What are some stressors in the child’s life that are making it difficult to focus in school?
Order a What are some stressors in the child’s life that are making it difficult to focus in school? paper today!
Jessica Alper discussion
Areas of concern
An important area of concern for this 16-year-old patient is to find out why she is having difficulties concentrating in school. As the practitioner, I would want to inquire in more details about the child’s life. What are some stressors in the child’s life that are making it difficult to focus in school? How is her family life? How are her friends? Additionally, seeing that this patient already looks thin and frail in appearance, I would wonder what her diet consists of. Why would a thin and frail teenager inquire about diet pills? What is the reason for her wanting to lose weight?
It seems that this patient could be experiencing depression, as well as body dysmorphic disorder, and an investigation of her lifestyle is a must. There are six categories to discuss with a teenager that can help the practitioner understand the health-related behaviors leading to death and disability. The topics include behaviors contributing to unintentional injuries and violence, risky sexual behaviors that can lead to unintended pregnancy and sexually transmitted diseases, the use of alcohol or any drug use, tobacco use, unhealthy dietary behaviors, as well as physical activity that can be inadequate (Youth Risk, 2020).
Screening tools
An important screening tool to be used at the beginning of the visit is using the HEADSSS assessment. This acronym stands for Home, Education, Activities, Drugs and alcohol, Sports, Sex, Suicide as well as Safety. Asking these questions can help the practitioner understand the patient a bit more in order to better help them. When inquiring about the home, it is important to note who the patient lives with and if they feel safe. Questions related to the education includes grades, interests, and career aspirations. Activities questions may include extracurricular involvements, and favorite pass times. When covering the topic of drugs and alcohol, many screens can be performed, such as the CRAFFT assessment tool. This specific tool includes questions regarding driving a car while being under the influence of alcohol or drugs, the need to take drugs or alcohol to be able to relax, if the patient ever uses any substances when they are alone, if the patient ever forgets things when using substances, if family or friends ever think they should cut down on drugs, and finally, if the patient has ever gotten in trouble while using mind alternating substances (Adolescent Medicine, 2020).
The next step of the HEADSSS assessment includes asking questions about sports. Such questions may be related to what types of concussions, palpitations, or any history of cardiac issues in the family. Sexual questions may include their age at their first sexual encounters, number of partners, and sexual orientation. Suicide questions may revolve around anxiety and/or depression the teenager may be feeling. An assessment tool that can be used at this point is the Patient Health Questionnaire-9 (PHQ-9), modified for teens. This tool allows the patient to understand questions about their moods and feelings in the last two weeks. The patient answers these questions with “not at all”, “several days”, “more than half the days”, and “nearly every day”. Depending on the score, depression may be better assessed, and additional help provided, whether it includes referral to psychiatry, therapy, or low-dose medications. The last portion of the HEADSSS assessment includes inquiring about safety. These questions can include physical and sexual abuse, bullies, gang involvement, seatbelt usage, helmet, etc. (Adolescent Medicine, 2020).