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Treating Childhood Abuse

Although disturbing, child maltreatment is common and can cause long-term psychological effects as they grow and develop socially and emotionally (Primavera & Jackson, 2019). The trauma experienced as a cause of child abuse can lead to other mental health disorders, such as alcoholism, depression, anxiety, substance use disorder, and behavioral problems, amongst others (Primavera & Jackson, 2019). In 2018, statistics in the United States indicated that 4.3 million child abuse reports were made, and only 3.3 million children of those reports received prevention and post response services (Administration for Children & Families, 2018). As a future psychiatric mental health nurse practitioner (PMHNP), it is vital to assess, determine, and act when child abuse is present. Reporting child abuse to the appropriate authorities and following the policies based on your scope of practice and state protocol is essential. Children that have dealt with abuse and trauma can positively benefit from treatment from a PMHNP to reduce the long-term effects noted above that could impact them.

Strategies to Assess the Patient for Abuse

There are various assessment tools available for assessing childhood abuse, whether it includes the participation of the parents or the children. The lack of brief and straightforward screening tools is the issue when assessing and detecting child abuse and maltreatment (Shakil et al., 2018). If child abuse is suspected, I would ensure to assess the child individually and with the parent to note the stories and behaviors that could be associated when the child is around their parent. Based on the case study provided of the 19-year-old male that presents seeking help, I would further investigate details about the abuse he experienced from his cousin. Since the client is communicating about the traumatic event, knowing more details could help in helping the individual cope and process the abuse as it becomes more severe with his cousin not being in jail anymore. Also, investigating his parent’s mental health issues and any physical, sexual, or emotional abuse could help when treating this client. A family history of mental health disorders can be a risk factor for the client’s mental health diagnosis, which obtaining comprehensive information about can help determine the predisposing factors to such diagnoses, like anxiety and depression (Weissman et al., 2013).

Exposure to Media/Social Media

Social media has become a commodity for our current generation. Although social media can be a form of positive connection with family and peers, a distraction from stressors, and a form of expression for some individuals, children and adolescents are at some risk when navigating social media. Exposure to the media for the presenting client about his traumatic event could lead to bullying. Bullying, privacy issues, and addiction are among the many problems that occur due to social media activity (O'keeffe & Clarke-Pearson, 2011). Until the presenting client is emotionally and mentally ready to share his traumatic experience with other individuals, aside from his girlfriend, which he mentions is his support system, his event shouldn't be exposed to social media by any individual; as it is only considered his story to share.

Mandatory Reporting

Arkansas requires healthcare workers, among other individuals, to report any suspicion of child maltreatment, elderly maltreatment, and the abuse of mentally and physically disabled individuals. As a future PMHNP, if a situation occurs in which a client presents experiencing abuse that meets the regulations, it is my duty as a health care provider to advocate and do good for my client by reporting the situation to the Arkansas Department of Human Services. For this particular case study, the presenting client is 19 years old, therefore I would advise the client to reach out to law enforcement and provide him appropriate resources such as information about restraining orders. Besides just seeing a PMHNP for assessment, diagnosis, and pharmacological treatment, I would also encourage the client to seek psychotherapy, as combined treatment has proven beneficial for many individuals. Various psychotherapy approaches, such as Eye Movement Desensitization & Reprocessing therapy, are used for individuals following a traumatic event.

References

Administration for Children & Families. (2018). Child maltreatment 2018. Retrieved from https://www.acf.hhs.gov/sites/default/files/cb/cm2017.pdf

O'keeffe, G. S., & Clarke-Pearson, K. (2011). The Impact of Social Media on Children, Adolescents, and Families. Pediatrics, 127(4), 800-804. doi:10.1542/peds.2011-0054

Primavera, J., & Jackson, S. A. (2019). Child abuse. Salem Press Encyclopedia of Health.

Shakil, A., Day, P. G., Chu, J., Woods, S. B., & Bridges, K. (2018). PedHITSS: A screening tool to detect childhood abuse in clinical settings. FAMILY MEDICINE, 50(10), 763–769. https://doi-org.ezp.waldenulibrary.org/10.22454/FamMed.2018.778329

Weissman, M. M., Wickramaratne, P., Adams, P., Wolk, S., Verdeli, H., Olfson, M., Nelson, B. D., McGowan, S. K., Sarapas, C., Robison-Andrew, E. J., Altman, S. E., Campbell, M. L., Gorka, S. M., Katz, A. C., & Shankman, S. A. (2013). Family history screen. Journal of Abnormal Psychology, 122(3), 662–671