Select a child/adolescent patient from your clinical experience that presents with a significant concern. Create a focused SOAP note for this patient using the template in the Resources. American Psychiatric Association. (2010). Practice guideline for the treatment of patients with borderline personality disorder Links to an external site.. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bpd.pdf Oldham, J. M. (2005). Guideline watch: Practice guideline for the treatment of patients with borderline personality disorder Links to an external site.. American Psychiatric Association. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bpd-watch.pdf Recommended Media Grande, T. (2018, Nov. 30). What are paraphilic disorders? Links to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=YOV61lKxqxY Taylor Study Method. (2014, Aug. 18) Paraphilic disorders Links to an external site.. [Video]. YouTube. https://www.youtube.com/watch?v=0TtryBLokZc CASE STUDY A 15-year-old male patient come to the clinic for suicidal thought and bizarre behavior. Patient has history of suicidal attempted on overdose on medication for wanting to kill himself, history of paraphilic disorders, personality disorder and schizophrenia. Patient will be transfer to the nearest hospital for inpatient unit for further evaluation. Patient is guarded, he will be admitting for hearing voices and the voice is telling him that to kill himself. Patient appears preoccupied with his thoughts. Patient has been off his meds for 2 months. Patient is medicating at the clinic with Haldol 10 mg IM, Benadryl 50 mg IM, and Ativan 2 mg IM. Drug screen positive for THC. Covid test is negative. Patient will follow up with psychiatrist on the next four weeks for re-evaluate. Meds: Benztropine 1 mg PO BID Citalopram 10 mg PO DAILY Haldol 5 mg PO BID Quetiapine 100 mg QBEDTIME State 3–4 objectives for the presentation that are targeted, clear, use appropriate verbs from Bloom’s taxonomy, and address what the audience will know or be able to do after viewing. Present the full complex case study. Include chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; and plan for treatment and management. Report normal diagnostic results as the name of the test and “normal” (rather than specific value). Abnormal results should be reported as a specific value. Pose three questions or discussion prompts, based on your presentation, that your colleagues can respond to after viewing your video. Be succinct in your presentation, and do not exceed 8 minutes. Specifically address the following for the patient, using your SOAP note as a guide. Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life? Objective: What observations did you make during the psychiatric assessment? Assessment: Discuss their mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses and why you chose them. List them from highest priority to lowest priority. What was your primary diagnosis, and why? Describe how your primary diagnosis aligns with DSM-5-TR diagnostic criteria and is supported by the patient’s symptoms. Plan: What was your plan for psychotherapy (include one health promotion activity and patient education)? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan. Discuss an identified social determinate of health impacting this patient’s mental health status and provide your recommendation for a referral to assist this patient in meeting this identified need (students will need to conduct research on this topic both in the literature and for community resources). Reflection notes: What would you do differently with this patient if you could conduct the session again? If you are able to follow up with your patient, explain whether these interventions were successful and why or why not. If you were not able to conduct a follow-up, discuss what your next intervention would be. Case formulation consists of 5Ps – Presenting , Predisposing , Precipitating , Perpetuating , and Protective factors to a patient’s presentation. You may want to review this site: https://positivepsychology.com/case-conceptualization-examples/ and this site: https://www.psychdb.com/teaching/biopsychosocial-case-formulation