psy8001_Sutton_Week10 Assignment1_Case Study PartII

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Week 10 Assignment: Case Study Part II John Sutton Capella University PSY8001 Orientation to Prof Psych Dr. Zach Held 12/15/23

2 Week 10 Assignment: Case Study Part II Understanding the complexities surrounding suicide attempts by adolescents requires gaining information that provides enough context surrounding the multitude of causalities associated with such an attempt (Donaldson et al., 2005). To gather information that highlights those causalities requires extensive collaboration with not just the client but the people in their life who either influence, impact, or are a part of the events leading to and after an attempt, as well as those who are a part of their hospital stay and aftercare team. Within the collaboration process, there are typically three phases towards the progression of information identification and care planning. The first phase assists those involved in defining the problem, the second is the development of strategies to address the issues associated with the client's attempt, and lastly, each collaborator works together as a group to implement and monitor the identified strategies (Iachini et al., 2018). Applying this phased process of collaboration to the case study scenario, the clinician would need to consult and collaborate with the parents of the youth (mother and father), his school counselor, the neighbor who found the teen during his attempt, the first responders (police and paramedics who arrived on the scene) the doctor who stabilized the client once arriving at the hospital, and his primary care physician, in order to attain the identified information to assist in gathering patient history, diagnosing, treatment development, and designing an aftercare plan. Before collaboration with the individuals involved in the client's care or personal life, consent must be attained from the client to ensure they clearly understand the clinician's therapeutic process and are comfortable with the entire process surrounding information gathering and treatment plan. Safeguarding client information and including the client in the decision-making process surrounding their care allows for trust and buy-in to the therapeutic

3 process (Compliancy Group. 2023). Since family, as well as those individuals who play integral roles within a client's life, will be, in some capacity, involved in the patient's health care and after-treatment plan, a clinician must follow HIPPA guidelines when collaborating and communicating with those integral individuals. As such, a clinician will ask the client permission to share relevant information and inquire about their history with family, behaviors, interactions at school, and events leading up to and after hospitalization (OAC.Gov, 2023). Once permission and buy-in by the client are attained, the clinician's initial points of information gathering would be with the doctor who stabilized the teen upon entering the hospital and the first responders (paramedics and police officers) following his suicide attempt. The reason for collaborating with the doctor who treated the teen is to obtain information regarding the type and amount of medication the teen ingested during his attempt, as well as to establish the time frames and aftercare processes that the teen may still need to maintain his stabilization. For example, say the teen overdosed on a barbiturate-based medication; there may be a significant process necessary for detoxing and possible identification of side effects long after immediate stabilization (King et al., 2013). Additionally, this information helps in identifying possible SUD issues the teen may have been experiencing, which can direct diagnosis and treatment options. Speaking with the paramedics and police who responded to the attempt provides additional context to the time frames surrounding the incident as well as the environment the client was found in, which helps with building the biopsychosocial history of the client. The approach a clinician can take when gathering information from the stabilization doctor and first responders is to inform them of the clinician's intent and process while being transparent in that intent (e.g., to identify aftercare processes and possible diagnostic criteria). By providing intent and involving the doctor and first

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4 responders in the clinician's thoughts behind the questioning/information gathering, they will be more receptive to collaborating and offering independent suggestions for aftercare and context surrounding the event, which goes beyond simple statements of medical information noted in a police report or medical chart and allows for a more client-centered treatment plan (Donaldson et al., 2005). Adding more context to possible events that contributed to the client's attempt also requires consulting with the client's primary care physician to obtain past and current medical history and identify any medications the client may have been on or is currently taking. Through collaboration with their primary care physician, the clinician can gain insight into the client's physical health history as well as any medical needs that may impact assessments, diagnosis, or treatment options/plans. Moreover, specific insights into the client's past behaviors and cultural perspectives on receiving medical care by the primary care physician can provide valuable behavioral and mental health history, which otherwise would not be incorporated into the overall treatment plan without such insight ( Zamani & Harper, 2019). An approach to collaborating with the primary care physician would be to express the need for such information, and professional medical opinion will allow for a more thorough aftercare plan, which will require ongoing involvement of the primary care physician. For example, to provide ongoing medication prescriptions, referrals to therapists or psychiatrists, as well as physical checkups and outpatient care services once the client is discharged from the hospital (Levine, 2006). Such an approach will allow the physician to remain invested in the process of treatment even though they may not be directly involved while the client is hospitalized. After gathering information and collaborating with medical professionals and first responders, speaking with the client's parents (mother and father) becomes necessary to establish

5 the family dynamic as well as the structure and roles each member plays within the family system. Interviewing each parent will provide valuable information about past behaviors the client may have exhibited, as well as elaborate on the events leading up to the attempt as well as the support the client will need while in treatment, and the type of resources and aftercare plan the clinician will identify or design. Additionally, the family becomes expressly critical to establishing client trust and understanding the emotional needs a client may be expressing or repressing while in treatment (Tait & Dunn, 2018). Moreover, gaining insight into the client's role and how the client identifies within his family system (both individually and culturally) allows the clinician to effectively assess and diagnose the client by establishing key factors towards past and present behaviors, beliefs, and self-designators. An approach a clinician can take when collaborating with family members is to educate and enforce proper conceptualization of the event. For example, allowing the family to process while providing them with the knowledge that this attempt is a means for addressing the ongoing issues that otherwise may not have come to light. Furthermore, to encourage the family to view the event as a means to help and grow as a unit instead of blaming or judging. When a family can group together to solve problems and stand in unity for the well-being of the family, then a client who may have felt disconnected from their family system can begin to view that system in a more supportive light (Litman & Wold, 1976). This approach can also foster additional information sharing and inclusive suggestions for treatment approaches that involve the family members in the client's current treatment and aftercare. Lastly, the clinician will need to interview and collaborate with the client's neighbor and school counselor to obtain information regarding social interactions and perceptions of client behaviors leading up to the event and the cultures and identities the client expresses while in

