Practicum – Assessing Client Families

Assignment 1: Practicum – Assessing Client Families

Learning Objectives

STUDENTS WILL:

Assess client families presenting for psychotherapy
Develop genograms for client families presenting for psychotherapy

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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.

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).

Week 3: Experiential and Narrative Family Therapy

The Smiths, a family of five, present with their 14-year-old male son, Joshua, who is identified as “the patient.” Almost immediately, the psychiatric mental health nurse practitioner notices the subtle struggle between the parents to be heard first, often talking over one another. Joshua finally blurts out, “You see, you two are crazy, and you think it’s me.” Joshua’s father immediately becomes angry, and Joshua’s mom is quick to rush to Joshua’s side. She begins to argue with her husband about his treatment of their son.

The Smiths and other clients like them may be candidates for both experiential therapy and narrative family therapy, and it is important to note that these are distinctly different therapeutic approaches. Experiential therapy examines experiences of the “here and now,” whereas narrative family therapy focuses on retelling one’s story to understand why one behaves in certain ways. When assessing client families and selecting one of these therapies, you must not only select the one that is best for the clients, but also the approach that most aligns to your own skill set.

This week, as you explore experiential and narrative family therapy, you assess families presenting for psychotherapy. You also examine the effectiveness of therapeutic approaches for client families with impaired family functioning.

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

REQUIRED READINGS

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

Standard 5B “Health Teaching and Health Promotion” (pages 55-56)

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
Note: Retrieved from Walden Library databases.

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
Note: Retrieved from Walden Library databases.

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
Note: Retrieved from Walden Library databases.

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
Note: Retrieved from Walden Library databases.

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
Note: Retrieved from Walden Library databases.

REQUIRED MEDIA

Governors State University (Producer). (2009). Emotionally focused couples therapy [Video file]. Chicago, IL: Author.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 115 minutes.

Laureate Education (Producer). (2013b). Hernandez family genogram [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 3 minutes.

Credit: Provided courtesy of the Laureate International Network of Universities.

Psychotherapy.net (Producer). (1998). Narrative family therapy [Video file]. San Francisco, CA: Author.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 111 minutes.

OPTIONAL RESOURCES

Psychotherapy.net (Producer). (2007). Existential psychotherapy [Video file]. San Francisco, CA: Author.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 61 minutes.