NRNMP 6635 Discussion: The Psychiatric Evaluation and Evidence-Based Rating Scales

NRNMP 6635 Discussion: The Psychiatric Evaluation and Evidence-Based Rating Scales

Walden University NRNMP 6635 Discussion: The Psychiatric Evaluation and Evidence-Based Rating Scales-Step-By-Step Guide

This guide will demonstrate how to complete the Walden University PRAC 6645 WEEK 8 Assignment 1 : Clinical Hour and Patient Logs assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for PRAC 6645 WEEK 8 Assignment 1 : Clinical Hour and Patient Logs

Whether one passes or fails an academic assignment such as the Walden University PRAC 6645 WEEK 8 Assignment 1 : Clinical Hour and Patient Logs depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for PRAC 6645 WEEK 8 Assignment 1 : Clinical Hour and Patient Logs

The introduction for the Walden University PRAC 6645 WEEK 8 Assignment 1 : Clinical Hour and Patient Logs is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for PRAC 6645 WEEK 8 Assignment 1 : Clinical Hour and Patient Logs

After the introduction, move into the main part of the PRAC 6645 WEEK 8 Assignment 1 : Clinical Hour and Patient Logs assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for PRAC 6645 WEEK 8 Assignment 1 : Clinical Hour and Patient Logs

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for PRAC 6645 WEEK 8 Assignment 1 : Clinical Hour and Patient Logs

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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The purpose of this discussion was to examine the assessment tool (The Michigan Alcoholism Screening Test) that have been assigned to me and consider its usefulness in psychotherapy and to determine which disorder to focus on for this initial discussion post based on the assigned screening tool. Another focus for this discussion is to examine the psychometric understanding and performance of the Michigan Alcoholism Screening Test (MAST) commonly used in screening measures for alcohol and to give Psychiatric Mental Health Nurse Practitioners an enhanced empirical foundation to refer to when screening for alcohol.

Nurses strive to provide the best possible care to diverse clients under consistently changing conditions. From the medications administered to the type of dressing used to heal a wound, nurses apply procedures that have been tested through research and deemed appropriate according to evidence-based standards of practice. Through foundational knowledge related to research methods, translation of research data is used to improve nursing practice and, ultimately, patient outcomes. Therefore, nurses must become familiar with the specific language of scientific research and the research process. As health care professionals, nurses seek to provide their patients with the best possible health care. To determine which approaches to care result in the best possible care, the effectiveness of each approach specific to a chosen population must be investigated. The pursuit of knowledge is the basis for research. Researchers seek to find answers to various scientific questions, but there are the boundaries associated with the pursuit of knowledge (Helbig, 2018).

The purpose of the Michigan Alcoholism Screening Test was to serve as a measurable, quantifiable, and reliable tool for alcohol dependence screening. Questions on this test are associated with the patient’s vocational and family problems, and social problems associated frequently heavy drinking of alcohol. Evidence/r

NRNMP 6635 Discussion The Psychiatric Evaluation and Evidence Based Rating Scales
NRNMP 6635 Discussion The Psychiatric Evaluation and Evidence Based Rating Scales

esults from the literature obtain seen in several studies suggest that the Michigan Alcoholism Screening Test is a useful instrument for screening alcohol related problems in outpatients. Nevertheless, this screening tool has been unable to overcome outpatients’ population denial and/ defensiveness. Because of some methods of measurement and conditions of sampling characteristics are related to scoring reliability. As a result, interventions and community resources, and counseling implications are not put in place in a timely matter.  To consider the Michigan Alcoholism Screening Test usefulness in psychotherapy and to determine which disorder to focus on, it is essential to be familiar with its reliability – a meta-analytic method require for archival collection of data and reporting (Minnich, Erford, Bardhoshi & Atalay, 2018).

The Healthy people 2030: National Health and Disease objectives to lower alcohol and other drugs issues identified by decreasing utilization of alcohol, by promoting screening measures as a primary goal for the years 2030 and beyond (Department of Health and Human Services, 2018). Increasing awareness of, and empirical guidelines for, the accurate use of alcohol screening measures, psychiatric mental health nurse practitioners assist in achieving this goal (Sharma, 2018).

