), 1-14

Bush, N. R., Wakschlag, L. S., LeWinn, K. Z., Hertz-Picciotto, I., Nozadi, S. S., Pieper, S., Lewis, J., Biezonski, D., Blair, C., Deardorff, J., Neiderhiser, J. M., Leve, L. D., Elliott, A. J., Duarte, C. S., Lugo-Candelas, C., O’Shea, T. M., Avalos, L. A., Page, G. P., & Posner, J. (2020). Family environment, neurodevelopmental risk, and the Environmental Influences on Child Health Outcomes (ECHO) initiative: Looking back and moving forward. Frontiers in Psychiatry, 11(5), 1-17

Caqueo-Urízar, A., Urzúa, A., Villalonga-Olives, E., Atencio-Quevedo, D., Irarrázaval, M., Flores, J., & Ramírez, C. (2022). Children’s mental health: Discrepancy between child self-reporting and parental reporting. Behavioral Sciences, 12(10), 1-8.

Fongaro, E., Picot, M. C., Stringaris, A., Belloc, C., Verissimo, A. S., Franc, N., & Purper-Ouakil, D. (2022). Parent training for the treatment of irritability in children and adolescents: A multisite randomized controlled, 3-parallel-group, evaluator-blinded, superiority trial. BMC Psychology, 10(1), 1-20.

Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38(9) 581–586.

Hall, C. L., Guo, B., Valentine, A. Z., Groom, M. J., Daley, D., Sayal, K., & Hollis, C. (2019). The validity of the Strengths and Difficulties Questionnaire (SDQ) for children with ADHD symptoms. PloS One, 14(6), e0218518.

Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: Barriers, facilitators, and the way forward. BMC Nursing, 20(1), 158.

Kurzweil, S. (2023). Involving parents in child mental health treatments: Survey of clinician practices and variables in decision making. American Journal of Psychotherapy, 76(3), 107-114

Magee, K. E., & Connell, A. M. (2021). The role of substance use coping in linking depression and alcohol use from late adolescence through early adulthood. Experimental and Clinical Psychopharmacology, 29(6), 659–669.

Merikangas, K. R., Nakamura, E. F., & Kessler, R. C. (2010). Epidemiology of mental disorders in children and adolescents. Dialogues in Clinical Neuroscience, 12(1), 7–20.

Micol, V. J., Prouty, D., & Czyz, E. K. (2022). Enhancing motivation and self-efficacy for safety plan use: Incorporating motivational interviewing strategies in a brief safety planning intervention for adolescents at risk for suicide. Psychotherapy, 59(2), 174–180.

Moscardini, E. H., Hill, R. M., Dodd, C. G., Do, C., Kaplow, J. B., & Tucker, R. P. (2020). Suicide safety planning: Clinician training, comfort, and safety plan utilization. International Journal of Environmental Research and Public Health, 17(18), 6444.

Ray, D. C., Burgin, E., Gutierrez, D., Ceballos, P., & Lindo, N. (2021). Child?centered play therapy and adverse childhood experiences: A randomized controlled trial. Journal of Counseling & Development, 100(2), 134–145.

Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian Journal of Psychiatry, 61(2), 158–175

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.). Wiley Blackwell.

Vess, S. F., & Campbell, J. M. (2022). Parent-child interaction therapy (PCIT) with families of children with autism spectrum disorder. Autism & Developmental Language Impairments, 7(3),1-16