6 public. The neighbor offers valuable context to the event since he found the client and saw him take the medication. Additionally, they expressed contradictory views of the client's behaviors from the family, which can be instrumental in connecting with the client and understanding his state of mind at the time of the event. Moreover, the neighbor may also be (with the client and family's permission) a means of aftercare support for the client. Involving the client's school counselor in the collaboration and information-gathering process can reinforce the information provided by the family and neighbor about the client's behaviors, identities, and expressions of self (while in public) by providing information on the quality of the client's school involvement, interactions with friends and fellow classmates, teachers, and any school activities the client may be involved in. These outside views of client behaviors and identification while in public, as well as the social involvement or disconnect the client has a history of, will be beneficial in assessments and treatment plans. The approach the clinician can take while collaborating with the neighbor and school counselor would be to provide information (as long as the client is fully aware of what information is being provided) that expresses the need of the client for social support, such as parts of the after-care plan and continued services which are non-medical in nature (APA, 2013). For example, regarding the neighbor having specific information that allows them to feel included in the support system will strengthen the client's bond with the neighbor and provide a sense of self-confidence for the client that others care about his well-being, not because they are family but because they genuinely care for the client as an individual (Tolan & Dodge, 2005). Providing the school counselor with information and expressing the need for their involvement in the aftercare process will also allow for an extended resource of support as the client may have a hard time readjusting after the attempt and may need additional time to integrate back into the

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7 social structure of a school setting. Moreover, the school counselor, when involved and approached in such a collaborative manner, can allow for notification of any changes that may express the client's backsliding after release that perhaps a family or neighbor may not identify. For example, taking much longer to reintegrate back into the social structure the client used to belong to before the incident, adverse behaviors while in class, self-isolating, etc. (Rezapur- Shahkolai et al., 2020). To conclude, through the consultation and applying a phased process of collaboration with the doctor who stabilized the teen after the attempt, the first responders, the primary care physician, his parents, the neighbor, and the school counselor to gather the identified information that will assist the clinician with patient history and the development of a treatment and aftercare plan. This collaborative effort is paramount to understanding questions surrounding the adolescent's recent and current mental state, any collateral data that can identify health issues, the teen's biopsychosocial history, his past and current behaviors, his self-dichotomies, the cultural belief systems he identifies with, his family structure and system, the environment he lives in, and any coping mechanisms he may possess; all of which is needed for assessments, designing treatment plans, and providing resources for the teen during and after his release from the hospital following his attempted suicide.

8 References American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association . https://doi-org.library.capella.edu/10.1176/appi.books.9780890425596 . Compliancy Group. (2023). HIPAA California: How to Comply with California HIPAA Laws. https://compliancy-group.com/how-to-comply-with-california-hipaa-laws/Links to an external site. Donaldson, D., Spirito, A., & Esposito-Smythers, C. (2005). Treatment for adolescents following a suicide attempt: Results of a pilot trial. Journal of the American Academy of Child and Adolescent Psychiatry, 44(2), 113–120. Iachini, A. L., Bronstein, L. R., & Mellin, E. (2018). A guide for interprofessional collaboration. Council on Social Work Education. King, C. A., Ewell, F. C., & Rogalski, K. M. (2013). Teen suicide risk : A practitioner guide to screening, assessment, and management. Guilford Publications. Levine, C. (2006). Hippa and Talking with Family Caregivers. The American Journal of Nursing., 106(8), 51–53. Litman, R.E., & Wold, C.I. (1976). Beyond crisis intervention. In E.S. Schneidman (Ed.), Suicidology: Contemporary developments (pp. 528–546). New York: Grune & Stratton. OAC.Gov. (2023). Office of the Attorney General. California Consumer Privacy Act. https://oag.ca.gov/privacy/ccpaLinks to an external site. Rezapur-Shahkolai, F., Khezeli, M., Hazavehei, S. M., Ariapooran, S., Soltanian, A. R., & Ahmadi, A. (2020). The effects of suicidal ideation and constructs of theory of planned

9 behavior on suicidal intention in women: a structural equation modeling approach. BMC psychiatry, 20(1), 217. https://doi.org/10.1186/s12888-020-02625-w Tait, A., & Dunn, B. (2018). Conversation starters for direct work with children and young people : guidance and activities for talking about difficult subjects. Jessica Kingsley Publishers. Tolan, P. H., & Dodge, K. A. (2005). Children's mental health as a primary care and concern: a system for comprehensive support and service. The American psychologist, 60(6), 601–614. https://doi.org/10.1037/0003-066X.60.6.601 Zamani, Z., & Harper, E. C. (2019). Exploring the Effects of Clinical Exam Room Design on Communication, Technology Interaction, and Satisfaction. HERD., 12(4), 99–115. https://doi.org/10.1177/1937586719826055

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