Walden NRNP 6645 Week 2 Assignment: Family Assessment
A family’s patterns of behavior influences [sic] the individual and therefore may need to be a part of the treatment plan. In marriage and family therapy, the unit of treatment isn’t just the person—even if only a single person is interviewed—it is the set of relationships in which the person is imbedded.
—American Association of Marriage and Family Therapy, “About Marriage and Family Therapists”
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When issues arise within a family unit, the family often presents with one member identified as the “problem.” However, you will frequently find that the issue is not necessarily the “problem client,” but rather dysfunctional family patterns and relationships. To better understand such patterns and relationships, and develop a family treatment plan, it is essential that the practitioner appropriately assess all family members. This requires you to have a strong foundation in family assessment and therapy.
This week, you practice assessing and diagnosing client families presenting for psychotherapy.
Learning Objectives
Students will:
Apply concepts, theories, and principles related to patient interviewing, diagnostic reasoning, and recording patient information
Formulate differential diagnoses for patients using DSM-5 criteria
Formulate plans of care for patients that incorporate family psychotherapy interventions
Develop psychotherapy genograms
Learning Resources – Walden NRNP 6645 Week 2 Assignment: Family Assessment
Required Readings (click to expand/reduce)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.)
For reference as needed
Nichols, M., & Davis, S. D. (2020). The essentials of family therapy (7th ed.). Pearson.
Introduction
Chapter 2, “Basic Techniques of Family Therapy”
Chapter 3, “The Fundamental Concepts of Family Therapy”
Chapter 4, “Bowen Family Systems Therapy
Therapist Aid. (2012–2020). Genograms for psychotherapy. https://www.therapistaid.com/therapy-guide/genograms
Therapist Aid LLC. (© 2012-2020). Genograms for psychotherapy. https://www.therapistaid.com/therapy-guide/genograms
Document: Comprehensive Psychiatric Assessment Note Template
Document: Comprehensive Psychiatric Assessment Note Exemplar
Required Media (click to expand/reduce)
Gehart, D. R. (2013, August 29). Progress note [Video]. YouTube. https://www.youtube.com/watch?v=CEB1vBObUqc
Masterswork Productions. (2003). Mother and daughter: A cultural tale [Video/DVD]. https://video-alexanderstreet-com.ezp.waldenulibrary.org/watch/mother-and-daughter-a-cultural-tale
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2013). Counseling and psychotherapy theories in context and practice [Video]. https://waldenu.kanopy.com/video/counseling-and-psychotherapy-theories-contex
Family Systems Therapy (starts at 4 hours)
Assignment: Family Assessment
Assessment is as essential to family therapy as it is to individual therapy. Although families often present with one person identified as the “problem,” the assessment process will help you better understand family roles and determine whether the identified problem client is in fact the root of the family’s issues. Walden NRNP 6645 Week 2 Assignment: Family Assessment
Photo Credit: Getty Images
To prepare:
Review this week’s Learning Resources and reflect on the insights they provide on family assessment. Be sure to review the resource on psychotherapy genograms.
Download the Comprehensive Psychiatric Assessment Note Template and review the requirements of the documentation. There is also an exemplar provided with detailed guidance and examples.
View the Mother and Daughter: A Cultural Tale video in the Learning Resources and consider how you might assess the family in the case study.
The Assignment
Document the following for the family in the video, using the Comprehensive Assessment Note Template:
Chief complaint
History of present illness
Past psychiatric history
Substance use history
Family psychiatric/substance use history
Psychosocial history/Developmental history
Medical history
Review of systems (ROS)
Physical assessment (if applicable)
Mental status exam
Differential diagnosis—Include a minimum of three differential diagnoses and include how you derived each diagnosis in accordance with DSM-5 diagnostic criteria
Case formulation and treatment plan
Include a psychotherapy genogram for the family
Note: For any item you are unable to address from the video, explain how you would gather this information and why it is important for diagnosis and treatment planning. Walden NRNP 6645 Week 2 Assignment: Family Assessment
By Day 7
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Submission and Grading Information – Walden NRNP 6645 Week 2 Assignment: Family Assessment
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Week 2 Assignment Rubric
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Submit your Week 2 Assignment draft and review the originality report.
