Assessing children for psychiatric symptoms can be much different than assessing adolescents or adults. Children tend to be less patient, full of energy and interested in moving around and playing. Adolescents prefer no parents present and enjoy privacy and brief sessions. Adults are on the opposite end, ready to spill everything onto the table. Learning more about children requires a few different approaches.
For instance, children enjoy imaginative play with dolls, puppets and toys. Imaginative play is when children are role playing and acting out various experiences they may have had or that is of current interest to them. During role playing, they are experimenting with decision-making on how to behave, while at the same time, practicing their social skills.
It’s crucial to develop rapport with children, more so than with adults. Adults can compensate for less rapport, but no rapport with a child is like talking to a wall; no response or meaningful information will be obtained. The rapport with children must also be built off side-conversations that are not related to their symptoms and experiences, while with adults, you can jump straight to the symptoms most of the time.
When you have developed rapport with a child via side-conversations and imaginative play, it becomes easier to assess their psychiatric symptoms; the child has become comfortable with your presence. During role playing, you may gain essential information by talking through the puppet or toy; this is a nice technique that often works well.
Children love to get lost in imaginative play; it’s like an escape from school, parents and other children. A child can start talking to a toy as if a switch were suddenly pressed: one second he’s talking to you and the other second his voice has changed and he’s talking to the toy. But you must be comfortable role playing with a child, or else he or she will lose interest in playing with you.
Also keep in mind that depressed children oftentimes do not manifest the same symptoms as depressed adults. They will often experience irritability and somatic symptoms such as headaches or abdominal pain. It’s important to always assess their home life as well, to make sure that their parents are giving them medication and that they are safe.
It takes patience, good rapport and imagination to learn more about children, but with time, it can turn into a fun and pleasant experience, especially when they are improving from their psychiatric symptoms.
What are your experiences with children suffering from psychiatric symptoms?
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