Psychotherapy is a conversational approach with a patient. During psychotherapy, a client has a dialogue with a

NRNMP 6635 Discussion The Psychiatric Evaluation and Evidence-Based Rating Scales
NRNMP 6635 Discussion The Psychiatric Evaluation and Evidence-Based Rating Scales

psychiatric mental health nurse practitioner regarding issues experienced or experiencing. Psychotherapy could take place in a family setting, group, individual session. The psychiatry mental health nurse practitioner and the client may discuss day to day challenges, long standing problems, and past traumatic events. On the basis of psychoanalysis, psychotherapy allows the psychiatric mental health nurse practitioner to formulate mental health diagnosis and medications for clients.  In the case of alcoholism for psychotherapy, a psychiatric mental health nurse practitioner assists a client to better understand their issue and management of cravings behaviors to keep motivated and achieve a goal of sobriety.

Psychotherapy sessions could be limited to few weeks or may continue for many months. Throughout the psychotherapy sessions, practitioners and patient develop rapport, on the basis of trust, confidentiality and openness. Furthermore, psychotherapy is a guided roadmap for practitioners to understand an individual and develop realistic approach (Berglund, Rauwolf, Berggren, Balldin & Fahlke, 2019). The literature indicates that depressive symptoms reported as alcoholism associated consensus problems attributes to history of mood disorders. The Michigan Alcoholism Screening Test have been developed for this purpose, to screen for possible addictive behaviors, depressive disorder, alcohol induced bipolar disorder, and assess for symptoms severity.

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Berglund, K. J., Rauwolf, K. K., Berggren, U., Balldin, J., & Fahlke, C. (2019). Outcome in Relation to Drinking Goals in Alcohol-Dependent Individuals: A Follow-up Study 2.5 and 5 Years After Treatment Entry. Alcohol & Alcoholism54(4), 439–445.

Minnich, A., Erford, B. T., Bardhoshi, G., & Atalay, Z. (2018). Systematic review of the Michigan Alcohol Screening Test (MAST). Journal of Counseling & Development, 96(4), 335-344.

Sharma, M. (2018). Progress in Substance Abuse Indicators of Healthy People 2030: Implications for Research and Practice. Journal of Alcohol & Drug Education59(3), 3–6.

Discussion Week 2

The purpose of the psychiatric interview is to establish a therapeutic relationship with the patient to collect, organize, and synthesize data that can become the basis for a formulation, differential diagnosis, and treatment plan (Beresin & Gordon, 2015). The three components that I believe are essential components of the psychiatric interview are substance use and past medical history, family medical history, and current treatment regimen. It Is necessary to understand the patient’s substance use history to tailor their care specifically to their needs. Obtaining the patient’s family history allows the practitioner to know if a specific mental illness runs in the family or if other family members have substance abuse issues. Being aware of any medications the patient is currently taking decreases the patient’s chances of having any adverse reaction related to drug interactions.

The Michigan alcoholism screening test is one of the oldest mental health screening tools Melvin Selzer created in 1971. This tool is frequently used as a self-report screening tool to determine problematic drinking and alcohol use disorder (Minnich et al., 2019). The assessment tool can be used in both adults and adolescents to detect the symptoms of drinking behavior that can affect the individual’s life. The MAST screening tool consists of 25 yes or no questions about a patient’s past and current alcohol use.

The use of the MAST has been helpful for nurse practitioners to identify individuals that need further assessment or need a refe3rral for treatment. However, it is vital to keep in mind that the MAST is just a screening tool and is not intended to evaluate the efficacy of psychopharmacologic medications (Minnich et al., 2019). Several studies have been conducted on the reliability of the MAST and found results that were coefficient alpha values ranging from 0.83-0.90, indicating that the MAST screening tool had good reliability (Yu-Jung et al., 2014). This test also has test-retest reliability, convergent correlations with other substance use measures, structural validity and confirmatory factor analysis, and diagnostic validity across different cutoff scores and samples, with positive and negative predictive values (Minnich et al., 2019).


