Treating Childhood Abuse Essay

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Treating Childhood Abuse Essay.

Treating Childhood Abuse

Child abuse and neglect is a societal problem that is known to lead to mental health issues in later life for the affected child. This abuse can take many forms and includes sexual abuse and physical molestation. As for neglect, children may have parents who are mentally unstable or suffering from diagnosed mental illness as in the case study. Because of this, the parents may not be able to take care of their responsibilities towards the children who then end up neglected.Treating Childhood Abuse Essay.

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Other parents simply abscond from their parental duties leading to their children being taken into foster care. Some of the children end up with relatives who, like in the case study, take advantage of the children to abuse them. These children get traumatised in later life and may suffer anxiety and post-traumatic stress disorder or PTSD. Both of these are diagnostic categories in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders or DSM-5 (APA, 2013). This paper discusses the strategies for assessing these kinds of patients and the matter of mandatory reporting of child abuse and neglect.Treating Childhood Abuse Essay.

Strategies the Author Would Use to Assess for Abuse

Because persons who have experienced abuse as children may be reluctant to divulge information about those experiences, an important strategy is to exercise patience. These persons are afraid of reliving the traumatic experiences and hence try to avoid any memories of them. For this reason, the psychiatric-mental health nurse practitioner (PMHNP) would do well to give them time. This may mean allowing them to go home and rescheduling another appointment to try and get the information when the client is ready. The other strategy would be to avoid appearing as though you are blaming the person for what befell them. This will mean avoiding questions like “Why did you not tell someone you trust like a neighbor who could have helped you?” This is because these kinds of questions put the client on the defense and only serve to shut them up.Treating Childhood Abuse Essay. The traumatic experiences happened in their childhood and many factors may have led to them not telling anyone else. One of these factors is threats by the perpetrators (who are close relatives to the victims most of the times) of dire consequences. The victims would be afraid to report them also because they may be depending on them for food and shelter too. These strategies have been selected by the author because they stand a good chance of enabling the author to unearth the real causes of the client’s current mental status.Treating Childhood Abuse Essay.

Exposure to Media/ Social Media and Mandatory Reporting

Exposure to media or social media bombards the client with a barrage of information about child abuse and neglect. This makes them realise that they were actually victims even if they had not previously thought of it like that. This exposure may actually be the start of the client’s symptoms relating to their psychiatric diagnosis (Sadock et al., 2015; APA, 2013). In the United States, there are 48 states with mandatory reporting laws. These laws obligate particular classes of adults or professionals to report to the relevant authorities any cases of child abuse and neglect that they come across or learn about. These could be teachers or healthcare professionals (Thomson Reuters, 2020). In this case, the form of mandatory reporting would depend on the state in which the now 19 year-old Morgan was in when they were suffering the neglect and child abuse. This is because the state laws and mandatory reporters are not uniform across the country. For instance, in New York physicians and school officers can report. In California, the clergy too are mandatory reporters.Treating Childhood Abuse Essay.

Conclusion

The problem of child abuse and neglect is an important mental health concern for PMHNPs. This is because it contributes immensely to cases of anxiety and PTSD in later life for the children who are victims. Each state in the US has a mandatory reporting law that spells out the categories of persons or professionals who are mandatory reporters of child abuse and neglect cases. For the PMHNP, there are several strategies that they can use to effectively assess this kind of client during history taking and mental status examination (MSE). Treating Childhood Abuse Essay.

References

American Psychological Association APA. Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 5th ed. Author.

Sadock, B.J., Sadock, V.A., & Ruiz, P. (2015). Synopsis of psychiatry: Behavioral sciences/ clinical psychiatry, 11th ed. New York, NY: Wolters Kluwer.

Thomson Reuters (2020). Mandatory reporting laws: Child abuse and neglect. FindLaw. https://criminal.findlaw.com/criminal-charges/mandatory-reporting-laws-child-abuse-and-neglect.html

“He was drunk again, so I should have known better. I should have stayed away from the house, but that would have made him madder. He has done this before, but not nearly this bad. He broke my wrist as I was protecting my mom. The neighbor heard the screaming and called the cops. They hauled him away, but I know he will be back. She always lets him come back.”Treating Childhood Abuse Essay.

