Nursing Psychotherapy Prac 6650 Essay

5 REFERENCES

Assess client families presenting for psychotherapy
Develop genograms for client families presenting for psychotherapy
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.
Reflect on elements of writing a comprehensive client assessment and creating a genogram for the client you selected.
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). Nursing Psychotherapy Prac 6650 Essay.

Nursing Psychotherapy Prac 6650

Part 1: Comprehensive Client Family Assessment

Demographic information

Peter is a 30 years old Caucasian male who is married to Candy, a 25-year-old woman of African American origin. They have a 3-year-old son. Candy grew up in the foster care system and is unaware of her parental heritage while Peter is an immigrant from Britain who came to American for College education and has stayed to work in the country.

Presenting problem

Candy reports that Peter has been subjecting her to domestic violence and she is thinking of getting a divorce and taking her son away from her husband. Peter describes that spousal violence was not uncommon in his home. His father hit his mother for supposed mistakes she made and he witnessed the same among his other relatives. He reports that some of his female relatives would spend time in hospital after being subjected to domestic violence. He recalls a case in which one of his aunts lost a pregnancy after being subjected to domestic violence. Peter explains that he inherited this behavior (domestic violence) from his parents after being a part of their lives for a long time. Intervention is necessary because Candy has threatened to get a divorce and leave with her son if the domestic violence continues.

History or present illness

Peter has a history of occasionally using drugs while in college but stopped immediately after finishing college.

Past psychiatric history

Peter is of sound psychiatric health status as indicated by the annual assessments he undergoes at work.

Medical history

Peter is healthy and does not have any significant health issues. However, Candy was diagnosed with diabetes while pregnant and is still receiving care for diabetes.

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Substance use history

Peter used drugs while in college. Peter occasionally drinks alcohol at social occasions such as family and work parties.

Developmental history

Peter did not experience any delays in development.

Family psychiatric history

Peter’s mother was diagnosed with depression while there are no other psychiatric issues in the family history. His brother is an alcoholic.

Psychosocial history

Both Peter and Candy are described as sociable persons who interact with others in a friendly manner.

History of abuse and/or trauma

No other form of abuse has been reported on Peter except for occasionally being beaten by his parents as a child. Candy was not subjected to any physical abuse as a child.

Review of systems:

Physical assessment

Peter is a heavy set male who appears smart and cheerful all the time. Nursing Psychotherapy Prac 6650 Essay.

Mental status exam

The psychotherapy has to involve both Peter and Candy. That is because there is a need to address the root causes of the problem while developing a solution that allows the family to stay together (Wheeler, 2014). Candy seems ready to give Peter a chance to change his behavior. Peter seems ready to learn how to overcome the habit that he inherited from his parents of subjecting his wife to domestic violence. He does not want his wife to suffer in the same way he has seen his other female relatives suffering from being subjected to domestic violence. Therefore, Peter is ready to be helped on how he can stop the spousal abuse habit and improve his relationship with his wife (Sperry, 2016).

Differential diagnosis

Peter got married at a young age and appears to have inherited many behaviors from his parents, including how to act with his wife in terms of perpetrating domestic violence. The diagnosis concerns how Peter can change his behavior that he inherited from his parents on how to related with his wife.

The differential diagnosis is that Peter could be suffering from disruptive mood dysregulation disorder. He is easily irritable at home and has aggressive verbal outbursts that are out of proportion with the trigger. The outbursts are targeted at this wife. He appears happy most of the time but is irritable (American Psychiatric Association, 2013).

Case formulation

The psychotherapist will try to assess why Peter inherited the domestic violence (spousal abuse) behavior and how this behavior can be halted. Peter works in a high pressure job and does not use any drugs. He is physically healthy. His wife suffers from diabetes that is being managed and is concerned that the continued spousal abuse threatens her health (Green, 2019).

Treatment plan

The goal of the treatment plan is to have Peter do away with the domestic abuse behavior that he inherited from his parents of subjected his wife to spousal abuse, and adapt positive ways of communicating with his wife even as the couple’s relationship is improved. Nursing Psychotherapy Prac 6650 Essay. The first treatment step is make Peter understand that spousal abuse is wrong and the behavior threatens his family. This would improve his willingness to change the behavior. The second step is to teach Peter and Candy better ways of communicating that do not involve abuse thereby improving their relationship.

Family genogram

Figure 1. Peter’s family genogram

References

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders. Author.

Green, S. (2019).  Cognitive Behavioral Therapy for Anxiety and Depression During Pregnancy and Beyond: How to Manage Symptoms and Maximize Well-Being. Routledge.

Sperry, L. (2016). Handbook of diagnosis and treatment of DSM-5 personality disorders: assessment, case conceptualization, and treatment (3^rd ed.). Routledge.

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: a how-to-guide for evidence-based practice (2^nd ed.). Springer Publishing Company, LLC. Nursing Psychotherapy Prac 6650 Essay.