Beresin, & Gordon. (2015). The Psychiatric Interview. Clinical Gate.

Minnich, A., Erford, B. T., Bardhoshi, G., Atalay, Z., Chang, C. Y., & Muller, L. A. (2019).

Systematic Evaluation of Psychometric Characteristics of the Michigan Alcoholism

Screening Test 13‐Item Short (SMAST) and 10‐Item Brief (BMAST) Versions. Journal

of Counseling & Development, 97(1), 15–24. https://doiorg.

Yu-Jung, H., Hsin, C., Chang-Chih, H., Keng-Liang, O., Chiung-Hua, C., & Kuei-Ru, C. (2014).

Psychometric Properties of the Chinese Version of the Michigan Alcoholism Screening Test (MAST-C) for Patients With Alcoholism. Perspectives in Psychiatric Care, (2), 83.


week 2

Three Important Components Of The Psychiatric Interview

The first essential component of the psychiatric interview is giving proper guidance on building alliances, boosting morale, and negotiating treatment to prevent the drop-out consultation rate (Carlat, 2017). Second, it reiterates the power of observation as the Provider incorporates the Mental Status Examination (MSE) throughout the interview process (Carlat, 2017). Lastly, it integrates the screening questions and assessment tools, which are essential concepts in assessing a diagnosis (Carlat, 2017).

Psychometric Properties Of The Rating Scale

The Abnormal Involuntary Movement Scale  (AIMS) is a scale specifically designed to measure the presence and severity of abnormal movements in seven areas of the body: muscles of facial expression, lips and perioral area, jaw, tongue, upper extremities, lower extremities, and trunk. Ratings of tremor are specifically excluded. A 5-point rating scale is used to rate the movements in each body area, overall severity of abnormal movements, incapacitation because of abnormal movements, and patients’ awareness and distress because of abnormal movements, yielding a total score.  The AIMS yields a possible total score of 0 to 40; a score of zero is considered diagnostic of no TD. As mentioned previously, seven body areas, severity of movements, incapacitation, and patient awareness of movements are assessed, for a total of 10 components. The rating scale is 0 to 4 (5 point), with 0 indicating none or normal and 4 indicating severe (Menzies & Farrell, 2002).  

Importance And Appropriateness Of Rating Scale

The importance of the AIMS is that it offers a set of criteria by which to determine the presence of TD in individuals who are prescribed antipsychotic medications (Menzies & Farrell, 2002). Persons taking any kind of anttipsychotics medication need to be monitored for movement disorders. The AIMS  (Abnormal Involuntary Movement Scale) aids in the early detection of tardive dyskinesia as well as providing a method for on going surveillance ( Psychatric Times, 2021).

Evidence-Based Literature

Clinicians are able to effectively contribute to both preventative and palliative care of the patient receiving, or about to receive, antipsychotic medications by gaining familiarity with the AIMS and acquiring expertise through recommended application of AIMS as a regular component of patient assessment (Menzies &Farrell, 2002). When the nurse and the provider both fail the assess the  patient using the AIMS upon admission, the opportunity to establish a baseline status is missed. Should the patient become symptomatic during the hospital stay, it should be evident the proper procedures were followed to promote the early detection and treatment of involuntary movements that may be indicative of tardive dyskinesia (Otiabure, 2021).


Carlat, D. J. (2017). The psychiatric interview (4th ed.). Wolters Kluwer.

Menzies V, & Farrell SP. (2002). Schizophrenia, tardive dyskinesia, and the Abnormal Involuntary Movement Scale (AIMS). Journal of the American Psychiatric Nurses Association8(2), 51–56.

Psychiatric Times. 2021. AIMS Abnormal Involuntary Movement Scale. [online] Available at: <> [Accessed 9 September 2021].

