Family Therapeutic Interview and Assessment Paper

Family Therapeutic Interview and Assessment Paper

Family Therapeutic Interview and Assessment Paper

A family assessment interview is essential in helping the clinician get a better understanding of the problems a family is facing. It enables the provider to identify the best treatment interventions to help the family members, in what ways, and why. However, the examiner should explain to the client/family that providing information about their medical history and relationships will help address family issues affecting them and help build a positive family support network (Zhang, 2018). The purpose of this paper is to outline the findings from a Family Interview and Assessment, identify a therapeutic approach for the family, and present a genogram and ecomap.

Family Interview and Assessment

An interview was conducted with Mr. Hamilton, a 64-year-old Caucasian male living in Carroll County, GA. Mr. Hamilton is a retired high school teacher with a Bachelor’s degree in Education. He currently runs his restaurant alongside his wife (a hotelier), which he established in his late 40’s. He falls in the American middle class with an annual income of about $60, 000 which he gets from the restaurant and other investments. Hamilton was born in North Carolina and moved to Georgia about 34 years ago when he married. He has three children, 32, 29, and 25 years old, that have already moved out of the family home. Hamilton has a medical history of diabetes, hypertension, hyperlipidemia, obesity, and kidney failure. He was diagnosed with type 2 diabetes at the age of 48 years and has been on treatment since. He was started on kidney dialysis a year ago when the kidney failure deteriorated. He reports being overweight since his 30s which he attributes to the development of diabetes and hypertension.

The client had an episode of generalized anxiety two years ago after he was diagnosed with kidney failure due to excessive worries about his kidneys failing. The anxiety episode was managed through psychotherapy, and he was referred to community support groups for people with kidney failure. Hamilton has a history of alcohol consumption and tobacco use which he stopped at 55 years to control diabetes and hypertension. However, he has no history of illicit drug use. Hamilton states that his blood pressure has been controlled in the past year, but he has not attained the desired glycemic levels despite adhering to treatment.

Hamilton explains that before being diagnosed with diabetes, he experienced excessive thirst and increased urinary frequency. He initially attributed the acute thirst to summer, but when the problem persisted during fall, he went for a medical checkup, where it was established that he had hyperglycemia. He was then diagnosed with type 2 diabetes following various tests that revealed hyperlipidemia. Four years later, he was diagnosed with hypertension, initiated medication, and counseled on lifestyle modification. The client started exhibiting signs of kidney failure at 61 years and was started on dialysis at 63 when he was diagnosed with kidney failure.

Hamilton’s health condition has impacted his family relationships, especially with his wife, since he now needs more support. The wife now takes on more duties in running the restaurant since he cannot manage to constantly be present to manage it. The children take turns taking their father for dialysis when the wife is busy, which affects them financially and emotionally. The family members perceive that Hamilton’s health condition is genetically-related since his father had a history of diabetes and kidney failure. They hope to learn measures to reduce the risk to themselves, improve Hamilton’s quality of life, and prolong it. The strengths and resources to help the family find relief include having a strong support system and community resources for CKD patients. Besides, there are caregiver courses that the family members can undertake to acquire knowledge and skills in providing care to patients with kidney failure. This will improve their confidence in providing care and lower physical and psychological exhaustion

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Clinical Hypothesis

The family has effective communication and social skills, which have enabled them to function properly and have healthy interactions with each other. There is also adequate self-control and rationality among the family members, which enable them to make logical decisions regarding the family and the healthcare interventions that will improve Mr. Hamilton’s quality of life and lower their risk of developing chronic illnesses (Zhang, 2018). Furthermore, the family members demonstrate clear judgment and practical problem-solving approaches, which has helped to reduce family conflict. The family also has healthy coping and stress management techniques. The family relationship has contributed to an improved quality of life for Mr. Hamilton since he has a strong family support system and a healthy functioning family. Nonetheless, I perceive that the family’s problem is due to poor physical and behavioral health, as evidenced by unhealthy lifestyle practices that have led to Hamilton’s chronic diseases.

Therapeutic Approach

Strategic family therapy (SFT) is the selected family therapy model for Hamilton’s family. SFT incorporates a strategic approach to identifying a constructive type of change for people within the person’s immediate social context, specifically the family. SFT is based on the assumption that all family members are connected, a family’s habits affect the behavior of its members, and intervention must be targeted to the problem and meet the family’s needs (Jiménez García et al., 2019). Thus, SFT uses strengths to change problematic family behaviors into constructive interactions. The SFT therapist imitates a family’s interactions and conversations, setting off and engaging the family members with provocative questions and discussions (Lebow, 2019). The therapist also identifies problem-solving strategies unique to the family’s interactions and structure and views the problem as part of a series of interactions of those in the client’s immediate social environment.

