Prac 6635: Psychpathology Diagnostic Reason Paper

Prac 6635: Psychpathology Diagnostic Reason Paper

Prac 6635: Psychpathology Diagnostic Reason Paper

Prac 6635: Psychpathology Diagnostic Reason sample Paper

Journal Entry

Critical reflection of your growth and development during your practicum experience in a clinical setting has the benefit of helping you to identify opportunities for improvement in your clinical skills, while also recognizing your strengths and successes.

Use this Journal to reflect on your clinical strengths and opportunities for improvement, the progress you made, and what insights you will carry forward into your next practicum

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To Prepare

• Refer to your “Clinical Skills Self-Assessment Form” on the next page, and consider your strengths and opportunities for improvement.
• Refer to your Patient Log in Meditrek, and consider the patient activities you have experienced in your practicum experience. Reflect on your observations and experiences.

The Assignment

In 450–500 words, address the following:

Learning From Experiences

• Revisit the goals and objectives from your Practicum Experience Plan on page 3. Explain the degree to which you achieved each during the practicum experience.
• Reflect on the three (3) challenging patients you encountered during the practicum experience. What was most challenging about each?

Patient #1: 44 year female presents to psychiatric clinic feeling socially isolated and reports not felt comfortable visiting and spending time with family. Reports hallucinations, voices telling her it’s best to be alone . She also reports she seems to forget things more often and she is not as active as she was a few months ago. Dx dementia, clinic depression, schizophrenia. Patient is oriented x3, fairly groomed, dressed appropriately for the environment, no apparent distress. He has fair eye contact with no psychomotor disturbance. He is presently calm but demanding; Speech: nonpressured and fluent, slightly increased amount, unremarkable rate and volume; Mood: not acutely depressed or elevated; Affect: restricted,goal directed, associations intact; He denies current SI or HI. He does not endorse overt delusions or perceptual disturbance, denies current VH, not internally preoccupied.

Patient #2 : 17-year -old female present to clinic with a hx of seasonal affective disorder. Reports difficulty sleeping, sleeps 5 hours with interruptions, wakes up several times. decrease in appetite, but denies restricting, binging, purging. She reports no motivation to finish school this senior year or work since she has been outcasted by all her friends even on social media. Grooming ang hygiene are ok, dressed appropriately for the environment, no apparent distress noted. She has poor eye contact with no psychomotor disturbance. Periods of tearing. She appears sad. Speech: nonpressured and fluent, slightly decreased amount, unremarkable rate and low volume; Mood is depressed or elevated; Affect: restricted, goal directed, associations intact; She denies current SI or HI, does not endorse overt delusions or perceptual disturbance, denies current auditory or visual hallucinations.

Patient #3: 48 year old seen in clinic for depressive symptoms attributed to the death of her child from cancer four months ago. She reports appetite decrease,concentration difficulties,crying episodes and difficulty sleeping. Her appearance is disheveled,exhibits speech that is normal in rate, volume, and articulation and is coherent and spontaneous. Language skills are intact.She is tearful. Body posture and attitude convey an underlying depressed mood. She denies suicidal ideas or intentions. Supportive Therapy and Celexa 20 mg PO QAM, Klonopin 0.25 mg PO TID and Ambien CR 6.25 mg PO QHS PRN were started.

• What did you learn from this experience?
• What resources did you have available?
• What evidence-based practice did you use for the patients?
• What new skills are you learning?
• What would you do differently?
• How are you managing patient flow and volume?

Communicating and Feedback

• Reflect on how you might improve your skills and knowledge and how to communicate those efforts to your Preceptor.
• Answer the questions: How am I doing? What is missing?

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PRAC 6635 Clinical Skills Self-Assessment Form

Desired Clinical Skills for Students to Achieve	Confident (Can complete independently)	Mostly confident (Can complete with supervision)	Beginning (Have performed with supervision or need supervision to feel confident)	New (Have never performed or does not apply)
Comprehensive psychiatric evaluation skills in:
Recognizing clinical signs and symptoms of psychiatric illness	X
Differentiating between pathophysiological and psychopathological conditions		X
Performing and interpreting a comprehensive and/or interval history and physical examination (including laboratory and diagnostic studies)	X
Performing and interpreting a mental status examination	X
Performing and interpreting a psychosocial assessment and family psychiatric history	X
Performing and interpreting a functional assessment (activities of daily living, occupational, social, leisure, educational).	X
Diagnostic reasoning skill in:
Demonstrate knowledge of psychopathology of mental illnesses through discussion for different age groups and mental illnesses	X
Developing and prioritizing a differential diagnoses list	X
Formulating diagnoses according to DSM 5-TR based on assessment data		X
Differentiating between normal/abnormal age-related physiological and psychological symptoms/changes	X
Psychotherapeutic Treatment Planning:
Provide psychoeducation to individuals and/or any caregivers	X
Promote health and disease prevention techniques	X
Self Assessment skill:
Develop SMART goals for practicum experiences	X
Evaluating outcomes of practicum goals and modify the plan as necessary	X
Documenting and reflecting on learning experiences	X
Professional skills:
Maintains professional boundaries and therapeutic relationships with clients and staff	X
Collaborate with multi-disciplinary teams to improve clinical practice in mental health settings		X
Identifies ethical and legal dilemmas with possible resolutions		X
Demonstrates non-judgmental practice approach and empathy	X
Practices within the scope of practice		X
Selecting and implementing appropriate screening instrument(s) and interpreting results:
Demonstrates selecting the correct screening instrument appropriate for the clinical situation		X
Implements the screening instrument efficiently and effectively with the clients		X
Interprets results for screening instruments accurately		X
Identifies the need to refer to another specialty provider when applicable	X
Accurately documents recommendations for psychiatric consultations when applicable.	X

