Nursing homework help.
NOTE: my assessment tool: The patient Health Questionnaire (PHQ-9
According to the American Academy of Child and Adolescent Psychiatry (1995), children and adolescents are evaluated due to psychiatric disorders that impair emotional, cognitive, physical, and/or behavioral functioning. The child or adolescent is evaluated in the context of the family, school, community, and culture. The purpose and aims of the clinical diagnostic assessment are to determine whether psychopathology is present and, if so, to establish a differential diagnosis and tentative diagnostic formulation, to develop a treatment recommendation and plan, or to communicate the above findings in an appropriate fashion to the parents and child. In addition, the aims of the assessment process are to identify the stated reasons and factors leading to the referral, to assess the nature and severity of the child’s behavioral difficulties, functional impairments, subjective distress, and to identify individual, family, or environmental factors that may potentially account for, influence, or ameliorate these difficulties. When assessing children, parents’ interviews and school functioning reports are necessary.
The assessment tool I will discuss in this post is the Screen for Child Anxiety Related Emotional Disorders (SCARED). Per the University of Pittsburg (2019), SCARED is a child and parent self-report instrument used to screen for childhood anxiety disorders including general anxiety disorder, separation anxiety disorder, panic disorder, and social phobia. In addition, it assesses symptoms related to school phobia. The SCARED consists of 41 items and 5 factors that parallel the DSM-IV classification of anxiety disorders. The child and parent versions of the SCARED have moderate parent-child agreement and good internal consistency, test-retest reliability, and discriminant validity, and it is sensitive to treatment response
Target population: Children ages 8-18 years
Intended users: Clinicians and Psychiatrists
Time to Administer: 10 minutes
Completed by: Children and Parents
How to Use SCARED: SCARED is a questionnaire with scales that describes how people feel. Clients read each phrase and decide if it is “Not True or Hardly Ever True” or “Somewhat True or Sometimes True” or “Very True or Often True”. Then, for each sentence, they fill in one circle that corresponds to the response that seems to describe them for the last 3 months. After each phrase and circles, there are abbreviations of the various disorders. Therefore,
a total score of >25 may indicate the presence of an Anxiety Disorder. Scores higher than 40 are more specific.
A score of 7 for items 1, 6, 9, 12, 15, 18, 19, 22, 24, 27, 30, 34, 38 may indicate Panic Disorder or Significant Somatic Symptoms (PN).
A score of 9 for items 5, 7, 14, 21, 23, 28, 33, 35, 37 may indicate Generalized Anxiety Disorder (GD).
A score of 5 for items 4, 8, 13, 16, 20, 25, 29, 31 may indicate Separation Anxiety Disorder (SP).
A score of 8 for items 3, 10, 26, 32, 39, 40, 41 may indicate Social Anxiety Disorder (SC)
A score of 3 for items 2, 11, 17, 36 may indicate Significant School Avoidance (SN)
(see the attached document or link, it’s the SCARED assessment and how the score is calculated: source http://www.shared-care.ca/files/SCARED_Child_Updated_June_2015.pdf)
Psychometric Properties: There are accumulating studies that have shown the SCARED to have good psychometric properties for children and adolescents from various cultures, so SCARED can be utilized in various countries as a cross-cultural screening instrument for DSM-V anxiety disorders. The psychometric properties of the SCARED are strong because females scored significantly higher than males, and that age had a moderating effect on male and female score differences. Studies have demonstrated that girls run a higher risk of developing anxiety disorders than boys. The moderating effect of age on anxiety symptoms, particularly generalized anxiety disorder symptoms increases for older girls that may highlight the importance of early interventions for them to help reduce the risk for later developmental maladaptation (Crocetti et al., 2011)
Diagnosis for a Client Receiving Psychotherapy: Possible diagnoses for these clients under Anxiety Disorders are Panic Disorder and Agoraphobia (fear of places and situations that might cause panic, helplessness, or embarrassment), Separation Anxiety Disorder, Social Anxiety Disorder (formerly Social Phobia), and Generalized Anxiety Disorder (American Psychiatric Association, 2017).
Legal and Ethical Implications of Counseling Children: The four ethical/ legal issues that arise when counseling children are counselor competence, informed consent, confidentiality, and mandatory reporting of child abuse. Counselor Competence– that is knowledge and skills of the counselor (e.g. use of play therapy), knowledge of mental disorders, understanding human development, understanding family structure, culture/ diversity, and a more talked about topic (transgender). Informed Consent– It is formal permission that allows treatment. The counselor and client fall under legal jurisdiction of contract law. Minors can only enter a contract by parental / guardian consent, involuntary at parent’s insistence, or ordered by juvenile court. Through informed consents, clients are given voluntary knowledge of treatment, must understand consequences of treatment, and if not obtained, counselors are held responsible, and sued for battery, failure to gain consent, & child enticement. Confidentiality must be maintained so it will not cause lack of trust and communication, child not seeking treatment, or early termination of psychotherapy. Mandatory Reporting: mental health professionals must report in all States. It’s the duty of health care providers to report and failure to report breaches legal and ethical standards (Garnsey, n.d.)
American Academy of Child and Adolescent Psychiatry (1995).
Practice Parameters for the Psychiatric Assessment of Children and Adolescents.
Retrieved March 2, 2020, from
American Psychiatric Association (2013).
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
Retrieved March 2, 2020, from
American Psychiatric Association (2017). What Are Anxiety Disorders?
Retrieved March 3, 2020, from
Crocetti, E., Meeus, W. H. J., Raaijmakers, Q. A. W., William, W. H. (2011).
A meta-analysis of the cross-cultural psychometric properties of the Screen for Child
Anxiety Related Emotional Disorders (SCARED). Retrieved March 3, 2020, from
Garnsey, E. (n.d.). Legal and Ethical Issues When Counseling Children.
Retrieved March 3, 2020, from
Screen for Child Anxiety Related Disorders (SCARED)- (2012).
CHILD Version—Page 1 of 2 (to be filled out by the CHILD)
Retrieved March 3, 2019, from
University of Pittsburg (2019). Instruments- Screen for Child Anxiety Related Emotional
Disorders (SCARED). Retrieved March 2, 2020, from