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Week 2 Assignment
Rubric Detail – Walden NRNP 6645 Week 2 Assignment: Family Assessment
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Writing Guide:
Comprehensive Psychiatric Assessment Note Template:
Chief Complaint:
The family presents with conflict between the mother and daughter regarding the daughter’s choice of career and marriage partner. The mother wants the daughter to pursue a more traditional path while the daughter wants more independence and autonomy.
History of Present Illness:
The daughter, Mai, is a 19-year-old college student studying to become a teacher. Her mother wants her to quit school and get married. Mai wants to finish her education and choose her own husband. They have been arguing frequently about this, causing stress and tension in the home.
Past Psychiatric History:
None reported for any family members.
Substance Use History:
None reported.
Family Psychiatric/Substance Use History:
No history of mental illness or substance abuse reported in the extended family on either side.
Psychosocial/Developmental History:
Mai was raised in a traditional Vietnamese family and culture that values obedience, family responsibility, and preserving cultural traditions. She is the eldest daughter and feels pressure to fulfill expectations for her role. However, she also values independence, choice, and pursuing her dreams.
Medical History:
None reported for any family members.
Review of Systems:
No abnormalities reported.
Mental Status Exam:
Appearances appropriate. Mood frustrated. Affect restricted. Speech normal. Thought processes logical and goal-directed. No evidence of delusions, hallucinations, or other abnormal thinking.
Differential Diagnoses:
Adjustment disorder with mixed anxiety and depressed mood
Acculturation conflict
Normative developmental transition difficulties
I derived these diagnoses based on DSM-5 criteria for adjustment disorder which fits the acute stress reaction to the intergenerational value conflict. Acculturation conflict criteria apply to the clash between traditional Vietnamese and American individualistic values. Developmental transition difficulties are normative for Mai’s age as she establishes independence.
Case Formulation:
The core issue appears to be an intergenerational value conflict as Mai seeks to balance her cultural heritage with her personal goals and identity. Both she and her mother have reasonable perspectives but lack understanding of the other’s view. Their relationship and communication styles need improvement to resolve conflicts respectfully.
Treatment Plan:
Conduct family therapy sessions to improve understanding between Mai and her mother
Use genograms to explore cultural values and family expectations over generations
Teach active listening and assertiveness skills to help each express their perspectives respectfully
Consider including an elder from their community to provide cultural perspective
Set small, achievable goals to build trust and increase flexibility in meeting each other’s needs
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Sample Answer:
In the video “Mother and Daughter: A Cultural Tale,” the family presents with a chief complaint of conflict between the mother and daughter regarding the daughter’s choice of career and marriage partner. The mother wants the daughter to follow traditional cultural expectations, while the daughter desires independence and the freedom to make her own choices. This conflict has led to frequent arguments and tension within the family.
Upon reviewing the family’s past psychiatric history, no mental illness or substance abuse issues were reported for any family members. Similarly, there is no history of substance use within the family.
In terms of the family’s psychosocial and developmental history, the mother, Mai, was raised in a traditional Vietnamese family and culture that places a strong emphasis on obedience, family responsibility, and preserving cultural traditions. As the eldest daughter, Mai feels pressure to fulfill these expectations. However, she also values independence, choice, and personal fulfillment. This clash between traditional Vietnamese values and American individualistic values may contribute to the conflict within the family. Additionally, Mai is at an age where she is establishing her independence, which can lead to developmental transition difficulties.
Based on the assessment, the core issue in this case is an intergenerational value conflict. Mai is seeking to balance her cultural heritage with her personal goals and identity. Both Mai and her mother have valid perspectives, but they lack understanding of each other’s viewpoints. To address this, family therapy sessions should be conducted to improve understanding and communication between Mai and her mother. Additionally, the use of genograms can be beneficial in exploring cultural values and family dynamics, providing a visual representation of the family’s strengths and weaknesses.
Overall, the treatment plan for this family involves working towards resolving conflicts respectfully and improving the relationship and communication styles between Mai and her mother. By addressing the intergenerational value conflict and promoting understanding, the family can work towards finding a balance between cultural expectations and individual autonomy.
References:
Gehart, D. R. (2013). Progress note and treatment plan bundle. [Video]. YouTube. https://www.youtube.com/watch?v=CEB1vBObUqc
Masterswork Productions. (2003). Mother and daughter: A cultural tale [Video/DVD].
Therapist Aid. (2012–2020). Genograms for psychotherapy. Retrieved from https://www.therapistaid.com/therapy-guide/genograms
