Pediatric Psychotherapy

1 Psychotherapy Pediatric psychotherapy is a complex task that calls for family, teacher, and client involvement in the assessment and development of a treatment plan (Blake, 2019). Clinicians work closely with parents to make the right diagnosis and offer the right treatment.

Psychological assessments are made at various points of treatment and the necessary treatment adjustments made per the results obtained (Nemeth & Glozman, 2020). This paper highlights the plan of care for a child presenting with abnormal behavior.

Decision Point One: Differential Diagnosis Selected decision: Early-onset of schizophrenia Rationale: The early onset of schizophrenia was the right diagnosis for this client. The symptoms presented in this case are typical of this disorder. They also align with the Criteria for schizophrenia specified in the DSM-5 manual.

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2 Per the DSM criteria, a person must show at least two symptoms of schizophrenia for a month to be diagnosed with this condition. The symptoms include hallucination, disorganized speech, delusions, low level of functioning, poor emotional expression, and catatonic behavior (Geddes & Andreasen, 2020). Delusions and hallucinations are typified by the belief that she can control other people’s minds as well as the belief in spirits and half-cat, half-human friends. The client does not maintain eye contact implying that she has a negative-affect. She is also genetically predisposed to this condition since her father was diagnosed with schizophrenia.

Additional diagnostic tests you would perform on Carrie.

Expected results: The primary aim of the assessment was to make the right diagnosis for the client.

Differences between Achieved and Expected Results Psychiatric assessment for a child is a complex task due to the similarity of symptoms with those of other health conditions and normal development processes (Geddes & Andreasen, 2020).

Assessment should also focus on the family history of the child besides the presenting symptoms. This assessment revealed that the client does not present with symptoms of depression and schizotypal personality disorder.

Decision Point Two: Treatment Decision made: Begin Psychotherapy using a psychodynamic approach.

Rationale: Psychotherapy is the preferable treatment for children with psychiatric disorders despite psychopharmacology is the first line of treatment. Psychotherapy improves the child's adaptive functioning together with academic and social performance (Brems & Rasmussen,

3 2018). The psychodynamic approach enables the PMHNP to understand the child’s experience as well as her interpersonal relationships.

Expected Outcome: This approach aimed to improve the client's and family's knowledge of the disease and the treatment to suppress the fears associated with the use of psychotic medications.

Further, psychotherapy was expected to improve psychological functioning without the risk of adverse health outcomes.

Differences in Results: Psychotherapy aided in addressing only some of the symptoms presented by the client. For psychotherapy to achieve the anticipated outcomes, it must be combined with antipsychotic medications. Medications would act as an adjunct intervention for alleviating the symptoms.

4 Decision Point Three: Treatment Decision made: administer Lurasidone 40mg once daily Rationale: Lurasidone is the most suitable treatment for the early onset of schizophrenia. It is often used as an off-label agent in the treatment of schizophrenia in children. This medication can effectively address the symptoms without adverse health effects. This medication does not affect the lipid profile of the client. Haldol 5 mg was not selected since the high dose could have increased the client’s risk of side effects.

Projected Results: The use of Lurasidone was expected to help with delusional thoughts and other negative symptoms.

Differences in Results Lurasidone has been approved for use in children with schizophrenia. This medication reduces the symptoms of schizophrenia and only produces minor side effects as compared to Haldol and other first-generation antipsychotics. A follow-up is essential after four weeks to ascertain the client’s progress with treatment.

Ethical Considerations Various ethical factors need to be put into consideration during pediatric psychotherapy.

For instance, informed consent from the parent is vital before any antipsychotic medication is administered (Brems & Rasmussen, 2018). The parent and the client need to be educated on the benefits and possible side effects of the treatment plan. Importantly, the interventions employed should be beneficial to the patient as highlighted by the ethical principle of beneficence (Brems & Rasmussen, 2018).

5 Conclusion Psychotherapy and psychopharmacology are practical interventions for schizophrenia and other psychiatric conditions. These interventions help to reduce the symptoms and improve the psychological functioning of a person. Family is also involved in treatment not only for moral support but also to eradicate the possibility of relapse.

6 References Blake, P., (2019). Child and Adolescent Psychotherapy. Routledge.

Brems, C., & Rasmussen, C. H. (2018). A Comprehensive Guide to Child Psychotherapy and Counseling: Fourth Edition. Waveland Press.

Geddes, J. R., & Andreasen, N. C. (2020). New Oxford textbook of psychiatry. Oxford University Press, USA. Nemeth, D. G., & Glozman, J. (2020). Evaluation and Treatment of Neuropsychologically Compromised Children: Understanding. Elsevier.