PS 220 Walden University Child and Adolescent Psychology Assessing Mood Disorders Discussion Mood problems often constitute a primary reason why parents se

PS 220 Walden University Child and Adolescent Psychology Assessing Mood Disorders Discussion Mood problems often constitute a primary reason why parents seek professional help for their children or adolescents. Most often, mood problems include irritability, sadness, or anger. A certain amount of moodiness and impulsivity is normal during childhood and adolescence; therefore, it makes it exceptionally difficult to diagnose children and adolescents with conditions such as clinical depression or bipolar disorders. One of the most challenging elements in counseling is objectively assessing whether a child or adolescent has a mood disorder. Cultural and family factors are one reason this is challenging. At times, these factors are directly the cause of the mood disorder or contribute to the stress or distress of children and adolescents. Therefore it is important to use a systematic, objective, and dispassionate procedure for gathering data about children and adolescents when conducting assessments.

For this Discussion and subsequent Discussions, consider these questions: a) Where does the child’s or adolescents problem originate from, and b) Does the problem stem from the child or adolescent, or is it the family or other factors? By asking these questions, you can more accurately assess a child’s or adolescent’s problems and create evidence-based interventions to address the right problem effectively. Select a case study in this week’s Learning Resources, and consider the child’s or adolescent’s presenting problem and where the presenting problem may originate.

With these thoughts in mind:

Post by Day 4 a brief description of the presenting symptoms of the child or adolescent in the case study you selected. Then, explain one possible reason the child’s or adolescent’s problem exists and why. Finally, explain one intervention you might use to address the child/adolescent or parent/guardian in this case study. Be specific and support your response using the Learning Resources and current literature.

References:

