Assignment: Psychiatric Assessment of the Older Adult
Many assessment principles are the same for children and adults; however, with adults/older adults, consent for participation in the assessment comes from the actual client and not parents or guardians. The exception to this is adults/older adults who have been determined incapacitated by a court of competent jurisdiction. Some adults may be easier to assess than children/adolescents as they are more psychologically minded. That is, they have better insights into themselves and their motivations than children/adolescents (although this is not universally true).
Older adults present some of their own unique assessment challenges in that they may have higher levels of stigma associated with seeking psychiatric care. Additionally, there are higher rates of neurocognitive disorders superimposed on other clinical conditions such as depression or anxiety, which creates additional diagnostic challenges.
This week, you will develop your own personal format for initial interviews of mental health clients. You also will explore the restrictions and limitations for practice as a PMHNP in your home state and create a plan for passing the national certification exam.
Week 1-developing skills in interviewing and diagnostic reasoning
As we begin Week 1, the module is focused on developing an interview format that provides you with questions/responses that you will use in your work-ups and diagnostic assessments or some call them Psychiatric H & P. By now, you have seen many different formats and ways that providers conduct interviews.
For this document, I encourage you to think of your personal style as well as assure that all relevant information is collected in the first interview. Do not use a template that you find online or that your preceptor uses in the office. The purpose of this assignment is for you to think through how you interview patients. There are many examples online to use as a guide. The key elements are similar to a medical H &P, HPI, PPH, PMH, FH, SH, ROS (psychiatric), MSE, Clinical Assessment and Formulation, Diagnosis, and Plan. This will be your ‘bread and butter’, so to speak for your entire career. It is worth spending some time and effort on this. If you put in a canned template, I will not accept your work.
My personal style is what I would call ‘conversational’. I try to engage in some social conversation to get the visit started and then as the patient talks, I make notes on follow-up questions. I keep a list of the basic things that I need for my write-up: HPI, PPH, PMH, Soc/Dev, Substance use, Medication history, Stressors, coping abilities, therapy history. At the end of what I consider ‘the interview’ I review my list to make sure that I have all the information and I sometimes say to patients, “let me make sure that I got all the information that I need to make an accurate diagnosis and develop a treatment plan”. Then, I will say to the patient, “do you have anything that you’d like to add?”
This conversational style is not for everyone and I know many providers that use more of a ‘checklist’ style. Think about what you want and how you will feel most comfortable. Feel free to provide feedback to your colleagues –there are no right or wrong styles. Psychiatric Assessment of the Older Adult.
Instructions- Week 1:
Despite what you may believe (or may have been told), there is no such thing as one “right” way to do an interview. In fact, there are numerous books written about the various ways of conducting the clinical interview. In actual clinical practice, you will find the format that “works” best for you and addresses your unique strengths and the needs of the client.
In this Discussion, you will practice finding the interview format that works for you and share those ideas with your colleagues for feedback.
- Develop formats for initial interviews of mental health clients
To prepare for this Discussion:
- Review the Learning Resources.
- Develop an interview format you would use for an initial interview of a client.
- Attach the interview format document you would use for an initial interview of a client.
- Describe what interview format your preceptor uses for the initial interview of a client.
- Describe which element of your interview format is most helpful in your practice.
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.
- Section 5.1, “Psychiatric Interview, Mental Status Examination” (pp. 192–211)
- Section 5.2, “The Psychiatric Report and Medical Record” (pp. 211–217)
- Section 5.3, “Psychiatric Rating Scales” (pp. 217–236)
- Section 5.5, “Personality Assessment: Adults and Children” (pp. 246–257)
- Section 5.7, “Medical Assessment and Laboratory Testing in Psychiatry” (pp. 266–275)
- Chapter 6, “Classification in Psychiatry” (pp. 290–308)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
- “Cautionary Statement for Forensic Use of DSM-5”
- “Assessment Measures”
- “Cultural Formulation”
- “Glossary of Technical Terms”
- “Glossary of Cultural Concepts of Distress”
Barton Associates. (2017). Nurse practitioner scope of practice laws. Retrieved from https://www.bartonassociates.com/locum-tenens-resources/nurse-practitioner-scope-of-practice-laws/
American Psychiatric Association. (2016). Practice guidelines for the psychiatric
evaluation of adults. Retrieved from http://psychiatryonline.org/doi/pdf/10.1176/appi.books.9780890426760
Laureate Education (Producer). (2017b). Working with Adults and Older Adults” [Video file]. Baltimore, MD: Author.
Hagen, B. (Producer). (n.d.-a). Conducting a mental status exam [Video file]. Mill Valley, CA: Psychotherapy.net.
American Psychological Association. (2008). Assessment of older adults with diminished capacity. Retrieved from https://www.apa.org/pi/aging/programs/assessment/capacity-psychologist-handbook.pdf
Rosen, S. L., & Reuben, D. B. (2011). Geriatric assessment tools. Mount Sinai Journal of Medicine, 78(4), 489–497. doi:10.1002/msj.20277
Substance Abuse and Mental Health Services Administration (SAMHSA). (2015). TIP 59: Improving cultural competence. Retrieved from http://store.samhsa.gov/product/TIP-59-Improving-Cultural-Competence/SMA15-4849
Important information for writing discussion questions and participation
Please read through the following information on writing a Discussion question response and participation posts.
Contact me if you have any questions.
Important information on Writing a Discussion Question
- Your response needs to be a minimum of 150 words (not including your list of references)
- There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
- Include in-text citations in your response
- Do not include quotes—instead summarize and paraphrase the information
- Follow APA-7th edition
- Points will be deducted if the above is not followed
Participation –replies to your classmates or instructor
- A minimum of 6 responses per week, on at least 3 days of the week.
- Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
- Each response needs to be at least 75 words in length (does not include your list of references)
- Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
- Follow APA 7th edition
- Points will be deducted if the above is not followed
- Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
- Here are some helpful links
- Student paper example
- Citing Sources
- The Writing Center is a great resource
Welcome to class
Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to.
I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.
Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.
If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.
Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.
Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.
I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!