Assignment 4 – Wk4 (G) Paper
Assignment 4 – Wk4 (G) Paper
Practicum – Assessing Client Families
To prepare:
· Select a client family that you have observed or counseled at your practicum site.
· Review pages 137–142 of Wheeler (2014) and the Hernandez Family Genogram
video in this week’s Learning Resources. (SEE ATTACHED VIDEO TRANSCRIPT)
· Reflect on elements of writing a comprehensive client assessment and creating a
genogram for the client you selected.
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The Assignment
Part 1: Comprehensive Client Family Assessment
Create a comprehensive client assessment for your selected client family that addresses (without violating HIPAA regulations) the following:
· Demographic information
· Presenting problem
· History or present illness
· Past psychiatric history
· Medical history
· Substance use history
· Developmental history
· Family psychiatric history
· Psychosocial history
· History of abuse and/or trauma
· Review of systems
· Physical assessment
· Mental status exam
· Differential diagnosis
· Case formulation
· Treatment plan
Part 2: Family Genogram
Develop a genogram for the client family you selected. The genogram should extend back at least three generations (parents, grandparents, and great grandparents).
N:B. (1)PLEASE THIS ASSIGNMENT HAS 2 PARTS, AND I HAVE ATTACHED A SAMPLE OF THE ASSIGNMENT, BUT THE SAMPLE TALKS ONLY ABOUT HERNANDEZ, BUT THIS ASSIGNMENT IS FOCUS ON HERNANDEZ FAMILY.
(2). HERNANDEZ FAMILY GENOGRAM VIDEO TRANSCRIPT IS ATTACHED INCASE YOU CAN NOT VIEW THE VIDEO
Learning Resources
Required Readings
Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.
- Chapter 8, “Experiential Family Therapy” (pp. 129–147)
- Chapter 13, “Narrative Therapy” (pp. 243–258)
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.
- “Genograms” pp. 137-142
Cohn, A. S. (2014). Romeo and Julius: A narrative therapy intervention for sexual-minority couples. Journal of Family Psychotherapy, 25(1), 73–77. doi:10.1080/08975353.2014.881696
Escudero, V., Boogmans, E., Loots, G., & Friedlander, M. L. (2012). Alliance rupture and repair in conjoint family therapy: An exploratory study. Psychotherapy, 49(1), 26–37. doi:10.1037/a0026747
Freedman, J. (2014). Witnessing and positioning: Structuring narrative therapy with families and couples. Australian & New Zealand Journal of Family Therapy, 35(1), 20–30. doi:10.1002/anzf.1043
Phipps, W. D., & Vorster, C. (2011). Narrative therapy: A return to the intrapsychic perspective. Journal of Family Psychotherapy, 22(2), 128–147. doi:10.1080/08975353.2011.578036
Saltzman, W. R., Pynoos, R. S., Lester, P., Layne, C. M., & Beardslee, W. R. (2013). Enhancing family resilience through family narrative co-construction. Clinical Child and Family Psychology Review, 16(3), 294–310. doi:10.1007/s10567-013-0142-2
Required Media
Governors State University (Producer). (2009). Emotionally focused couples therapy [Video file]. Chicago, IL: Author.
Laureate Education (Producer). (2013b). Hernandez family genogram [Video file]. Baltimore, MD: Author. (SEE ATTACHED VIDEO TRANSCRIPT)
Psychotherapy.net (Producer). (1998). Narrative family therapy [Video file]. San Francisco, CA: Author.
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HERNANDEZFAMILYGENOGRAMVIDEOTRANSCRIPT.pdfHernandez Family Episode 6
Hernandez Family Episode 6 Program Transcript
FEMALE SPEAKER: So last week I showed you how to make a genogram, like this one. Now, the idea behind making a genogram is to help you draw a picture of your family history. And then we use that to discuss the relationships and connections among your relatives. OK? So Juan, why don’t you start off and talk about what you came up with. Assignment 4 – Wk4 (G) Paper
JUAN HERNANDEZ: So we’re starting with my family. My father, Hector, he’s still alive. And he married my mother, Freda. And she passed away two years ago. And then there’s their children, myself– I’m the oldest– and then there’s my three sisters, Marie, Senta, and Rose.