Oriabure, R. (2021). Promotion of the Abnormal Involuntary Movement Scale in a Psychiatric Hospital. Retrieved 9 September 2021, from

Week 2 Main Discussion

According to Barnhill, J.( 2017), the core goals of the initial psychiatric interview are to ensure safety, understand the patient , and develop a workable treatment plan. Knowing the mental state of the patient at the initial evaluation enables the clinician to know if the patient is a danger to himself and others. Their previous mental history and treatment course also determines the course of treatment and saves time as we can avoid resorting to previous unsuccessful treatment plans.

The interview itself if well conducted, becomes part of the treatment process, shapes the nature of the patient-physician relationship, and provides information necessary to create an individualized treatment plan.(Sadock, B. et al; 2015)

Zimmerman, M. et al (2017), observes that although the Hamilton Anxiety Rating Scale(HAM-A)  was originally developed  to assess the severity of anxiety symptoms, the format of this rating scale has been criticized for not being properly structured to address the level of anxiety of patients, and as a tool that can be said to be assessing the level of depression rather than anxiety in some of the multiple symptoms addressed. It is sometimes difficult to determine if the ratings reflect symptoms of anxiety or side effects of medication.

Psychiatric rating scales are used for diagnosis, functioning  and symptom  severity. The Hamilton Anxiety Rating Scale (HAM-A) may be used to determine the severity of the clinical symptoms of anxiety in a patient who has already been diagnosed as suffering from anxiety and enables proper monitoring of symptoms in measurable terms to determine improvement in prognosis. The length of time to administer, the experience and training needed, may make this test less practical for everyday clinical practice.( E. Thompson, 2015).


Barnhill, J. W. (2017). The initial interview. Co-occurring Mental Illness and Substance Use Disorders: A Guide to Diagnosis and Treatment, 1.

Euan Thompson, Hamilton Rating Scale for Anxiety (HAM-A), Occupational Medicine, Volume 65, Issue 7, October 2015, Page 601,

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.

Zimmerman, M., Martin, J., Clark, H., McGonigal, P., Harris, L., & Holst, C. G. (2017). Measuring anxiety in depressed patients: A comparison of the Hamilton anxiety rating scale and the DSM-5 Anxious Distress Specifier Interview. Journal of psychiatric research93, 59-63.

Assessment is the basis of evidence discovery as it pertains to establishing foundational diagnoses and treatment plans predicated on a patient’s presentation. These next steps in the process of caring for a patient cannot accurately be had without pertinent assessment data (Sadock, et al., 2017). Just as pertinent to this data in information discovery as other data such as chief complaints and past medical, surgical, and psychiatric histories in the holistic assessment of a patient is their substance abuse history (APA, 2016; Sadock, et al., 2017). Given that this such history may be difficult to discuss for a patient, however, due to their own concerns of privacy, shame, or embarrassment, there are different resources with exceptional reliability and validity to investigate such potential concerns delicately and sensitively (Sadock, et al., 2017). A potential to implement for assessment purposes could be the Michigan Alcoholism Screening Test (MAST) that is the predecessor to the more commonly seen AUDIT (Alcohol Use Disorders Identification Test) and has been acknowledged as a reliable resource since the seventies (Center for Substance Abuse Treatment, 1997; Selzer, 1971). 

For the psychiatric interview, many facets of the assessment can be deemed important, such as the past psychiatric history of a patient, their coping skills and support systems, and their substance abuse history as it is being discussed currently. Whereas the past psychiatric history of a patient serves a more self-explanatory purpose to the psychiatric interview, it is important nonetheless, as it establishes a relevant baseline for a patient’s current problems if any, past or potential concerns, and can identify disorders that may be frequently comorbid with other psychiatric sequelae. In investigating whether a person is experiencing the problems of a psychiatric disorder, their social history may be important, however, the specifics that can be included of a patient’s psychosocial supports and coping mechanisms is a noteworthy inclusion because not only will a person’s potential problems be acknowledged, but so will the resources they use to challenge and overcome them. Knowing a person has adequate support or can be self-sufficient in times of need as applicable is important because it leads to the concerns that arise when they cannot. When maladaptive coping strategies come into play, the last – but certainly not least important – factor of the psychiatric interview as being reviewed currently comes into play. The substance abuse history of a patient is intertwined with the past psychiatric history of a patient and their coping mechanisms as a positive substance abuse history can be a product of a cooccurring psychiatric disorder from a commonly comorbid condition and exemplifies what problems may be present if a person has coping deficiencies and helps establish when substance usage can range from occasional and recreational to harmful, addictive, and maladaptive. When all these factors are accounted for, significant portions of a psychiatric interview can be accounted for, however, what will further be investigated is the substance use history, and more specifically, screening a patient’s alcohol use.  

