P4#2
TaniAlexis
P42.docx5 hours ago
Sommer Rucker
W4D1
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Trauma and Stressor-Related Disorders in Childhood
Trauma and stress related disorders occur when there is an atypical response to a physical, mental, or emotional stressor/event resulting in intense symptoms that make it difficult to move past the stressor/event (American Psychological Association, 2019). The trauma/stressor could have been witnessed or directly experienced and includes but is not limited to violent acts, serious injury, natural/manmade disasters, and sexual violations. Additionally, this discussion will identify strategies to assess potential patient abuse, effect of media/social media exposure on the patient, and mandatory reporting.
Strategies
There are multiple strategies to employ when assessing a patient for abuse. First, a comprehensive assessment would be completed. This includes an interview to obtain past/present information and gain an understanding of the patient’s symptoms/concerns/interactions/thoughts/emotions/behaviors. Second, screening tools would be used. This includes HEADDSSS which stands for and assesses home life, education, activities, drugs, sexual activity, safety, and suicide and/or depression (Clark et al., 2018). The Life Events Checklist which is a self-report tool that screens for exposure to 16 possible traumatic events/distress throughout the patient’s life (Weathers et al., 2013). The Childhood Trauma Questionnaire which is a self-report tool of 70 items to assess abuse and neglect in childhood and adolescence (Bailhache et al., 2013). The Checklist of Sexual Abuse and Related Stressors (C-SARS) which is a self-report tool to identify childhood and adolescent sexual victimization as well as perpetrator behaviors, consequences of abuse, and affects of disclosure of the abuse (National Child Traumatic Stress Network, n.d.). Third, I would obtain consent to gather information from other individuals such as the girlfriend, caregivers, and/or parents to gain additional insight into the patient’s difficulties/needs. Fourth, I would ask about any previous psychiatric treatment including dates and providers. I would obtain consent for records from the providers. These strategies would be selected to assist in optimizing the information obtained, formulating an accurate diagnosis, and developing an appropriate treatment plan.
Media/Social Media Exposure Affect
Media and/or social media exposure can affect the patient. For instance, if the patient is engaging in media that has explicit/violent sexual acts or depicts sexual victimization of a child, the media can lead to the patient having a more severe stress reaction, increased intensity of flashbacks, etc.
Additionally, patient mental health and social media usage have a direct correlation in that at-risk teens can develop mental health disturbances such as symptoms of depression/anxiety and feelings of isolation (Clark et al., 2018). Also, patients may look to social media to express themselves. However, the feedback may be negative which in turn creates increased negative thoughts, emotions, and/or behaviors. Therefore, it is important to consider the influence of media/social media to the patient.
Mandatory Reporting
Mandatory reporting is a legal obligation indicating whether certain situations/events/issues are reported by certain individuals. The PMHNP will be included as an individual required to comply with mandatory reporting. When assessing this week child abuse case study, the patient acknowledges being molested and that it was discovered that the perpetrator molested other children. The patient never explicitly stated that he disclosed being molested it is only inferred. Hence, the PMHNP needs to inquire the following:
1. Did the patient explicitly stated to anyone that he was molested?
2. Did anyone from child protective services speak with the patient regarding his molestation?
3. Did the patient attend any court hearings?
Next, the PMHNP would reiterate being a mandatory reporter as this was discussed upon initially meeting the patient. The PMHNP would discuss reporting the patient’s case of sexual abuse of a child. The PMHNP would explain that if the case were already reported, this call would be noted only with no follow-up regarding any information. The PMHNP would explain that if the case were not reported previously that someone from child protective services would be contacting the patient. In support, California prosecution for felony sex offense against a victim under 18 years of age must be started prior to the victim’s 40th birthday (National Conference of State Legislatures, 2017). Thus, it is important to know and understand your state laws.
Conclusion
Working with children and adolescents can be a task within itself. When combined with trauma and stress, the challenge of working with this population of individuals becomes more unique. However, understanding strategies for assessing this population, affect of media/social media, and implications of mandatory reporting can improve the quality of care. With improved quality of care, this population of individuals can effectively manage symptoms and possibly recover from the trauma and stress.
References
American Psychological Association. (2019). How to cope with traumatic stress. https://www.apa.org/topics/traumatic-stress#
Bailhache, M., Leroy, V., Pillet, P., & Salmi, L. R. (2013). Is early detection of abused children possible?: a systematic review of the diagnostic accuracy of the identification of abused children. BMC Pediatrics, 13, 202. https://doi.org/10.1186/1471-2431-13-202
Clark, D. L., Raphael, J. L., & McGuire, A. L. (2018). HEADS4: Social Media Screening in Adolescent Primary Care. American Academy of Pediatrics, 141 (6) e20173655; DOI: https://doi.org/10.1542/peds.2017-3655
National Child Traumatic Stress Network. (n.d.). CHECKLIST OF SEXUAL ABUSE AND RELATED STRESSORS. https://www.nctsn.org/measures/checklist-sexual-abuse-and-related-stressors
National Conference of State Legislatures. (2017). State Civil Statutes of Limitations in Child Sexual Abuse Cases. https://www.ncsl.org/research/human-services/state-civil-statutes-of-limitations-in-child-sexua.aspx
Weathers, F. W., Blake, D. D., Schnurr, P. P., Kaloupek, D. G., Marx, B. P., & Keane, T. M. (2013). The Life Events Checklist for DSM-5 (LEC-5). https://www.ptsd.va.gov/professional/assessment/te-measures/life_events_checklist.asp
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