Hernandez Family Assessment Essay Example
Hernandez Family Assessment Essay Example 1
Demographic information
The assessment is conducted for Hernandez Family who are of Latino origin. This is a nuclear family with four members who are comprised of a father (Juan), mother (Elena), and two sons (8-year-old Juan Jr. and six-year-old Alberto). All the family members live within the same residence. Hernandez Family Assessment Essay Example.
Presenting problem
The family presents itself for psychiatric assessment and therapy because of reported physical abuse that occurs in the family. In this case, the two parents are accused of physically abusing their children through the use of harmful corporal punishment. The parent’s mode of punishing their sons is considered physical abuse since the children are forced to kneel down and raise their hands with heavy reference books. The parents do not consider the punishment as physical abuse since they were subjected to similar punishments as children, and feel that this is necessary correct misbehavior. They are particularly insistent that associated misbehavior with pain (punishment) is good deterrence to ensure that their sons have the right character. The issue of concern is that the parents consider physical punishment as part of ‘normal’ parenting, a perspective that is contrary to legislative opinions. As such, there is a need to change the parents’ mentality and opinions, ensuring that they conform to the legislative opinions so that they apply alternative forms of punishing their children that are not considered as physical abuse. The desired changes are expected to occur through deliberate processes that entail enrolling the parents in parenting classes. It is important to note that should the parents continue using punishment that is considered physical abuse, then the family is likely to be broken down through proactive withdrawal of the children into protected care that is considered a safer environment. Hernandez Family Assessment Essay Example. The implication is that if the parents’ opinions and mentality concerning corporal punishment is not changed, then the family would be harmed through physical injuries to the children and family breakdown (Nichols, 2014). In this respect, the issue of concern is that the children are suffering from physical abuse at home and there is a need to create a safer home environment by having the parents adopt other forms of punishing their children that will not be considered as abusive.
History or present illness
The history of the present issue is that the parents have been using corporal punishment on their children, and this is the best form of punishment they know of since they were similarly subjected to corporal punishment as children. Their experiences as children has created a unique mentality in which they look at corporal punishment as a necessary tool for raising good children. Hernandez Family Assessment Essay Example.
Medical history
There is a need for additional assessment.
Substance use history
There is a need for additional assessment.
Developmental history
There is a need for additional assessment.
Family psychiatric history
There is a need for additional assessment since the parents have not indicated any history of psychiatric issues, except for a history of physical abuse when they were children although they do not consider is as such and only look at it as punishment to correct misbehavior.
Psychosocial history
This is a nuclear family that has four members comprised of a father, mother and two sons. All the family members reside within the same house. The father works to financially provide for the family although he indicates that his earnings are barely enough to cover the family expenses and he fears that the situation will worsen over time. The mother stays at home to manage the domestic chores. The two sons attend school.
History of trauma and abuse
The two parents report that they were subjected to corporal punishment as children and this enabled them to turn into good adults, and they expected corporal punishment to effectively deter their sons from misbehavior thus allowing them to turn into responsible and good adults.
Review of systems
There is a need for additional assessment.
Mental status examination
The father is communicative and cooperative, offering details that are relevant to the case. Still, he is irritable as seen when he feels that his parenting approaches are being questioned by persons he considers as strangers. He appears resistant to changing his parenting approach, claiming that his parents applied a similar approach and he turned out right.
The mother is similarly communicative and cooperative, offering details that are relevant to the case. Still, she appears timid since she only echoes what her husband stated and does not offer an independent opinion. This is especially seen when she seems to have concerns about the use of corporal punishment on her sons but is not ready to contradict her husband. Hernandez Family Assessment Essay Example.
Differential diagnosis
The diagnosis for the children is that they are suffering from psychological harm as a result of the physical abuse. The corporal punishment physical harms the children. In addition, it erodes the trust that the children have in their parents to protect them (Thompson, 2016). The alternative diagnosis is that the parents are transferring the anger they experienced as children onto their sons. They were physically abused as children and could have let the anger fester since they had no recourse (American Psychiatric Association, 2013).
Case formulation
The two parents are of the opinion that corporal punishment conditions the children to avoid misbehaving through associating the misbehavior with pain. They view corporal punishment as a good deterrence and not physical abuse.
Treatment plan
The treatment plan is to make that parents aware that corporal punishment is the wrong parenting approach and is physical abuse. Once they are aware that they have been applying the wrong parenting approach, they can be guided in exploring alternative parenting and punishment approaches that are more appropriate. In addition, the possibility of them having repressed anger should be explored and treatment provided that allows them to express their anger in constructive ways (Cautin & Lilienfeld, 2015; Wheeler, 2014).
Reference
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Cautin, R. & Lilienfeld, S. (2015). The encyclopedia of clinical psychology, volume II Cli-E. Hoboken, NJ: John Wiley & Sons.
Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson Hernandez Family Assessment Essay Example.
Thompson, R. (2016). Counseling techniques: improving relationships with others, ourselves, our families, and our environments (3rd ed.). New York, NY: Routledge.
Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company Hernandez Family Assessment Essay Example.
Assignment 1: Hernandez 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. As you examine the Hernandez Family: Sessions 1-6 videos in this week’s Learning Resources, consider how you might assess and treat the client family.
Learning Objectives
Students will:
Assess client families presenting for psychotherapy
To prepare:
Review this week’s Learning Resources and reflect on the insights they provide on family assessment.
View the Hernandez Family: Sessions 1-6 videos, and consider how you might assess the family in the case study.
