How to Write the Assessing, Diagnosing, and Treating Adults With Mood Disorders Focused SOAP Note (Petunia Park)

To Prepare

• Review this week’s Learning Resources. Consider the insights they provide about assessing, diagnosing, and treating mood disorders.
• Review the Focused SOAP Note template, which you will use to complete this Assignment. There is also a Focused SOAP Note Exemplar provided as a guide for Assignment expectations.
• Review the video, Case Study: Petunia Park . You will use this case as the basis of this Assignment. In this video, a Walden faculty member is assessing a mock patient. The patient will be represented onscreen as an avatar.
• Consider what history would be necessary to collect from this patient.
• Consider what interview questions you would need to ask this patient.
• Consider patient diagnostics missing from the video:Provider Review outside of interview:Temp 98.2  Pulse  90 Respiration 18  B/P  138/88

  Laboratory Data Available: Urine drug and alcohol screen negative.  CBC within normal ranges, CMP within normal ranges. Lipid panel within normal ranges. Prolactin Level 8; TSH 6.3 (H)

The Assignment

Develop a Focused SOAP Note, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:

• Subjective: What details did the patient provide regarding their chief complaint and symptomatology 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 the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
• Plan: What is your plan for psychotherapy? What is 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. Also incorporate one health promotion activity and one patient education strategy.
• Reflection notes: Reflect on this case. Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), social determinates of health, health promotion, and disease prevention that takes into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

How to Write the “Assessing, Diagnosing, and Treating Adults With Mood Disorders” Focused SOAP Note (Petunia Park) — A High-Scoring Guide for Busy PMHNP Students

If you’re juggling work, family, and practicum responsibilities, this assignment can feel heavy because it’s not just a SOAP note. You are being graded on whether you can think like a PMHNP:

• collect the right history

• perform a psychiatric assessment and MSE

• build 3+ differentials using DSM-5-TR logic

• justify the primary diagnosis with critical thinking (positives/negatives)

• create a complete treatment plan (psychotherapy + meds + alternatives + follow-up)

• include health promotion + patient education

• write a mature reflection that addresses ethics/legal, SDOH, prevention, and patient factors

• incorporate objective data and missing diagnostics (including the high TSH)

This guide shows you a rubric-safe way to answer it efficiently—and helps you publish content that converts overwhelmed PMHNP students.

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Assignment Overview (Confirm you’re in the right place)

You will write a Focused SOAP Note based on the video Case Study: Petunia Park, using the Focused SOAP Note template and exemplar as standards.

You also have “outside of interview” data you must integrate:

• Vitals: T 98.2, P 90, R 18, BP 138/88

• UDS/EtOH: negative

• CBC/CMP/Lipids: WNL

• Prolactin 8: WNL

• TSH 6.3 (High) (this matters clinically)

You must include:

• Subjective

• Objective

• Assessment (MSE + 3 differential diagnoses + DSM-5-TR reasoning)

• Plan (psychotherapy + pharmacologic + nonpharm + alternative + follow-up + rationale + health promotion + education)

• Reflection (ethics/legal beyond confidentiality, SDOH, prevention, patient factors)

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Why students lose points on this assignment

Most students lose marks because they:

• Write subjective/objective too thin (missing severity, duration, impairment)

• List differentials without DSM-5-TR rule-in/rule-out logic

• Don’t show “pertinent positives/negatives”

• Pick a medication without safety monitoring or rationale

• Ignore the abnormal lab (TSH) and medical rule-outs

• Forget health promotion + education

• Write a generic reflection (only “confidentiality”) instead of real PMHNP ethics/legal reasoning

• Don’t integrate SDOH or prevention

This assignment rewards structured clinical reasoning.

1) SUBJECTIVE (What to include so it sounds PMHNP-level)

Your Subjective must show you gathered:

• Chief complaint in patient’s words

• Symptom cluster: mood, sleep, energy, appetite/weight, concentration, psychomotor, guilt/worthlessness, anhedonia

• Duration and severity (mild/moderate/severe)

• Functional impact: work, relationships, self-care

• Safety: SI/HI, self-harm, access to means

• Bipolar screen: past mania/hypomania symptoms (key)

• Substance use (UDS negative supports this, but still ask)

• Medical contributors: thyroid symptoms, meds, recent stressors

• Psychiatric history: prior episodes, past meds, hospitalizations, therapy

• Family history: mood disorders, bipolar, suicide

• Trauma history (brief screen)

• Current supports and stressors (SDOH items)

High-scoring move: include a short “ROS psych” style sentence (sleep/appetite/energy) and at least one clear functional impairment statement.

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2) OBJECTIVE (What you observed + what was provided)

Include:

• General appearance/behavior (hygiene, posture, eye contact)

• Speech (rate, volume)

• Mood/affect (congruent/incongruent, range)

• Thought process/content (logical, tangential, ruminations, delusions)

• Perception (hallucinations yes/no)

• Cognition (attention, memory, orientation)

• Insight/judgment

• Risk indicators (agitation, hopelessness)

Then explicitly include the objective data:

• Vitals (BP etc.)

• Labs (UDS negative; CBC/CMP WNL; TSH high)

High-scoring move: note how the elevated TSH may overlap with depressive symptoms and requires follow-up.

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3) ASSESSMENT: MSE + Differential Diagnoses (This is the core of your grade)

A) Mental Status Exam (MSE)

Write a clean MSE paragraph (not bullets unless your template supports bullets). Keep it organized:

• Appearance, behavior, speech

• Mood/affect

• Thought process/content

• Perception

• Cognition

• Insight/judgment

• Safety (SI/HI)

B) Differential Diagnoses (minimum 3, ordered)

You must list at least 3 diagnoses from highest to lowest priority with evidence.

