1. Copyright © The REACH Institute. All rights reserved. Why Assessment is SO Important

2. Copyright © The REACH Institute. All rights reserved. Learning Objectives Explain importance of a thorough assessment in management of pediatric mental health issues Discuss how assessment impacts on the three legs of clinical work: Diagnosis, Treatment, & Alliance Practice using assessment methods including good interviewing skills, use of standardized questionnaires, and assessment components

3. Copyright © The REACH Institute. All rights reserved. Agenda Table Activity #1: Review clinical goals served by an assessment Review case of a youth (Nora) who comes to you with a mental health problem in primary care Table Activity #2: Discuss approaches to the initial assessment of Nora – –Develop consensus on initial assessment components & key questions to ask – –Report results of small group consensus Discussion of feasibility – –Present Mental Health card

4. Hidden Slide: Time Table Total time: 30 minutes Intro- Goals & objectives, agenda: 2’ Activity #1: Why Do an Assessment? 3’ Activity #1 Debrief: 3’ Nora / Noah Case Role Play: 7’ (Review role play information in Faculty Training and Tips section) Table Activity #2: 12’ Introduce Mental Health (White) card: 1’ Introduce next speaker 1’ 4 Copyright © The REACH Institute. All rights reserved. Unit B: Why Assessment is So Important

5. Copyright © The REACH Institute. All rights reserved. Table Activity #1 Hidden Slide Explain Activity #1 Allow 3-4 minutes for tables to work together to brainstorm ideas on flipchart – –Provide examples for each area to help start their conversation: 1. 1. Diagnosis - “How long has this (chief complaint) been going on?” 2. 2. Treatment planning - “What have you tried so far?” 3. 3. Working relationship with the family - “What has this been like for you?”, or “What has been the hardest, most difficult part of this problem affecting you and your family?” Debrief activity 5 Unit B: Understanding Why Asessment is So Important

6. Copyright © The REACH Institute. All rights reserved. Table Activity #1 As a group, discuss the 3 goals you are trying to accomplish in an ideal assessment: 1. 1. Diagnosis 2. 2. Treatment planning 3. 3. Working relationship with the family SCRIBES: Write on your flipchart: What assessment questions would you ask that would help you in each assessment goal area: 1. 1. Diagnosis 2. 2. Treatment planning 3. 3. Working relationship with the family

7. Copyright © The REACH Institute. All rights reserved. HIDDEN SLIDE Presenter introduces the case of Nora / Noah, the doctor, and Mr./Mrs. James After case, facilitate brief group discussion of content & process 7 Unit B: Understanding Why Asessment is So Important

8. Copyright © The REACH Institute. All rights reserved. A new patient shows up Nora and Mrs. James Content – –What might be your differential diagnosis? Process – –What did you note about the interactions between the Doctor, Nora, and Ms. James?

9. Copyright © The REACH Institute. All rights reserved. Table Activity #2 Hidden Slide After brief group discussion, explain Table Activity #2: – –1) Identify, then prioritize your initial differential for Nora / Noah – –2) Write your best, key questions you might ask that will help you narrow down your differential diagnosis list. These questions might encompass HPI, Past Hx, Soc Hx, Fam Hx, ROS, MSE, labs Group discussion of key components of assessment 9 Unit B: Understanding Why Asessment is So Important

10. Copyright © The REACH Institute. All rights reserved. Table Activity #2 Task 1 – Identify, then prioritize your initial differential for Nora on flipchart Task 2 – SCRIBES: On your flipchart, write your best, key questions you might ask that will help you narrow down your differential diagnosis list: – –Chief complaint – –Birth, development, past medical, & family history – –Behavioral history – –School history – –Social history – –PE/Labs/Other tests

11. Copyright © The REACH Institute. All rights reserved. Hidden Slide Ask participants to pull out their (white) Mental Health card, and review it briefly Orient participants to the card: Little detail, just a 1 min. overview and description of how it might help them. – –Analogy: Card is like an aircraft pilot’s checklist - helps them not forget anything before take-off. Alert them that they will be using the card with a case in the anxiety unit. 11 Unit B: Understanding Why Asessment is So Important

12. Copyright © The REACH Institute. All rights reserved.

13. Wrapping Up A good assessment is not only developing a differential but considering potential treatment feasibility & building a therapeutic alliance The assessment process can make or break the entire treatment process Assessment skills are learnable Standardized questionnaires can be helpful

14. Copyright © The REACH Institute. All rights reserved. REMINDER: REMINDER: Please fill out Unit B evaluation