FEMALE SPEAKER: Good. And Elena, what about your family?
ELENA HERNANDEZ: Well, here’s my father, Anthony. He met and married my mother, Sofia. They are both still alive. They had five children. Firstborn was my brother Daniel, then my brother Tomas, then my sisters Martina and Camila, and there’s me, the baby.
And then I met Juan, and we started our own family. And we have two beautiful sons that you met, one, Junior, who is eight, and Alberto, who is six.
FEMALE SPEAKER: Good. So for the last several weeks we’ve been talking a lot about how you discipline your sons at home. And both of you mentioned how your parents used to punish you when you were growing up. Juan, why don’t you talk about that and point to anybody on the genogram as you mention them?
JUAN HERNANDEZ: Sure. So my dad, when he was mad at me he would send me to get books from the encyclopedia. And he’d make me hold them out, straight out like this, until he told me to stop. It caused so much pain in my arms, I mean, my arms felt like they would break off.
And my mom, she did basically the same thing. Except when she was really mad, when would make me get more books than my dad. I hated those books so much. I never went near them on my own. To me, they only meant one thing, misery. And now, I guess I inherited that from them. Assignment 4 – Wk4 (G) Paper
FEMALE SPEAKER: Elena, how about you?
ELENA HERNANDEZ: Yes, misery. That’s what it was like for me, too.
© 2017 Laureate Education, Inc. 1
Hernandez Family Episode 6
Hernandez Family Episode 6 Additional Content Attribution
MUSIC: Music by Clean Cuts
Original Art and Photography Provided By: Brian Kline and Nico Danks
© 2017 Laureate Education, Inc. 2
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SAMPLEOFHERNANDEZGENOGRAM.docx
THE HERNANDEZ CASE STUDY 1
THE HERNANDEZ CASE STUDY 6
HERNANDEZ CASE STUDY 1
The Hernandez Case Study
Damian Ngodo
Cufa Behavioral Services Inc Festus Uzokwe (MD)
(713) 360-7972
December 22, 2017
HERNANDEZ CASE STUDY 2
The Hernandez Case Study
Part 1: Comprehensive Client Family Assessment
Demographic information
Juan Hernandez Junior is an 8-year-old, Latino, male.
Presenting problem
Juan Hernandez Junior described a punishment at school that led to them calling the ACS. The school social worker was told of how the Hernandez parents made him kneel on his knees for hours while holding two heavy encyclopedias in each hand as a form of punishment. He reiterated that this punishment had been used on them on several occasions and this led to the ACS sending a worker to their home. The ACS worker thought that the concern was credible since this form of punishment was abusive and suggested that they start attending family sessions and visit the local community mental agency to complete a parenting group.
History or present illness
Parent’s reports Hernandez has no drug abuse problem but a criminal history of juvenile petty theft that has since been expunged in 2010.
Past psychiatric history
Parents report that Juan Jr. has been of sound psychiatric health.
HERNANDEZ CASE STUDY 3
Medical history
Parents report that Juan Jr has been healthy. However, his mother has been diagnosed with diabetes recently.
Substance use history
Both parents have no history of substance abuse nor does Juan Jr.
Developmental history
Parents reports no delays
Family psychiatric history
Parents report no psychiatric problems in their family history.
Psychosocial history
Juan Jr is quite sociable. He and his parents go to the beach and the park near their home on weekends to socialize and play.
History of abuse/trauma
Prior to the current problem that involves the form of punishment that the Hernandez are using on their children, there are no other abuse incidents that Juan Jr. has experienced.
Review of systems
Gen: Has no fever, night sweats, heat intolerance, weakness or fatigue.
HERNANDEZ CASE STUDY 4
Head: No migraine headaches reported.
ENT: No visual changes, eye pain, hearing loss, tinnitus, vertigo, ear pain, ear discharge, epistaxis, nasal discharge, sinusitis, teeth problems, abnormal taste, sore throat, or speech difficulty
Neck: Denies neck swelling, pain, stiff neck, goiter, or masses, nodes.