Flamez, B. & Sheperis, C. J. (2015). Diagnosing and treating children and adolescents: A guide for clinical and school settings. Hoboken, NJ: John Wiley & Sons, Inc.
Chapter 9 “Depressive Disorders”
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2007). Tough kids, cool counseling: User-friendly approaches with challenging youth (2nd ed.). Alexandria, VA: American Counseling Association.
Chapter 4, “Rapid Emotional Change Techniques: Teaching Young Clients Mood Management Skills”
Chapter 8, “Assessment and Management of Young Clients Who Are Suicidal”
Gutierrez, P. M. (2006). Integratively assessing risk and protective factors for adolescent suicide . Suicide and Life-Threatening Behavior, 36(2), 129–135.
© 2006 by BLACKWELL PUBLISHING. Reprinted by permission of BLACKWELL PUBLISHING via the Copyright Clearance Center.
Pirruccello, L. M. (2010). Preventing adolescent suicide: A community takes action . Journal of Psychosocial Nursing and Mental Health Services, 48(5), 34–41. Suicide Assessment Procedures, Documentation, and Risk Factors
The following checklists are from your course text (Sommers-Flanagan & SommersFlanagan, 2007) and are designed to guide your through the general suicide assessment domains
and general documentation standards.
Checklist of General Suicide Assessment Procedures (Table 8.1)
_____ 1. Assess risk factors (see comprehensive risk factor checklist)
_____ 2. Ask about suicidal thoughts
_____ 3. Assess suicide plans
_____ 4. Assess self-control
_____ 5. Assess client intent or goals associated with suicidal behaviors
_____ 6. Obtain psychiatric or collegial consultation
_____ 7. Determine appropriate action (degree of intervention)
Suicide Assessment Documentation Checklist (Table 8.2)
Check off the following items to ensure that your suicide assessment documentation is up to
professional standards.
_____ 1. I discussed limits of confidentiality and informed consent with the client and parents.
_____ 2. I conducted a thorough suicide assessment, including:
_____ Risk factor assessment
_____ Suicide assessment instruments or questionnaires utilized (write in)
_____ Assessed suicidal thoughts, plan, client self-control, and suicidal intent
_____ 3. I obtained relevant historical information from the client regarding suicidal behavior
(e.g., suicidal behaviors by family members, previous attempts, lethality of previous
attempts, etc.).
_____ 4. Previous treatment records were requested/obtained.
_____ 5. I consulted with one or more licensed mental health professionals.
_____ 6. An appropriate “no-suicide” contract was established.
_____ 7. The patient was provided with information regarding emergency/crisis resources.
_____ 8. In cases of high suicide risk, appropriate and relevant authority figures (police officers)
and/or family members were contacted.
Reference:
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2007). Tough kids, cool counseling: User-friendly approaches with challenging youth (2nd ed.).
Alexandria, VA: American Counseling Association.
Child and Adolescent Suicide Risk Factors and Warning Signs
There are different approaches to conducting suicide assessments, but all approaches
acknowledge the need to be familiar with suicide risk factors. The good news is that there have
been many suicide risk factors identified through research and clinical work. The bad news is
that suicide is essentially unpredictable. Despite this bad news, you should definitely be familiar
with the following risk factors and warning signs. Generally, the risk factors are more researchbased and the warning signs are more clinical based.
5min
Suicide Risk Factors
___ 1. Vulnerable group due to age/sex/ethnicity
___ 2. Previous suicide attempt
___ 3. Using alcohol/drugs excessively or abusively
___ 4. DSM diagnosis
___ 5. School problems
___ 6. Isolated or harassed
___ 7. Physical health problems
___ 8. Recent significant personal loss (of ability, objects, or persons)
___ 9. Struggling with sexuality issues
___ 10. Victim of childhood or current abuse
___ 11. Diagnosis of depression
___ 12. If depressed, the teen is also experiencing:
____
Panic attacks
____
General psychic anxiety
____
Lack of interest and pleasure
____
Alcohol abuse increase
____
Diminished concentration
____
Global insomnia
___ 13. Significant hopelessness, helplessness, or excessive guilt
___ 14. Suicidal thoughts are present.
Note: Evaluate for:
____ Frequency of thoughts (How often do these thoughts occur?)
____ Duration of thoughts (Once they begin, how long do the thoughts persist?)
____ Intensity of thoughts (From 1 to 10, how compelling are the thoughts?)
___ 15. There is a history of impulsive behavior.
___ 16. A suicide plan is present (evaluate the plan based on the SLAP acronym, which refers to
specificity, lethality, accessibility of means, and proximity of social support).
___ 17. There is a moderate to high intent to kill self (or a previous lethal attempt).
___ 18. Recent prescription of an SSRI and associated disinhibition or agitation
___ 19. Possession of or access to firearms
Suicide Warning Signs
___ 1. Suicide threats, both direct and indirect
___ 2. Obsession with death
___ 3. Sudden or abrupt loss of interest in usual activities
___ 4. Sudden social withdrawal
___ 5. An increase in dangerous or illegal or risk-taking activities
___ 6. Poems, essays, and drawings that refer to death
___ 7. Dramatic change in personality or appearance
___ 8. Irrational, bizarre behavior
___ 9. Overwhelming sense of guilt, shame, or rejection
___10. Severe drop in school or work performance
___11. Giving away or throwing away important possessions
___12. Recent extreme stress (e.g., romantic break-up, parental abandonment,
parental/sibling/friend suicide, etc.)
___13. Possession (often secretive) of a dangerous weapon
___14. Recent and significant increase in drug or alcohol use
___15. An unexplained surge of cheerfulness or energy following a prolonged period of
depression
Child and Adolescent Counseling Cases
Mood Disorders and Self-Harm
Cases Week 7: Case 1
Salena is a 16-year-old Native American sophomore girl at a local high school. Her mother,
who accompanied her to the initial session, referred her for counseling.
During the first session you spent about 25 minutes with Salena and her mother and then
about 25 minutes with Salena alone. While you are interviewing Salena along with her mother, you
observe they appear to have a reasonably good relationship. Her mother is worried about her and
primarily attributes Salena’s symptoms to the fact they recently moved from the Indian reservation
to a more urban area. She believes Salena is having trouble adjusting to the new school and
neighborhood. The move was prompted by the fact that Salena’s mother is in a new romantic
relationship; Salena and her mother moved in with the mother’s boyfriend. Salena’s father has not
been involved in her life since she was about 6 years old.
Salena’s mother reports that Salena is often irritable and difficult at home. This irritability has
increased substantially in the past 3 months. Salena basically agrees with her mother on this point.
They also both agree that Salena is engaging in fewer recreational activities and reporting little
enjoyment from the activities in which she participates.
During the interview Salena’s mother describes one of her major concerns, “Salena keeps
talking about not really caring if she’s alive or not anymore.” Salena interrupts at this point and says
“Mom, you’re making way too much of that. It’s not that big a deal.” But her mother goes on and
says, “What about the other day when you said, ‘maybe if I get hit by a truck I won’t have to take
that algebra test,’ what am I supposed to do when you say things like that?” Salena responded that
she was just expressing her feelings about her upcoming algebra test.
Based on your time with Salena and her mother and with Salena alone, you discover she has
unintentionally lost 14 pounds and reports little appetite. She also recently quit her part-time job.
Her grades have been going down (from low As to low Bs and high Cs) and her attendance has been
poor recently; otherwise, she has a relatively positive behavioral record at school. Salena also reports
to you that she is having difficulty concentrating and that school is “boring and stupid.” Also, Salena
denies using alcohol/drugs, and this seems to be valid information as it is consistent with what her
mother reports. Finally, there is no evidence that Salena is suffering from any medical disorders. She
has no history of any mental disorders and no trauma history.
Week 7, Case 2
Monte is a 9-year-old white male who has been referred to you by a local school. In the
referral, Monte was described as exhibiting several behaviors that are very difficult to manage in the
classroom. Specifically, he quickly becomes verbally aggressive toward teachers, regularly accuses
them of picking on him, and he verbally insults most of the other students in his classroom. The
school counselor who has worked with Monte reports that Monte comes from a very chaotic family.
He has two older sisters who are often left to care for him. He complains about his sisters being
mean, but other than significant parental absence, there is no evidence of abuse in the family. The
school counselor further notes that she believes Monte has a tremendously low self-esteem. She says
that when other students are not around, he is clingy with teachers and seems to solicit their
approval. She reports that Monte was doing better in early elementary school, but over the past 2
years his behavior has generally declined. She further reports that he has difficulty concentrating and
that he states things like, “School is stupid. I always get bad teachers. Things will never get better for
me.” In the past year Monte has displayed a pattern of overeating, and there is some concern about
him developing a weight problem. He also complains of frequent headaches and his attendance at
school is poor.

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