Colleagues response week 4 | NURS 6660 – Psychiatric Mental Health Nurse Practitioner Role I: Child and Adolescent | Walden University

The Assignment

Respond to at least two of your colleagues by providing at least two ways that their strategies may be expanded or improved.

 Support your responses with evidence-based literature with at least two references in each colleague’s response with proper citation. 

 Colleagues Response # 1

Treating Childhood Abuse

The number of incidents that Child Protective Services (CPS) investigates annually in the United States is over two million alleged incidents of child abuse, 18 percent of physical abuse, 650,000 are confirmed to be physical violence, and neglect or abuse claims 1500 lives of children each year, with 80 percent being children under the age of four.  Psychological and somatic symptoms, as well as psychological and medical diagnosis, including depression, anxiety disorders, eating disorders, posttraumatic stress disorder (PTSD), chronic pain syndromes, chronic fatigue syndrome, and irritable bowel disorder, have been correlated with childhood violence.

From exposure to traumatic incidents in which they are victims of physical and sexual assault, domestic violence, motor vehicle accidents, serious medical disease, natural or human-created disasters, a large number of children and adolescents can experience PTSD (Sadock, Sadock, & Ruiz, 2017).

Assessing for Abuse

Identification and assessment of childhood abuse can be a complex process. It needs careful consideration of the situation involving alleged childhood abuse. A detailed interview is used in policies used to assess childhood abuse. In evaluating childhood violence evaluation, both physical examination and behavioral review should be assessed during the interview.   A conducive environment should be created to enable the client to feel comfortable so as to be forthcoming with information.  The client and the therapist should develop a good relationship. Prevention, early identification of violence with intervention restrict incidence, and avoid further development of trauma.

Trauma screening refers to a brief method, centered survey to evaluate if a person has undergone one or more traumatic events, has reactions to such events, has particular mental or behavioral health needs, and requires referral for a thorough trauma-informed mental health evaluation.  Screening and screening questionnaires and clinical interviews are techniques that help in evaluating for violence. The questionnaires can help diagnose a high-risk parent or caregiver who can mistreat a child or teenager and can determine whether they are at risk of abuse, are sexually abused or have been abused in the past.

Media Exposure

Media visibility can be helpful, but it has several drawbacks as well. An advantage of the media is that it can serve as a place for people to interact and exchange thoughts about the risks of child violence and prevention. Social networking and the internet also encourage abuse-victim children to find resources to aid coping.  Their emotional health will benefit from their receiving support. Media networks’ limitation can also be gateways for the perpetration of child exploitation and exposure to sex predators.   It allows children easy access to the attacker which can lead to cyberbullying and sexual assault.

 Colleagues Response # 2

Treating Childhood Abuse

           Child abuse is a horrifying problem and is the third leading cause of death in children between the ages of one and four (Kodner & Wetherton, 2013). Practitioners need to persistently assess children for possible abuse and neglect. The practitioner must know how to assess for abuse and what risk factors to look for. Emotional and behavioral difficulties in children place them at a high risk for abuse and children that have abuse and trauma often have mental health issues (Christian, 2015). Psychiatric Mental Health Nurse Practitioners (PMHNP) must know how to assess children because of the increased risk of abuse.

Assessing Children for Abuse

Assessment of abuse in children varies by age and cognitive level. In pre-verbal children, it is important to look for signs and symptoms of abuse, how they act during play, and the relationship between the child and their parents (Stanford Medicine, 2020). Symptoms in this age group can be behavioral, such as excessive crying or bedwetting, or physical, such as poor hygiene or poor weight gain (Stanford Medicine, 2020). In verbal children, it is suitable to ask age-appropriate questions (Stanford Medicine, 2020). It is important that practitioners don’t ask leading questions and only ask questions that are necessary (Stanford Medicine, 2020). Some questions include, “what happens when you do something your parents don’t like” or “has anyone ever touched you in a way that you don’t like” (Stanford Medicine, 2020)? It is important to examine the child’s history to look for patterns of abuse and risk factors for abuse (Kodner & Wetherton, 2013). A physical exam can also be a part of the assessment piece for abuse and neglect (Kodner & Wetherton, 2013). PMHNPs do not often do a complete physical exam, but they can assess visually and ask about pain and medical issues. Lastly, the PMHNP should document and report any concerns when necessary (Kodner & Wetherton, 2013). Prevention and early detection of child maltreatment are essential to the outcome of the situation.

Media and Social Media

           Exposure to media and social media can influence patients, especially teenagers. Social media is popular with teenagers and carries with it many dangers for children today. Social media allows teens to constantly compare themselves to others and decrease social interactions. Isolation can be especially dangers for kids that are abused or neglected at home because they have fewer relationships where they can reach out for help. Social media increases the potential for cyberbullying, trolling, identity issues, and fake news (Baccarella et al., 2018). All of these can negatively affect teenagers, especially those who are being mistreated. When teenagers are immersed in social media they have fewer outlets that they can find reprieve.

           Media and social media can also be positive. It can allow teenagers to find groups and support online. Teens might also be more willing to reach out to someone about abuse and neglect online instead of in person. They can search for resources and numbers to call for help. Media can be used to spread news about resources and help concerning abuse and neglect. Media and social media have good and bad things depending on how it is utilized.

Mandatory Reporting

In the case study for this week, Morgan confides in the PMHNP that he was molested by his cousin, as a child and was neglected by his family. Morgan is 19 years old and is disclosing past abuse as a child and the family member has already served a sentence for molesting him and other children. Because the patient is technically an adult and is no longer in harm, the practitioner is not mandated to report the information.

In Michigan, where I will be practicing, practitioners are mandatory reporters. If a practitioner is seeing a child who discloses abuse or neglect we must report suspensions of abuse or neglect to the Department of Health and Human Services immediately (Michigan.gov, 2020). The reporter can remain anonymous and can also be punished if they fail to report abuse (Michigan.gov, 2020). It is important that practitioners report all abuse or suspected abuse to prevent potential harm from occurring.