Comprehensive Psychiatric Assessment

Comprehensive Psychiatric Assessment

Shawn is a 16-year-old boy who has come to an outpatient clinic for a mental health assessment. The appointment was not his idea, and he is not happy to be at the clinic. The provider utilizing positive techniques to engage him will make him feel worth keeping the appointment. The practitioner must help the patient get beyond his closed-off presentation and help the client talk about himself (YMH Boston, 2013c, May 22). The assessment serves as a platform of interrelated purposes to present the chief complaint, formulate a primary differential diagnosis, determine the cause of the issue, and identify the risk of suicidal and homicidal ideations and gather an individualized treatment plan (Mash & Hundsley, 2005).

What did the practitioner did well?

In this scenario, the client is a 16-year-old white male whose mother wanted him to have counseling for potential anger management issues. The practitioner opened his session very well by first going over the session’s privacy and confidentiality portion. Privacy and confidentiality are held in remarkedly high esteem and considered extremely vital for providing patient care. Confidence and privacy help create and develop trust and a healthy relationship between the clinician and the patient; thus, leading to a positive patient care result/outcome. The provider maintained good eye contact and listened attentively. According to Sadock, Sadock &Ruiz, 2014, giving full attention to the patient shows that the clinician cares. Comprehensive Psychiatric Assessment

In what areas can the practitioner improve?

The practitioner could also work on his body language as he sat with his legs crossed, making the client feel as though the practitioner is tense, and the practitioner can smile a little (American Psychiatric Association, 2013). The practitioner could have encouraged Shawn to explain why “school sucks”. The topic should have been explored more with the client. The client also stated several times that he does not like school, but the provider did not ask questions as to why. There are many reasons why a young person might not be achieving academically, including bullying from other students, behavioral or emotional problems, school culture or environment, school workload, and poor relationship with the teacher and other students (Raising Children, 2017). The client seems to have had a difficult time communicating with his mother. The provider should have obtained more information about the client and his mother’s relationship and offered a more effective communication method/strategy. The provider should have used open-ended questions instead of leading questions, making it appear the provider is taking sides. Open-ended questions allow the client to explain his feelings in his own words (Smith, Duell & Martin, 2012). Comprehensive Psychiatric Assessment

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

Yes, I would be concerned about his behaviors when angry and during his outburst with his mom. Has he ever thought of harming her or physically hit her? Does he destroy things, and how long does he display the behaviors. These questions will help the practitioner will identify any risk-taking behaviors he might be engaging himself in. I would be concerned for the mother’s safety, what she does during his anger episodes, and afterward to cope with his outburst.

What would be your next question, and why?

The practitioner’s next questions to Shawn will include if he has thoughts of suicide or homicide, substance use, and sexual practices. As noted by Sadock et al. (2014), clinical interviews with adolescents should include exploration of suicidal thoughts, assaultive behaviors, psychotic symptoms, substance use, and use of safe sexual practices.


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Arlington, Va: American Psychiatric Association.


Mash, E. J. & Hundsley, J. (2005). Special section: Developing guidelines for the evidence-

based assessment of child and adolescent disorders. Journal of Child and Adolescent

Psychology, 34: 362-379. Comprehensive Psychiatric Assessment

Raising Children. (2017). School problems: Children 9-15 years. Retrieved from

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.

Smith, S. F., Duell, D., & Martin, B. C. (2012). Clinical nursing skills: Basic to advanced skills. Boston: Pearson.

YMH Boston. (2013, May 22). Vignette 4 – Introduction to a mental health assessment [Video

file]. Retrieved from Comprehensive Psychiatric Assessment

Response 2


Very well written and informative post. The therapist will endeavor to establish rules and regulations and reassure the client of his right to confidentiality during the visit. The practitioner should involve the client in the initial assessment to help develop a treatment plan that both of them are comfortable with. Saddock, Saddock & Ruiz (2014), in their studies, emphasize the importance and the need for the client to increasingly feel that the evaluation is a joint effort and that the practitioner will honestly invest in their story.

Many individuals lose it when it comes to controlling their anger (Tice, 2000). The client may be having many frustrations he is battling and exhibiting through anger. Because this client did not care for school, the frustration of not learning in the same way as his peers could have resulted in anger difficulties. According to Hammer (2015), children learn anger management from their role models-their parents. When parents do not manage anger appropriately, children will often imitate the same behavior.

The practitioner should endeavor to learn the client’s background to arrive at an appropriate diagnosis and help treat the behavior. According to Tarvis (2012), when parents are too strict and use physical punishment, the child tends to develop low self-esteem and anger difficulties.


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.

Hammer, D. (2015). Living with our genes. New York: Doubleday.

Tarvis, C. (2012). Anger: The misunderstood emotion, 2nd Edition. New York: Touchstone.

Tice, D. (2000). 131 creative strategies for reaching children with anger problems. Chapin, S. C.: Youthlight, inc. Comprehensive Psychiatric Assessment

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