NURS 6650 Week 2 Family Assessment and Phases of Family Therapy

NURS 6650 Week 2 Family Assessment and Phases of Family Therapy

NURS 6650 Week 2: Family Assessment and Phases of Family Therapy

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”

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, as you explore family assessment and therapy, you assess client families presenting for psychotherapy. You also develop diagnoses for clients receiving psychotherapy and consider the legal and ethical implications of counseling these clients.

NURS 6650 Week 2 Family Assessment and Phases of Family Therapy 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.

NURS 6650 Week 2 Family Assessment and Phases of Family Therapy Required Readings

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.

  • Chapter 12, “Family Therapy” (pp. 429–468)

Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.

  • Chapter 3, “Basic Techniques of Family Therapy” (pp. 29–48)
  • Chapter 4, “The Fundamental Concepts of Family Therapy” (pp. 49–68)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Note: It is highly recommended that you use this resource as a reference guide throughout the course. Retrieved from Walden Library databases.

L’Abate, L. (2015). Highlights from 60 years of practice, research, and teaching in family therapy. American Journal of Family Therapy, 43(2), 180–196.

Note: Retrieved from Walden Library databases.

Mojta, C., Falconier, M. K., & Huebner, A. J. (2014). Fostering self-awareness in novice therapists using internal family systems therapy. American Journal of Family Therapy, 42(1), 67–78. doi:10.1080/01926187.2013.772870. NURS 6650 Week 2: Family Assessment and Phases of Family Therapy.

Note: Retrieved from Walden Library databases.

Nichols, M., & Tafuri, S. (2013). Techniques of structural family assessment: A qualitative analysis of how experts promote a systemic perspective. Family Process, 52(2), 207–215. doi:10.1111/famp.12025

Note: Retrieved from Walden Library databases.

Papero, D. V. (2014). Assisting the two-person system: An approach based on the Bowen theory. Australian & New Zealand Journal of Family Therapy, 35(4), 386–397.

Note: Retrieved from Walden Library databases. NURS 6650 Week 2: Family Assessment and Phases of Family Therapy

Document: Group Therapy Progress Note

NURS 6650 Week 2 Family Assessment and Phases of Family Therapy Required Media

Laureate Education (Producer). (2013a). Hernandez family> Sessions 1—6 [Video file]. Author: Baltimore, MD.

Psychotherapy.net (Producer). (2006). Tools and techniques for family therapy. [Video file]. Mill Valley, CA: Author.

Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 52 minutes.

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 NURS 6650 Week 2 Family Assessment and Phases of Family Therapy. 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:

Note: For guidance on writing a comprehensive client assessment, refer to pages 137–142 of Wheeler (2014) in this week’s Learning Resources. NURS 6650 Week 2: Family Assessment and Phases of Family Therapy

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 NURS 6650 Week 2 Family Assessment and Phases of Family Therapy.

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission. NURS 6650 Week 2: Family Assessment and Phases of Family Therapy

Assignment 2: Practicum – Week 2 Journal Entry

Learning Objectives

Students will:
  • Apply documentation skills to examine family therapy sessions *
  • Develop diagnoses for clients receiving family psychotherapy *
  • Analyze legal and ethical implications of counseling clients with psychiatric disorders *

* The Assignment related to this Learning Objective is introduced this week and submitted in Week 3.

Select two clients you observed or counseled this week during a family therapy session. Note: The two clients you select must have attended the same family session NURS 6650 Week 2 Family Assessment and Phases of Family Therapy.

Then, address in your Practicum Journal the following:

  • Using the Group Therapy Progress Note in this week’s Learning Resources, document the family session.
  • Describe (without violating HIPAA regulations) each client, and identify any pertinent history or medical information, including prescribed medications.
  • Using the Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition (DSM-5), explain and justify your diagnosis for each client.
  • Explain any legal and/or ethical implications related to counseling each client.
  • Support your approach with evidence-based literature. NURS 6650 Week 2: Family Assessment and Phases of Family Therapy

By Day 7 of Week 4

Submit your Assignment.

Assignment 3: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability NURS 6650 Week 2 Family Assessment and Phases of Family Therapy.

You can access Board Vitals through the link sent to you in email or by following the link below:

https://www.boardvitals.com/

By Day 7

Complete the Board Vitals questions.

Making Connections

Now that you have:

  • Explored family assessment and therapy and assessed client families presenting for psychotherapy
  • Developed diagnoses for clients receiving family psychotherapy and considered legal and ethical implications of counseling these clients NURS 6650 Week 2 Family Assessment and Phases of Family Therapy.

Next week, you will:

  • Explore experiential and narrative family therapy as you assess families presenting for psychotherapy
  • Examine the effectiveness of therapeutic approaches for client families with impaired family functioning

Looking Ahead 1: Week 3 Clinical Supervision Discussion

In the Week 3 Clinical Supervision Discussion, you will produce a 3- to 5-minute Kaltura video in which you will discuss a client family you have observed and/or counseled during your practicum experience. Be sure to make arrangements with your preceptor so you can fulfill the requirements of the Discussion NURS 6650 Week 2 Family Assessment and Phases of Family Therapy. Refer to the Week 3 Discussion for additional guidance.