Cardiopulmonary: Patient indicates they have not witnessed any instances of cough, dyspnea, wheezing, hemoptysis, chest pain, palpitations, orthopnea, murmurs, edema, claudication, syncope, and hypertension.
GI: There have been no changes to the patients eating habits. He has tested negative for n/v, hematemesis, melena, dysphagia, heartburn, flatulence, abdominal pain, jaundice, and change in bowel habits, diarrhea, constipation, hematochezia, or rectal pain.
GU: He also has been cleared of dysuria, frequency, nocturia, hematuria, urgency incontinence or polyuria.
MS: On the other hand, he has reported no backache, joint pain, stiffness. Gait is normal and steady.
Heme/Skin: Patient insists they have had no bleeding, bruising, anemia. Denies changes, pruritis, rash, or changes in hair.
Neuro: No indication of seizures, paralysis, muscle weakness, parasthesia, sensation changes.
Psych: Thought content: no SI/HI or psychotic symptoms; Associations: intact; Orientation: x 3; Mood and affect: euthymic and full and appropriate.
Physical assessment
Vital Signs:
HERNANDEZ CASE STUDY 5
47 Height: inches
Weight: 129lbs
Temp: 37 0C.
RR: 16
BP: 120/59
Pulse: 79 BPM
Appearance: Slender, Latino male who appears his age and no distress observed. He is well groomed and dressed to impress.
Mental status exam
The whole family comes to the appointment since they should do both family sessions and a positive parenting program for the parents. Juan Senior comes on with a lot of anger and resentment towards the counselor a she sees no point in attending the classes.
Differential diagnosis
The parents grew up too fast and are projecting their feelings on their children.
Diagnosis
Anger Management issues
Case formulation
The Hernandez parents, Juan Senior and Elena are brought for sessions by the ACS as a result of their son’s abuse allegations. Juan Hernandez is a 27-year-old Latino man who works as a casual worker at the airport with back problems due to the amount of heavy lifting he should do
daily. He has no drug abuse problem but a criminal history of juvenile petty theft that has since been expunged. Additionally, he takes approximately six to eight beers every weekend.
HERNANDEZ CASE STUDY 6
On the other hand, Elena is a 25-year-old Latino woman born in Puerto Rico but raised in New York who was recently diagnosed with diabetes. She has no drug abuse problem nor a criminal history. She drinks 1 or 2 drinks a month.
Treatment plan
Treatment Goals
The weekly parenting classes and family sessions will teach the parents effective and safe discipline skills, the importance of recognizing age-appropriate behavior, managing one’s frustrations, and the child development techniques that boosts child’s self-esteem and their sense of confidence. It will also help the family come to terms with the situation at hand.
Estimated Completion: 3 Months
Objective #1
The parents will be able to discipline their children effectively and using safe options.
Treatment Strategy / Interventions: This will be done through teaching the parents the most effective and safe discipline skills they can use. These may include techniques such as setting
limits like taking away their privileges and using time-out. This can only be successful if the parents fully understand the age appropriate behavior of each stage s they do not cross boundaries and punish them unnecessarily.
Estimated Completion: 3 Months
Objective #2
In the end, the parents should be able to find child development techniques that will boost their children’s self-esteem and ensure they have a strong sense of confidence. They should also be able to manage their frustrations as a family.
HERNANDEZ CASE STUDY 7
Treatment Strategy / Interventions: Through role playing, both the parents and the children are able to find a way to understand the feelings of the other so they can rectify any issues they might have had. This will help ensure order at home is maintained without the need for discipline and that the parents do not put unrealistic expectations on their children. Assignment 4 – Wk4 (G) Paper
Estimated Completion: 3 Months
Social Support system:
Friends and family
HERNANDEZ CASE STUDY 8
Part 2: Family Genogram includes Juan Hernandez Junior’s family.
Paternal grandparents’ maternal grandparents
Hernandez’s uncles Hernandez’s father Hernandez’s mother Aunt
His brother Hernandez Hernandez’s sister
Sister in-law
His nephew
HERNANDEZ CASE STUDY 9
Reference
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.