Worked Example 1: Matthew
On the next few pages, you will find some assessment information. Please read through this information and then have a go at filling in a Current View for Matthew.
Some Patient Reported Outcome Measures (PROMs) have been provided; the parent- and CYP self-report versions of the Revised Child Anxiety and Depression Scale (RCADS), which looks at symptoms of anxiety and depression and the parent-report version of the Strengths and Difficulties Questionnaire (SDQ), which is a 25 item emotional and behavioural problem screening questionnaire.
Alongside the individual question responses, please consider the summary reports. These explain the clinical significance of the overall SDQ and RCADS scores.
Clinician’s report from first meeting
Matthew is a 9-year-old boy living with his parents and his 12-year-old sister. At assessment, his parents described him as ‘being on the go’ most of the time, rarely sitting down or being able to concentrate for long. They also reported that he breaks his toys and swears at them. Fights with his sister are increasing in frequency, now happening on a nearly daily basis, and sometimes involve him hitting her. The sister has started to spend more time on her own in her room rather than sitting in the family room in the evening. Parents report that Matthew has always been “a lively child” but things seem to just be getting worse and worse.
Matthew’s mother works part-time and feels drained at the thought of returning home. She says she finds it difficult to discipline Matthew and is feeling at the end of her tether as Matthew “never does as he’s told”. She feels like Matthew needs constant supervision and avoids taking him out to the shops as his behaviour has been so embarrassing in the past. Matthew’s father works long hours and has little involvement in the children’s upbringing.
Matthew attends a mainstream school and his teacher says his work is OK and that he is well-liked by other children. Matthew is generally co-operative at school although he can be disruptive at times. The teacher describes him as hyperactive, not sitting still and finding it difficult to register new information, but notes that he is able to function better when the class is working in small work groups.
Matthew was able to respond to questions politely and appropriately during the assessment, however he became quite restless when his parents were talking and was very disruptive towards the end of the meeting. Mother became tearful when talking about Matthew’s behaviour.
Summary of Parent-Report RCADS Scores (Completed by Matthew’s mother)
The Revised Child Anxiety and Depression Scale (RCADS) is a questionnaire designed to measure symptoms of several different anxiety disorders as well as depression. If scores exceed the clinical threshold for any subscale, this indicates that the related disorder may be present.
Click here to see the full parent-report RCADS (opens in a new page).
Summary of Self-Report RCADS Scores (Completed by Matthew)
Click here to see Matthew’s full self-report RCADS (opens in a new page).
Summary of Parent-Report SDQ Scores (Completed by Matthew’s Mother)
The Strengths and Difficulties Questionnaire (SDQ) is a questionnaire designed to measure emotional and behavioural difficulties in children aged 3-16. If scores exceed the clinical threshold for any subscale, this indicates that related disorders may be present.
Click here to see the full parent-report SDQ for Matthew (opens in a new page).
Now that you have looked at the information about Matthew, have a go at completing a Current View for him. You will be able to refer back to the assessment information as well as the rating guidance.
While filling in the Current View, it is important to remember that everyone reads into a vignette differently and perhaps some of our interpretations differ from yours. In a real-life situation, you would be likely to have a lot more information to base your judgements on.
We are most concerned with obtaining agreement on ratings of ‘mild’ ‘moderate’ or ‘severe’, so where these differ from ours, you might want to refer back to the rating guidance.
The major differences are likely to be with ratings of ‘not known’ and ‘none’, this is because everyone has a different clinical formulation and relates the vignette to real-life cases they have worked with. Where your ‘none’ or ‘not known’ ratings differ from ours, we ask that you consider the rationale for your choice (with reference to the guidance); as long as your decision was based on this rationale, then it is OK to have different answers to ours.
Current View Tool (Matthew)
Please rate each problem description, complexity factor and contextual problem referring to the assessment information and rating guidance. You will be able to refer back to this information at any point.
Press 'start' to begin.