Solved – NSG5905 Week 3 Discussion Board.  You are a psychiatric/mental health nurse practitioner employed in an outpatient community counseling center. Shortly before you leave for the day, you receive a phone call from the father of a new 13-year-old client, that you began seeing who informs you that the client is experiencing violent behaviors.  

1. How would you address this psychiatric emergency? 

The first step with a client experiencing violent behaviors is to make sure the patient and everyone around them are safe. It is best to try to deescalate the situation first. I would ask the patient to perform a telehealth visit or come in the clinic as soon as possible. The child must be approached in a calm manner and allowed time to calm down before beginning an assessment. For violent behaviors, in-patient treatment is occasionally necessary. If the violent behaviors are severe, calling EMS or local authorities may be warranted for safe transport to an emergency room. This will allow for further evaluation.

2. What is the follow-up management and treatment for this adolescent?  

Finding the underlying cause of the outburst is the main goal of treatment. This patient would need to start psychotherapy and a second-generation antipsychotic. Risperidone and olanzapine are the preferred drugs for children due to their rapid onset. Anger management and cognitive behavior therapy can be beneficial for this adolescent. The patient needs to understand how to control the anger with social and environmental alternative. This patient needs the support of the family.

3. What are the ways psychotherapy methods are different with children and adolescents as opposed to adults?  

Children and adolescent psychotherapy methods use play and expressive therapies. The therapist uses play to address emotions and behaviors with the child. Children may also use dance, arts, writing, or music to express themselves during therapy. This allows them to safely express their emotions. Adults tend to use talk therapy. This allows them to discuss their emotions and understand the correlation with their behaviors.

4. What are the legal and ethical principles integrated into the care of this patient? 

Ethical and legal considerations for this patient include providing autonomy as much as possible and obtaining informed consent. The patient needs to be involved in their care to provide adequate care. In violent situations where the patient is a harm to themselves or others, we have the duty to report the behavior. This ensures the safety of the patient, care team, family, and friends. APA