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Walden University: NURS 6650: Psychotherapy with Groups and Families / WeeK 4 ASSGN 4 POOLEN/ Practicum Experience: Comprehensive Family Assessment. Includes Family Genogram.

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Walden University: NURS 6650: Psychotherapy with Groups and Families / WeeK 4 ASSGN 4 POOLEN/ Practicum Experience: Comprehensive Family Assessment. Includes Family Genogram. I. Demographic Informa... tion: Family unit consist of two members. A 13 Y/O female (daughter) is accompanied by her mother a 41 Y/O old female. The client and her mother were born in the United States, and are from the Detroit Metropolitan area. The clients extended family (maternal grandparents) currently reside in the Detroit Metropolitan area in a lower socioeconomic neighborhood 2 miles from mother and daughter. Little knowledge can be provided related to client’s father, ex-husband, and the paternal family. A. 13 Y/O (daughter) B. Female C. African American D. Single E. No children F. Arrived via car with mom G. Referred by Children’s and Kingswood Hospital for impulsive behavior (anger, violence, SIH, AH.) H. Client is currently enrolled in family/group therapy with her biological mother. A referral to a psychiatrist has been initiated. I. Client has had previous admission to Children’s Hospital, Harbor Oaks, and KWH. A. 41 Y/O (biological mother) B. Female C. African American D. Single E. 1 biological child (13 Y/O daughter) F. Arrived via car G. Referred to A Better Tomorrow Counseling by Children’s and Kingswood Hospital for the impulsive behavior of her 13 Y/O daughter H. Client is currently enrolled in family/group therapy with her biological daughter. A referral to a psychiatrist has been initiated. I. Client does not have a past admission or psychiatric history II. Presenting Problem: Clients were referred to A Better Tomorrow Counseling by Children’s and Kingswood Hospital due to the 13 Y/O daughter’s anger, and impulsive behavior that has exacerbated over the past year. Mom reports that her daughter began cutting herself approximately a year ago, has difficulty concentrating in school, and does not obey rules set in the home or by authority figures. Mom reports that her daughter is very withdrawn and keeps in her room most times, with little interest in friends, and hobbies. a. Daughter reports feeling angry and irritable. b. Verbatim statement (daughter) i. “My mother does not know why I do not like her, she says that I don’t get along with anyone.” ii. “I hear voices and music that tells to me to cut myself, over and over again.” c. Verbatim statement (mother) i. “My daughter use to love to go outside and jump rope, and go to the mall with her friends, now she stays in her room and is mean, rude, defiant, and disrespectful to me and her teachers.” III. History of presenting illness a. Onset: Daughters impulsive, self-harm and defiance symptoms began in late 2016 (1.5 years); Duration (daily consistent); Symptoms have gotten increasingly worse over the past year. i. Late 2016: cutting of arms, legs, defiance, disobedience, loud outbursts, and throwing of objects; 2017: increased anger, aggression, increased withdrawal to room; profuse crying, and yelling; 2018: difficulty concentrating/focusing, very easily distracted at school, restlessness, and increased anxiety. Daughter has recently stolen the family car and crashed it in the garage after her mother told her to clean the kitchen. Client does not perceive her behavior to be a “big deal” or a serious problem ii. Clients mother sees her behavior as worsening and extremely problematic b. Precipitating Factors i. Client (daughter) starting cutting herself a year ago after her mother denied her usage of social media. Client (daughter) became so enraged that she threatened to kill herself and the police were called. Client was taken to Children’s Hospital and later transferred to Kingswood Hospital for an inpatient stay. ii. Baseline Functioning: Client (daughter) has difficulty falling asleep without medication. Client (daughter) has a poor appetite, lacks motivation, and does not shower daily. Client (daughter) attends middle school. Client (mother) is tired and having difficulty sleeping due to anxiety related to her daughter behavior and safety. Client (mother) is currently stress eating and has gained 40 pounds over the past year. Client (mother) no longer socializes with her friends, she reports she is fearful to be away from her daughter. iii. Last period of stability: Mother states, “The last time my house was peaceful was in 2013.” IV. Past Psychiatric history a. Inpatient i. Client (daughter) Harbor Oaks 2015 (1 week); Children’s Hospital 2017 (2 days); Kingswood Hospital 2017 (1 week); Kingswood Hospital 2018 (4 days) ::::::::::::::::::::::::::::::::::::::::CONTENT CONTINUED IN THE ATTACHMENT:::::::::::::::::::::::::::::::::::::::::::::::::: [Show More]

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