Discussion: Treating Childhood Abuse

In 2012, statistics in the United States indicated that state CPS agencies received 3.4 million referrals for child abuse and neglect. Of these, nearly 700,000 children were found to be victims of maltreatment: 18% were victims of physical abuse and 78% were victims of neglect (CDC, 2014). Discussion: Treating Childhood Abuse Child sexual abuse makes up roughly 10% of child maltreatment cases in the United States (CDC, 2014).

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The CDC considers sexual abuse at any age a form of violence. Child abuse of any kind can lead to an increased state of inflammatory markers in adulthood, as well as multiple physical illnesses and high-risk behavior such as alcoholism and drug abuse. If a PMHNP identifies child abuse, there may be a need to report the abuse to authorities. Once able to provide treatment, the PMHNP can be instrumental in reducing the long-term effects of child abuse.

In this Discussion, you recommend strategies for assessing for abuse and analyze influences of media and social media on mental health. You also evaluate the need for mandatory reporting of abuse.

Read the childhood abuse case study PDF attached.

 Post:

• What strategies would you employ to assess the patient for abuse? Explain why you selected these strategies.
• How might exposure to the media and/or social media affect the patient?
• What type of mandatory reporting (if any) is required in this case? Why?

REFERENCES TO REVIEW

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 31, “Child Psychiatry” (pp. 1216–1226) Discussion: Treating Childhood Abuse

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

• “Trauma- and Stressor-related Disorders” Pfefferbaum, B., & Shaw, J. A. (2013). Practice parameter on disaster preparedness. Journal of the American Academy of Child & Adolescent Psychiatry. ATTACHED IS THE PDF

American Psychiatric Nurses Association. (2017). Childhood and adolescent trauma. Retrieved from https://www.apna.org/i4a/pages/index.cfm?pageID=4545

Strategies to Assess the Patient for Abuse

The patient, in this case, underwent sexual abuse during his childhood. Psychological screening is important to evaluate the patient’s emotional and psychological needs (Pfefferbaum & Shaw, 2013). To assess the patient for abuse, the PMHNP should integrate questions regarding the abuse in order to have increased comfort (Christian, 2015). It is also important for the PMHNP to give the patient control regarding the disclosure.

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Even though it is vital to ask regarding the abuse, it is important to ensure that the patient has control regarding what he says and when to say it; this will ensure his emotional defense is intact.  Moreover, the PMHNP should actively listen to the patient. The active listening provides excessive reassurance and also indicates empathy which can negative the patient’s trauma and pain. Finally, it would be useful to use “Statement Validity Analysis” (SVA) during the interview. The rationale of employing this tool is to obtain and evaluate the statements provided by the patient. This tool will assist in exploring and taking into account all available information (Christian, 2015) Discussion: Treating Childhood Abuse.

Effect of Media and/or Social Media Exposure on the Patient

Exposure of the abuse in media or social media could have negative effects on the patient’s mental health. This is because the patient may end feeling ashamed that his dark secret has been discovered. This could cause embarrassment, humiliation, and indignity. In addition, the exposure may lead to the patient being blamed and criticized because of the abuse which may further adversely affect the patient’s mental health. According to Rodenhizer & Edwards (2017) media coverage of sexual abuse may end up opening up to blame and reproach for the victims.

Type of Mandatory Reporting

The PMHNP should make a report to the Department of Public Welfare. This is because the perpetrator of the abuse is out and he not only poses a danger to the patient, but also this is affecting the patient’s mental health as indicated by the recent nightmares and sleep disturbances after his abuser in the past was released from jail. The Department of Public Welfare can try to find the best means possible to assist the patient, including removing him from the environment (Child Welfare Information Gateway, 2016) Discussion: Treating Childhood Abuse.

References

Child Welfare Information Gateway. (2016). Mandatory reporters of child abuse and neglect. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau.

Christian C. (2015). The Evaluation of Suspected Child Physical Abuse. American Academy of Pediatrics. 135(5).

Pfefferbaum, B., & Shaw, J. A. (2013). Practice parameter on disaster preparedness. Journal of the American Academy of Child & Adolescent Psychiatry.  Trauma Violence Abuse. 1(17).

Rodenhizer K & Edwards K. (2017). The Impacts of Sexual Media Exposure on Adolescent and Emerging Adults’ Dating and Sexual Violence Attitudes and Behaviors: A Critical Review of the Literature. Trauma Violence Abuse. 1(1) Discussion: Treating Childhood Abuse