Avery, age 14

In August of 2005, thousands of children lost their homes in Hurricane Katrina. On December 14, 2012, the students at Sandy Hook Elementary School experienced the death of 20 of their classmates and six of their teachers. Every day, children experience physical and sexual abuse and neglect by their parents or caregivers. These types of trauma have a lifelong impact on the children involved and those witnessing the events. As much as we try to prevent unwanted childhood trauma and stressors, the phenomena are present in our culture. Childhood trauma is a significant contributor to both physical and mental health problems in children and adults.Treating Childhood Abuse Essay.

This week, you examine several cases of child abuse and neglect, and you recommend strategies for assessing for abuse. You analyze influences of media and social media on mental health and evaluate the need for mandatory reporting of abuse.

Resources

Required Readings

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Trauma- and Stressor-related Disorders”
American Psychiatric Nurses Association. (2017). Childhood and adolescent trauma. Retrieved from http://www.apna.org/i4a/pages/index.cfm?pageID=4545

Pfefferbaum, B., & Shaw, J. A. (2013). Practice parameter on disaster preparedness. Journal of the American Academy of Child & Adolescent Psychiatry, 52(11), 1224–1238. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00550-9/pdf

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 31, “Child Psychiatry” (pp. 1216–1226)

Review the following medications:

Posttraumatic stress disorder
citalopram
clonidine
desvenlafaxine
escitalopram
fluoxetine
fluvoxamine
mirtazapine
nefazodone
paroxetine
prazosin (nightmares)
propranolol (prophylactic)
sertraline
venlafaxine
Note: Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.”Treating Childhood Abuse Essay.

Document: Childhood Abuse Case Study (PDF)

Child Abuse Case Study:

Psychiatric Mental Health Nurse Practitioner Role I: Child and Adolescent Morgan, a 19-year-old male comes to your office to discuss his current mood and symptoms. This is his first visit to a mental health clinic. “I’ve had 26 jobs in the last 2 years; I finally have a job that I like and I want to make it work.” As you begin to get to know him, he tells you that his mood is down and that he also has times where he has “more energy and motivation”: Treating Childhood Abuse Essay.“That’s when I am able to get a new job.” He says that he has difficulty interacting with coworkers. “I feel like I can’t talk to them.” If it wasn’t for his supportive girlfriend, he wouldn’t be able to function. “She understands me and accepts me; she knows what I have been through.” As the PMHNP listens to the client and explores what he means by some of his statements, you try to put together his story. He mentions that he has been having nightmares and is not sleeping well. He says he startles easily. He becomes withdrawn when he begins to talk about the reason for the nightmares. “This all started a few weeks ago when a cousin of mine got out of jail.” He haltingly tells the story of his parents’ mental illness and how he had to live with various relatives. “One cousin who I stayed with a lot took advantage of me. He molested me.” They found out he also molested other children and he went to jail. “It gives me the creeps that he is out of jail. I have to face what he did to me.” Morgan asks about his diagnosis. The PMHNP tells him that he has some symptoms that sound like depression and anxiety, and that when a child has a traumatic experience, it can reoccur and stay with a person for many years. He acknowledges that he thought about PTSD but wasn’t sure what the symptoms look like. As you think about Morgan’s story, consider the following questions:Treating Childhood Abuse Essay. Where did he fall between the cracks? Are there agencies who advocate for children like him? There are thousands of children like Morgan. They were in a vulnerable family situation and the “responsible” adult was not able to care for the child. Sometimes it takes years for clients to remember and disclose the abuse.

Treating Childhood Abuse

In 2012, statistics in the United States indicated that state CPS agencies received 3.4 million referrals for child abuse and neglect. Of these, nearly 700,000 children were found to be victims of maltreatment: 18% were victims of physical abuse and 78% were victims of neglect (CDC, 2014). Child sexual abuse makes up roughly 10% of child maltreatment cases in the United States (CDC, 2014). The CDC considers sexual abuse at any age a form of violence. Child abuse of any kind can lead to an increased state of inflammatory markers in adulthood, as well as multiple physical illnesses and high-risk behavior such as alcoholism and drug abuse. If a PMHNP identifies child abuse, there may be a need to report the abuse to authorities. Once able to provide treatment, the PMHNP can be instrumental in reducing the long-term effects of child abuse.Treating Childhood Abuse Essay.

In this Discussion, you recommend strategies for assessing for abuse and analyze influences of media and social media on mental health. You also evaluate the need for mandatory reporting of abuse.

Treating Childhood Abuse Essay.