Date post: | 05-Dec-2014 |
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Understanding a youth’s mental health diagnosis and how to appropriately interact
with them
Understanding a youth’s mental health diagnosis and how to appropriately interact
with them
What is mental illness?• “Mental illnesses are medical conditions that
disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning.”– http://www.nami.org/template.cfm?
section=about_mental_illness
Why do we need them?
• A mental health diagnosis guides treatment– Treatment plans cannot be written without a
diagnosis
• Billing– In order to get reimbursed for services such as
therapy, a youth need to have a billable diagnosis.
Where to get your information
• Speak to the youth’s Clinician
• Consultant
• Caseworker and/or parent/s
What causes mental illness?
• Mental Health Issues can come from a variety of reasons: examples include but are not limited to:– Genetics/biochemistry– Difficult family background-unstable caregivers,
domestic violence, substance abuse– Stressful life events-death, abuse– Biochemistry
Important to Remember:
• Be careful of labeling– Be aware of statements such as “he is ADHD” or
“she is RAD”. Instead, use phrases such as “he has ADHD” or “she has RAD”.
• Their diagnosis is not an excuse to act out; but make sure you understand any limitations they may have
• Do not forget to empower the youth– They will often make statements to suggest they
cannot control their behaviors because of a missed medication or because they have ADHD. Empower them by saying “the medication helps but ultimately you are in control of your behaviors”.
Important to Remember:
Common Diagnosis:• Reactive Attachment Disorder
• Post Traumatic Stress Disorder
• Oppositional Defiant Disorder
• Anxiety Disorders (other than PTSD)
• Mood Disorders
RAD:• Reactive Attachment Disorder:
– Markedly disturbed and developmentally inappropriate ways of relating socially in most contexts; inhibited or disinhibited type.
– Consistent rules, boundaries and consequences are very important
– They will often go into “fight or flight” mode
RAD cont.:– These children have learned at a young age that
“adults cannot be trusted”.
– Do not discuss placement changes at it will increase anxiety and cause sabotaging behaviors.
– Do not promise “adoption” to children with this diagnosis; they will attempt to destroy the relationship and unfortunately, will often win.
PTSD:
• Post Traumatic Stress Disorder: Anxiety Disorder that develops after a traumatic event.
• The event may involve the threat of death to oneself or to someone else, or to one's own or someone else's physical, sexual, or psychological integrity.
• The trauma is so overwhelming that it interferes with the individual's ability to cope.
PTSD cont.:
• Common signs and symptoms:– Flashbacks– Nightmares/dreams– Often in a state of hyperarousal– Will sometimes go into fight or flight mode if
triggered
ODD:
• Oppositional Defiant Disorder: A pattern of negative, hostile and defiant behaviors.
– Often loses temper, argues, refuses to comply with requests, blames, lies, easily annoyed or deliberately annoys others.
ADHD:
• Attention Deficit Hyperactivity Disorder: Persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequently displayed and is more severe than is typically observed in individuals at comparable level of development.
ADHD cont:
• Can be predominantly inattentive, hyperactive-impulsive or combined.
• Has to occur in at least 2 or more settings
• Medication does help with symptoms of ADHD
Spectrum Disorders:• Aspergers/Autism/Pervasive Developmental
Disorder:
– Impairment in areas of development such as: social interaction, communication and restricted interest in activities.
– They may have a hard time with peer relationships (or not be interested at all)
Spectrum Disorders cont.:
– Trouble picking up on social cues.
– May have some language delays.
Anxiety Disorders (other than PTSD):
• Other than PTSD, the most common anxiety disorder is Generalized Anxiety Disorder
– Excessive anxiety or worry
– Finds it difficult to control the worry
Anxiety Disorders cont.:
– Restlessness or feeling on edge
– Easily fatigued
– Irritability
– Sleep disturbance
Mood Disorders:
• Major Depressive Disorder– Dysthymis Disorder
• Bipolar Disorder
• Mood Disorder NOS (not otherwise specified)
Mood Disorders cont. Major Depressive
Disorder• Characterized by one or more major
depressive episodes
• Dysthymic Disorder: chronically depressed mood for most of the day more days than not for at least 2 years (does not meet criteria for a major depressive episode)
Mood Disorders cont. Major Depressive
Disorder cont:• Depression looks different in children:
– Irritability– Depression should be considered if there are
changes in behavior without a identifiable trigger
• Take seriously any kind of self harm and/or suicidal thoughts/behaviors.
Mood Disorders cont. Bipolar Disorder:
• There are several different types of Bipolar Disorders
• Generally speaking, this diagnosis if viewed as a “cycle” between depressive symptoms and manic symptoms.
Mood Disorders cont. Mood Disorder NOS:
• Common diagnosis in children
• Usually diagnosed if moods are unstable yet they do not fit any other criteria
Ending Thoughts:
• Make sure to allow the Clinician to make the diagnosis.
• Staff concerns: the treatment team is there to help and support!
Ending Thoughts:
• No matter what the youth’s diagnosis is, use the Teaching Family Model– It gives the child consistency which ultimately
gives them a feeling of safety
• A diagnosis is not permanent!
References:
• National Institute of Mental Health– www.nimh.nih.gov
• National Alliance on Mental Health– www. nami.org
• American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.