Summary of strengths:

This exercise was key in revealing various areas of strength as far as psychopathology, and diagnostic reasoning is concerned. Among the areas of strengths identified include interpreting symptoms of psychiatric illness and performing a comprehensive history and physical examination. These two are particularly important for patient care as they contribute to the development of appropriate treatment plans.  Among the diagnostic reasoning skills, I have the ability to recognize normal/abnormal age based physiological and psychological behavioral issues, as well as demonstrate knowledge of psychopathology of mental illnesses for ages across the life span. This is also important since it leads to the formulation of an appropriate care plan for mental health patients depending on their age. Additionally, providing psychoeducation to ptients promotes health and wellness, this technique in another strength of mine in psychotherapeutic treatment planning.

 Opportunities for growth:

As earlier indicated, clinical skills self-assessment is important or key for finding out strengths and areas of weakness. Therefore, apart from the already discussed areas of strength, the assessment also revealed various areas of weakness which have presented areas of opportunities to grow. The implication is that I will be able to formulate an appropriate plan to strengthen my areas of weakness. One of the opportunities to grow is Differentiating between pathophysiological and psychopathological conditions under psychiatric evaluation skills. Even though I am confident when performing these skills, it is important to note that I can only successfully complete them under supervision, meaning that I need to improve my skills. In diagnostic reasoning, formulating diagnoses that meet  the DSM 5-TR criteria is a skill set that needs improvement, this is key when coming up with a treatment plan. Most of the skills that present opportunities to grow are in the categories of professional skills, where I am yet to attain independence and selection and implementation of the most appropriate screening instruments.

Now, write three to four (3–4) possible goals and objectives for this practicum experience. Ensure that they follow the SMART Strategy, as described in the Learning Resources.

1.      Goal: To be able to independently differentiate between pathophysiological and psychopathological conditions within the first month of practicum experience a.      Objective:  To perform a daily study on pathophysiological and psychopathological conditions b.     Objective:  To attend to self-test questions on psychopathological and pathophysiological condition c.      Objective: To hold weekly discussions with the preceptor and check on the progress 2.      Goal: To formulate at least a diagnosis every that meets DSM 5-TR criteria according to an individualized assessment for the period of practicum a.      Objective: To discuss with senior staff members on the correct use of DSM 5-TR b.     Objective: To assess at least one patient every week c.      Objective: To study the correct use  of DSM 5 guidelines to formulate a diagnosis 3.      Goal:  To improve my skills in collaboration with care teams of the mental health patient to enhance clinical judgement and skills by the end of the practicum experience a.      Objective: To participate in collaboration team activities at least once a week. b.     Objective: To practice strategies for multi-disciplinary team collaboration c.      Objective: To study collaboration skill enhancement strategies important to psychiatric patient care settings. 4.      Goal: To accurately select a correct screening instrument for clinical situations and interpret results for screening instruments within the first five weeks of the practicum experience. a.      Objective: To study the screening instruments for particular clinical situations b.     Objective: To conduct screening for at least one patient every week c.      Objective: To interpret at least one result for a screening instrument every day.

Practicum Experience Plan

Objective 1: be able to utilize autonomy when analyzing  between pathophysiological and psychopathological conditions within the first month of my practicum rotation.

Planned Activities: studying pathophysiological and psychopathological conditions at least once a day. Taking self-test questions to enhance the skills

Mode of Assessment: Assessment of scores obtained on the self-test questions.

PRAC Course Outcome(s) Addressed:

• Differentiating between pathophysiological and psychopathological conditions

Objective 2: To formulate a diagnosis every week that meets DSM 5-TR criteria for each patient’s individualized care during the period of my practicum.

Planned Activities: Discussions with senior members of staff on diagnosis according to DSM 5. Reading resources on the correct use of DSM  5 for diagnosis

Mode of Assessment: The formulated diagnosis will be checked by the preceptor for correctness and accuracy

PRAC Course Outcome(s) Addressed:

• Formulating diagnoses according to DSM 5-TR based on assessment data

Objective 3: Identify and interpret accurate screening tools and outcomes pertaining to specific clinical situations within the first five weeks of the practicum experience

Planned Activities: study guidelines on the correct selection of screening instruments. Interpret screening results daily. Meet and discuss with my preceptor interpreting the results of the screening instruments

Mode of Assessment: The interpreted results will be checked by the preceptor for accuracy and correctness

PRAC Course Outcome(s) Addressed:

• Recognizes when screening tools need to be implemented and carried out effectively.
• Demonstrates correct identification and interpretation of screening criteria on a case by case basis during patient care.