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.
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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 Evaluation 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 Evaluation 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.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
• 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
Masterswork Productions. (2003). Mother and daughter: A cultural tale [Video/DVD]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/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)
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• This week you will explore family assessment and therapy with families presenting for psychotherapy. You will also develop diagnoses for clients receiving family therapy. Please make sure you cover all items in the assessment. Please do not write this assessment in bullet points. Please review the rubric for grading. Your thoughts must be written out. Case formulation and treatment plan are not the same. Do not forget to submit your genogram.
If items are not included in the video, please explain how you would gather the information. What questions you would ask to get the information from the patients?
For example: In the video, the interviewer is not going to say I’m conducting an HPI, you need to know what’s included in an HPI in order to gather the information from the video.
Another example: In the video, the interviewer is not to say I’m conducting a Mental Status Exam (MSE). Again you need to know what’s included in an MSE in order to gather the information from the video (objective data)
PLEASE READ THE ASSIGNMENT THOROUGHLY!!!!!
***Information and examples of how to do a genogram and set up your psychiatric assessment note are provided under the required reading tab of the Learning Resources section.
Case Formulation
A case formulation (case conceptualization) is a summary and explanation of a client’s symptoms and problems. It involves the gathering of information regarding factors that may be relevant to treatment planning and formulating a hypothesis as to how these factors fit together to form the current presentation of the client’s symptoms.
A case formulation often has 5 ingredients: (example provided below as a reference)
• Presenting problem(s): Psychological symptoms and features of a disorder, and related problems in various areas of life—social, interpersonal, academic, occupational.
• Predisposing factors which made the individual vulnerable to the problem: Distal factors or processes that lead to the mechanisms and thereby predispose the client to developing certain psychological symptoms and problems.
• Precipitating factors which triggered the problem: Proximal factors that trigger or worsen the client’s symptoms and problems. Precipitants can be internal—physiological symptoms that trigger a panic attack—or external—a stressful life event that triggers a depressive episode.
• Perpetuating factors such as mechanisms which keep a problem going or unintended consequences of an attempt to cope with the problem. Psychological factors—cognitive, behavioral—that cause or maintain the client’s problems. Mechanisms are the primary treatment targets.
• Protective factors
Gehart, D. R. (2013, August 29). Progress note [Video]. YouTube. https://www.youtube.com/watch?v=CEB1vBObUqc