The longstanding and ever-present availability of the MAST is a product of its 94 to 97 percent validity serving as an important psychometric property to gauge whether this twenty-five yes or no self-assessment holds its own to help establish diagnoses for practitioners (Minnich, et al., 2018). Regarding diagnostic validity, this tool also helps identify alcoholism, if not problematic alcohol use at an eighty percent rate which can be conceding as varying based on the use of certain questions or abbreviated versions of this test (Minnich, et al., 2018). The tool is fast enough to be done in minutes and can be deemed appropriate for a patient who is a reliable self-reporter, however, as previously mentioned, the reliability, validity, and even consistency of this test can speak for itself when the test is provided in its entirety. Albeit the 13-question version shortened MAST (SMAST) and the ten-question version of the brief MAST (BMAST) are less consistent than the MAST, they are still available as resources for assessing a patient, just not as recommended (Minnich, et al., 2019). The ideal use of the test is to assess new patients from teenagers, students, and adults on their engagement in problem drinking or possibility of them facing alcoholism (Minnich, et al., 2018). Being accurate, efficient, free to use, and quick to perform, the use of the MAST can be indicated to use to initially screen all patients, patients reporting new alcohol use, or patients reporting concerns of their alcohol use (Minnich, et al., 2018). When results are interpreted, as already mentioned, scores can differentiate between problem-drinking and alcoholism by providing assessment criteria to be used towards diagnosis as questions answer how alcohol use affects family, social, and vocational aspects of a patient’s life, the severity of which problems have occurred, and the patient’s perception – if not acceptance – of their own potential problem (Minnich, et al, 2019; Minnich, et al., 2018). 

The gift and curse of healthcare is the variety of resources available to help assess and diagnose patients. Whereas the options are bountiful, it begs the responsibility of a provider to discern which resources are most applicable to be implemented and are psychometrically reliable, consistent, and have significant validities to be utilized for their best application(s). As it concerns the MAST, its existence and utilization spanning forty years is a product of its ability to provide psychometrically appropriate assessment data to help a provider diagnose a patient and further implement adequate interventions to not only address problematic alcohol use if present but help address psychosocial deficiencies in a patient’s life to provide for them not only acutely, but holistically. To provide optimal care, such a practice should be considered ideal, and it was with the MAST, this ideal can be achieved more frequently by providers.  


American Psychiatric Association (APA). (2016). Practice guidelines for the psychiatric evaluation of adults (3rd ed.). 

Center for Substance Abuse Treatment. (1997). A Guide to Substance Abuse Services for Primary Care Clinicians. Substance Abuse and Mental Health Services Administration (US). 

Minnich, A., Erford, B. T., Bardhoshi, G., Atalay, Z., Chang, C. Y., & Muller, L. A. (2019). Systematic Evaluation of Psychometric Characteristics of the Michigan Alcoholism Screening Test 13‐Item Short (SMAST) and 10‐Item Brief (BMAST) Versions. Journal of Counseling & Development, 97(1), 15–24. 

Minnich, A., Erford, B. T., Bardhoshi, G., & Atalay, Z. (2018). Systematic Review of the Michigan Alcoholism Screening Test. Journal of Counseling & Development, 96(3), 335–344. 

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2017). Psychiatric interview, history, and mental status examination. In Kaplan and Sadock’s Concise Textbook of Clinical Psychiatry (4th ed., pp. 9–15). Wolters Kluwer. 

Selzer M. L. (1971). The Michigan alcoholism screening test: the quest for a new diagnostic instrument. The American journal of psychiatry, 127(12), 1653–1658.