Posted: May 25th, 2023

Externalizing Disorders

Externalizing Disorders. Reflect on your first experience treating a toddler, school-aged child, or adolescent with a mood or anxiety disorder.

Describe a clinical situation, in detail. (Who was it, when did it happen, what happened, what caused it to happen, where did it happen, how did it happen). Describing the clinical experience should take less than 3 minutes. Discussing your reflection should take 3-5 minutes.
How did you manage these anxieties, feelings, prejudices, and biases?
What assumptions did you make about children or families with mental illness?
What awareness did you develop during your clinical experience?
Describe how you changed as a result of your clinical experience?
Describe how will this clinical situation impact your advanced nursing practice?

My first experience treating a toddler, school-aged child, or adolescent with a mood or anxiety disorder.

I was a new nurse at a children’s hospital, and I was assigned to the inpatient psychiatric unit. My first patient was a 10-year-old boy named John who was diagnosed with ADHD and oppositional defiant disorder. John was a very challenging patient. He was constantly fidgeting, talking out of turn, and refusing to follow directions. He also had a lot of anger issues. He would often get into fights with other patients and staff members.

I was initially very anxious about working with John. I didn’t know how to handle his behavior. I was also worried about getting hurt. However, as I got to know John, I started to understand him better. I realized that he was a good kid who was just struggling with some mental health issues. I also realized that I could make a difference in his life.

I worked with John for several weeks, and I saw a lot of progress. He learned how to control his anger, and he started to make friends with the other patients. He also started to do better in school. I was so proud of him, and I knew that I had made a difference in his life.

Reflecting on my experience with John, I learned a lot about working with children with mental health issues. I learned that it is important to be patient and understanding. It is also important to be firm and consistent. I also learned that it is important to build a relationship with the child. Once you have a relationship with the child, you can start to help them work through their problems.

I am grateful for the opportunity to work with John. He taught me a lot about myself and about working with children with mental health issues. I am confident that I will be able to use what I learned from John in my future nursing practice.

To answer your questions:

How did you manage these anxieties, feelings, prejudices, and biases?

I managed my anxieties by talking to my colleagues and supervisors. They helped me to understand that John’s behavior was a result of his mental health issues, and that he was not a bad kid. I also managed my anxieties by taking some time for myself to relax and de-stress.

What assumptions did you make about children or families with mental illness?

Before I worked with John, I made a lot of assumptions about children and families with mental illness. I assumed that they were all dangerous and unpredictable. I also assumed that they were all lazy and unmotivated. However, working with John helped me to realize that these assumptions were wrong. John was a good kid who was just struggling with some mental health issues. His family was also very supportive and loving.

What awareness did you develop during your clinical experience?

I developed a lot of awareness during my clinical experience. I became more aware of the signs and symptoms of mental health disorders in children. I also became more aware of the resources that are available to help children with mental health disorders.

Describe how you changed as a result of your clinical experience?

I changed a lot as a result of my clinical experience. I became more patient and understanding. I also became more confident in my ability to help children with mental health disorders.

Describe how will this clinical situation impact your advanced nursing practice?

This clinical situation will impact my advanced nursing practice in a number of ways. First, it will help me to better understand the needs of children with mental health disorders. Second, it will help me to develop more effective interventions for children with mental health disorders. Third, it will help me to build stronger relationships with children and families with mental health disorders.

References
Eilertsen, E. M., Cheesman, R., Ayorech, Z., Røysamb, E., Pingault, J. B., Njølstad, P. R., … & Ystrøm, E. (2022). On the importance of parenting in externalizing disorders: an Assessment of indirect genetic effects in families. Journal of child psychology and psychiatry, 63(10), 1186-1195.
Levy, T., Kil, H., Schachar, R. J., Itzhaky, L., & Andrade, B. F. (2023). Suicidality risk in children and adolescents with externalizing disorders: symptoms profiles at high risk and the moderating role of dysregulated family relationships. European Child & Adolescent Psychiatry, 1-10.

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