For an adult mood-disorder presentation, common differentials you may evaluate (depending on the video):

• Major Depressive Disorder (MDD)

• Persistent Depressive Disorder (PDD/dysthymia)

• Bipolar II Disorder (must rule out hypomania)

• Adjustment Disorder with Depressed Mood

• Depressive Disorder due to Another Medical Condition (thyroid)

Your job is to compare DSM-5-TR criteria and explain what rules diagnoses in/out.

C) DSM-5-TR rule-in / rule-out logic (how to write it)

For each differential:

1. DSM-5-TR criteria you see (pertinent positives)

2. Criteria missing (pertinent negatives)

3. Why it’s lower priority than the primary diagnosis

High-scoring move: explicitly state the “deciding factor” (e.g., duration, number of symptoms, impairment, absence of hypomania, medical contributors like TSH).

D) Primary diagnosis + critical-thinking narrative

Finish the Assessment with:

• A short paragraph stating your primary diagnosis and why it is best fit

• Acknowledgement of medical rule-outs and plan to address TSH

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4) PLAN (Psychotherapy + meds + alternatives + follow-up + health promotion + education)

A) Psychotherapy plan

Choose one evidence-based therapy appropriate for mood disorders:

• CBT, IPT, behavioral activation, etc.
  State frequency and rationale.

B) Pharmacologic plan

Even if you recommend an SSRI/SNRI, your plan must show:

• Medication choice and starting dose (per course expectations)

• Rationale for medication selection

• Side effects and warnings (including suicidality monitoring where appropriate)

• Monitoring plan (follow-up timeline, symptom scale, adverse effect monitoring)

C) Nonpharmacologic / alternative therapies

Include 1–2:

• Sleep hygiene, exercise plan, light therapy (if relevant), mindfulness, nutrition support

• Referral options (therapy groups, psychiatry if complex, endocrinology/PCP for thyroid)

D) Follow-up parameters

Be specific:

• Follow-up in X weeks

• Safety plan details if any risk exists

• When to seek urgent care

E) Health promotion activity (required)

Examples:

• regular aerobic exercise plan

• sleep routine

• smoking cessation if relevant

• stress management

F) Patient education strategy (required)

Examples:

• teach-back on meds and side effects

• warning signs of mania/hypomania

• adherence + what to do if adverse effects occur

• crisis resources if SI emerges

High-scoring move: add a simple measurement tool (e.g., PHQ-9) to track progress.

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5) REFLECTION (Where many students fail)

Your reflection must go beyond “confidentiality.”

Include all required areas:

A) What you learned / what you’d do differently

Examples:

• Ask more targeted bipolar screen questions

• Explore thyroid symptoms and medical contributors earlier

• Use structured rating scales sooner

B) Legal/Ethical considerations (beyond confidentiality)

Pick 2–3 relevant ones such as:

• suicide risk documentation standards

• duty to protect/duty to warn (if any risk indicators appear)

• informed consent for medication (risks/benefits/alternatives)

• scope of practice and collaborative care (PCP/endocrine referral for high TSH)

• safe prescribing considerations (monitoring, follow-up)

C) Social determinants of health (SDOH)

Address barriers and supports:

• finances, work schedule, transportation, insurance coverage

• stigma, cultural factors, family support

• access to therapy services

D) Health promotion + disease prevention

Tie to patient factors (age, PMH, risk factors):

• cardiovascular risk (BP elevated)

• sleep, nutrition, exercise

• relapse prevention plan

High-scoring move: connect SDOH to adherence and follow-up feasibility.

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Quick checklist (use before you submit)

• Subjective includes duration, severity, impairment, safety, bipolar screen

• Objective includes MSE observations + provided vitals/labs (TSH addressed)

• Assessment includes MSE + 3 differentials + DSM-5-TR rule-outs + primary diagnosis logic

• Plan includes psychotherapy + meds + nonpharm + alternatives + follow-up + health promotion + education

• Reflection includes ethics/legal beyond confidentiality + SDOH + prevention

• Writing is concise and clinical (no fluff)

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Time reality check

To do this well, most students need:

• time to re-watch the video and take structured notes

• time to build DSM-5-TR differential reasoning

• time to craft a safe med plan with monitoring

• time to write a meaningful reflection

For working students, this is exactly where deadlines cause stress—and where professional support makes sense.

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When getting help is the smart choice

This assignment is especially challenging if you:

• aren’t confident ruling out bipolar spectrum disorders

• struggle with DSM-5-TR differential reasoning

• aren’t sure how to integrate medical rule-outs (like elevated TSH)

• need help writing a treatment plan that includes monitoring + education

• want to avoid missing rubric elements in the reflection

Many PMHNP students seek help here not because they “can’t do it,” but because they don’t have time to do it at the level required.

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Need help with your Petunia Park Focused SOAP Note?

We can help you produce a clear, rubric-aligned submission:

• Organized notes from the video into the SOAP template

• Strong DSM-5-TR differential diagnoses with rule-in/rule-out logic

• Primary diagnosis justification using pertinent positives/negatives

• Safe treatment plan with monitoring, education, and follow-up

• Reflection with ethics/legal depth + SDOH + prevention

• Polished academic writing that reads PMHNP-level

Send your assignment template, your notes from the Petunia Park video, and your deadline, and we’ll tell you quickly how we can help.