Note: For guidance on writing a comprehensive client assessment, refer to pages 137–142 of Wheeler (2014) in this week’s Learning Resources. Hernandez Family Assessment Essay Example.
The Assignment
Address in a comprehensive client assessment of the Hernandez family 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
Note: Any item you are unable to address from the video should be marked “needs to be added to” as you would in an actual comprehensive client assessment. Hernandez Family Assessment Essay Example.
Hernandez Family Assessment Essay Example 2
Hernandez Family Assessment
An individual’s personality is shaped by their family life (Nichols, 2014). Family therapy is beneficial when dysfunction is present in the family or when one or more family members exhibits symptoms of mental illness (Knight, 2014). When the family is transformed through therapy, each member is changed (Nichols, 2014). Before psychotherapy can begin a thorough assessment of the family is needed. The purpose of this paper is to discuss the assessment, differential diagnosis, case formulation, and treatment plan of the Hernandez family
Comprehensive Psychiatric Assessment
Demographic information
The Hernandez family consists of Juan, Elena, Juan, Jr., and Alberto. Juan is the husband, father and primary client. Elena is the wife and mother. The oldest son, Juan Jr., is eight-years-old; and Alberto, the youngest son, is six-years-old. Hernandez Family Assessment Essay Example.
Race/Ethnicity. Hispanic.
Marital status. Married
Who referred?. ACS
Why?. ACS found the style of punishment Juan and Elena employ with their children, forcing them to kneel while holding encyclopedias extended in each arm, to be abusive. Juan and Elena are required to take parenting classes.
Sources of information. ACS worker, Juan, and Elena
Presenting problem
Juan and Elena want to keep their family intact but do not believe they abuse their children. Juan and Elena must learn new and appropriate parenting skills.
Verbatim statement.
Juan. “We didn’t do anything wrong.”
Elena. “I don’t want to lose our children.”
History of present illness
Needs further assessment.
Past psychiatric history
Needs further assessment
Medical history
Needs further assessment
Substance use history
Needs further assessment
Developmental history
Needs further assessment
Family psychiatric history
Needs further assessment
Psychosocial history
Current living arrangements. Juan lives with his wife, Elena, and their two children, Juan Jr. and Alberto.
Employment. Juan works full-time with frequent overtime.
Financial. The family has difficulty meeting all their financial obligations without Juan’s overtime pay.
History of abuse or trauma
Juan reports both of his parents disciplined him with the kneeling while holding heavy books punishment that the couple employs with their children. Elena states discipline from her parents caused her misery.
Review of systems
Needs further assessment
Mental status examination
Juan is clean and well-groomed. He exhibits normal speech, eye contact, and motor activity. The client’s affect is hostile which is congruent with his angry mood. He exhibits no impairment to orientation or memory. Juan displays a normal attention span, thought process, and content of thought. No signs of auditory or visual hallucinations are noted. Juan is agitated but cooperative. He displays poor judgement in the belief that his disciplinary methods used with his children are acceptable and poor insight regarding the need for therapy.
Elena is clean and well-groomed. She exhibits normal speech, eye contact, and motor activity. Elena’s affect is full and her mood is anxious. Elena has a normal attention span and a logical thought process. No impairment to orientation or memory is noted. Elena has no signs of hallucinations. She is cooperative. Elena seems to have poor judgment in the discipline of her children but fair insight into the necessity of therapy to meet the ACS requirements.
Differential diagnosis
Principal diagnosis. The principal diagnosis is child psychological abuse. Child psychological abuse is defined as nonaccidental acts by a child’s parent that result in or may result in significant psychological harm to the child (American Psychiatric Association [APA], 2013). The diagnosis includes behaviors such as excessive discipline even when not at a level considered to be physical abuse and forcing the child to inflict pain upon himself (APA, 2013) Hernandez Family Assessment Essay Example. The ACS caseworker has deemed that Juan and Elena use excessive discipline with their children. Although Juan mentioned holding the books for long periods of time caused him great pain, he forces his sons to do so.
Case formulation
Juan and Elena are a married Hispanic couple with two sons, aged six and nine. They have been referred to the clinic by ACS for therapy and parenting classes due to confirmed allegations of abuse. Both Juan and Elena discipline their sons by forcing them to kneel for long periods of time holding books in their hands with their arms extended. Juan states this was how he was punished as a child. Juan and Elena deny the use of corporal punishment or abusing their children.
Treatment plan
The treatment plan for the Hernandez family will include weekly family therapy and weekly parenting classes to improve parenting skills. Assistance with financial planning may make attendance less stressful for the family. Both Juan and Elena love their children very much. Hernandez Family Assessment Essay Example They are motivated to follow the ACS requirements and recommendations to keep their family together.
Conclusion
A recent meta-analysis found the family therapy and parent training to be effective in treating infant feeding, sleep, and attachment issues; conduct issues such as attention-deficit hyperactivity disorder, delinquency, and drug use; emotional problems including anxiety, depression, self-harm, and grief; child neglect and abuse; eating disorders; and somatic problems (Carr, 2014). In fact, the treatment guidelines of the American Academy of Child and Adolescent Psychiatry recommend family therapy for most child and adolescent problems (Stratton et al., 2015). Before therapy can commence, a thorough assessment must be performed. A thorough assessment allows the therapist to understand the problems from the family’s point of view which helps to build a therapeutic relationship (Nichols & Tafuri, 2013). Hernandez Family Assessment Essay Example.