Looking Ahead 2: Week 3 Videos

Next week, you will need to view several videos prior to completing your Discussions and Assignments. These videos are more than 3 hours in length NURS 6650 Week 2 Family Assessment and Phases of Family Therapy. Please plan ahead to ensure you have time to view these videos and complete your Discussions and Assignments on time.

Group and Family Therapy

Group therapy and family therapy are forms of psychotherapy used to treat diverse psychological disorders. In group therapy, one or more healthcare providers simultaneously treat multiple patients (Malhotra & Baker, 2021). Meanwhile, as the name suggests, family therapy implies a form of psychotherapy offered to the family by one or more family therapists (Varghese et al., 2020). It is important to note that the aforementioned forms of psychotherapy have underlying principles and guidelines that guide them. This piece of writing will analyze an assigned video and develop an appropriate form of psychotherapy.

Summary of the Video

Chase is a victim of a traumatic event that has culminated in his current state of post-traumatic stress disorder, as evidenced classically by the narration and presentation of his symptoms shortly after the incident. He exhibits flashbacks, nightmares, repetitive and distressing images or sensations, and physical sensations, such as tingly perception, pain, feeling sick or trembling. Furthermore, his behavioral pattern has since changed, and he is currently isolated and withdrawn. Chase demonstrates a clear picture of emotional numbness and avoidance of places and people that remind him not only of the trauma but also avoid talking to anyone about his experience. He gives an account of overindulgence in substances such as smoking, drinking, and taking some pills to cope with his state.

Therapeutic Treatment Plan

PTSD is a disabling condition and thus necessitates early diagnosis and initiation of treatment. The treatment of PTSD principally involves psychotherapy as the first line, with or without adjunctive pharmacotherapy (Pagel, 2021). The treatment plan for Chase will, therefore, be as follows: (1) The therapy goals include improving his symptoms, teaching him new skills to cope with, and restoring his self-esteem. (2) First line will be trauma-focused cognitive behavioral therapy, including exposure therapy and cognitive processing therapy (Pagel, 2021). 

In addition, eye movement desensitization and reprocessing therapy (EMDR) will also be offered. This has been shown to desensitize the patient and allow him to reprocess traumatic content through bilateral hemispheric stimulation. In their systemic review, Wilson et al. (2018) demonstrated that EMDR had an efficacy of more than 80% when used for treating PTSD. (3) Adjunctive pharmacotherapy with sertraline (a minimum of 12 months if effective), an SSRI approved by the FDA for the treatment of PTSD in adults (Mann & Marwaha, 2022). (4) Strategies for alcohol and smoking cessation and rehabilitation. (5) Finally, the treatment duration for psychotherapy will be weekly sessions for at least 18 to 24 weeks.

Group/Individual or both?

Effective treatment of PTSD is complex and multidisciplinary. For Chase, a combination of both individual and group therapy would be effective. For instance, individual therapy will be most important during EMDR as it will enable him to reprocess the incompletely processed and stored memories of the traumatic events. On the other hand, group therapy is essential for PTSD based on its principles, such as installation of hope, interpersonal learning, catharsis, imitative behavior, altruism, development of socializing behaviors, and universality, among others. According to Cowden et al. (2022), these core principles considerably enhance self-esteem, improve symptoms and enable PTSD patients to acquire new ways of coping. Finally, involving his family in the therapy is crucial to obtain social support.

Conclusion

PTSD is a disabling condition that warrants prompt diagnosis and treatment. Trauma-focused cognitive behavioral therapy and EMDR are the mainstays for treating PTSD, although medications can be used as an adjunct. Psychotherapy for PTSD can be offered as individual or group-based therapy or a combination of both.

References

Cowden, R. G., Captari, L. E., Chen, Z. J., De Kock, J. H., & Houghtaling, A. (2022). Effectiveness of an intensive experiential group therapy program in promoting mental health and well-being among mass shooting survivors: A practice-based pilot study. Professional Psychology, Research, and Practice, 53(2), 181–191. https://doi.org/10.1037/pro0000443

Malhotra, A., & Baker, J. (2021). Group Therapy. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK549812/

Mann, S. K., & Marwaha, R. (2022). Posttraumatic Stress Disorder. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559129/

Pagel, J. F. (2021). Group Therapy for PTSD. In Post-Traumatic Stress Disorder (pp. 75–82). Springer International Publishing. https://doi.org/10.1007/978-3-030-55909-0_9

Varghese, M., Kirpekar, V., & Loganathan, S. (2020). Family interventions: Basic principles and techniques. Indian Journal of Psychiatry, 62(Suppl 2), S192–S200. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_770_19

Wilson, G., Farrell, D., Barron, I., Hutchins, J., Whybrow, D., & Kiernan, M. D. (2018). The use of Eye-Movement Desensitization Reprocessing (EMDR) therapy in treating Post-traumatic Stress Disorder-A systematic narrative review. Frontiers in Psychology, 9, 923. https://doi.org/10.3389/fpsyg.2018.00923

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