The SFT model was chosen because it focuses on identifying the family interaction patterns that are creating problems and understanding the cultural tradition in which the patterns of interactions transpire. It also focuses on how families interact rather than what they interact about. The goals of SFT include getting rid of the problem or alleviating it to a point where it is no longer troublesome for the family (Finney & Tadros, 2019). It also seeks to increase mastery and competence; the skill level family members require to manage family life proficiently. SFT also aims to improve family functioning by amending interactional patterns that enable the family to decrease chronic negativity caused by unresolved conflicts.

Straightforward directives will be used for the Hamilton family to change how the family interacts by introducing new actions. The family members will be guided in uncovering the physical and behavioral health practices and how their strong family connections can help to change how they interact and introduce new lifestyle practices (Varghese et al., 2020). The expected outcome is that the family will identify their unhealthy behaviors and modify them to reduce their risk of chronic illnesses and improve their quality of life.

Conclusion

The interview and assessment concerned Mr. Hamilton, a 64-year-old Caucasian male with a medical history of type 2 diabetes, hypertension, hyperlipidemia, and kidney failure. The client’s kidney failure is being managed through dialysis. Hamilton requires more support in his daily activities, which has impacted his family’s relationship. The SFT model can be used for this family since it is founded on the assumption that family members are connected, and a family’s habits influence its behaviors. Intervention must be tailored to the problem and meet the family’s needs. Straightforward directives will be employed for the Hamilton family to modify how the members interact by introducing new behavior changes.

References

Finney, N., & Tadros, E. (2019). Integration of Structural Family Therapy and Dialectical Behavior Therapy With High-Conflict Couples. The Family Journal, 27(1), 31–36. https://doi.org/10.1177/1066480718803344

Jiménez García, L., Hidalgo García, M. V., Baena Medina, M. S., León, A., & Lorence Lara, B. (2019). Effectiveness of structural-strategic family therapy in the treatment of adolescents with mental health problems and their families. International Journal of Environmental Research and Public Health, 16 (7), 1-14. https://doi.org/10.3390/ijerph16071255

Lebow, J. L. (2019). Current issues in the practice of integrative couple and family therapy. Family Process, 58(3), 610-628. https://doi.org/10.1111/famp.12473

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

Zhang, Y. (2018). Family functioning in the context of an adult family member with illness: A concept analysis. Journal of clinical nursing, 27(15-16), 3205–3224. https://doi.org/10.1111/jocn.14500

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Hamilton Ecomap

Strong relationship

Direction of energy flow

Weak Relationship

Hamilton Family Genogram

Emily 59 YRS

Hamilton 64 YRS

 

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GUIDELINES for the Family Therapy Writing Assignment (FTWA):
*** The Family Therapy Writing Assignment (FTWA): Each student is expected to meet with an individual, a couple, or a family and ask permission to interview as part of a student assignment. The student is expected to compose a family case study. Use first names (not initials). The FTWA should be a minimum of five pages, a maximum of six pages, excluding the title, abstract and reference pages and the genogram and ecomap. Five recent peer-reviewed articles must be referenced.
The FTWA must follow the following GUIDELINES: Family Interview and Assessment, Clinical Hypothesis, Therapeutic Approach, Summary, Genogram, Ecomap and References. Refer to the FTWA PPTs under FTWA within the N779 BB Course.
The Family Interview and Assessment (20%) includes a family interview. If you are unable to meet with a family you may meet with an individual or couple. Follow these guidelines to conduct the interview: Gather all relevant demographic information related to the immediate family: gender, age, ethnicity, religion/spirituality, education, occupation, socioeconomic position, and, if relevant, migration history. Include pertinent history regarding medical, developmental, psychiatric, and substance use (history and current use) history. Identify significant events and relationships: births, deaths, marriages, divorces, moves, and accidents. Identify the “problem” and the “identified patient” (IP). Recount the history of the “problem.” Be specific. When did the problem begin? Identify corresponding events. How does the “problem” impact the relationships between family members and the overall functioning of the family? As you learn about the “problem,” be sure to identify family members’ perceptions of the problem and what created it and sustains it. Identify why the individual or family is seeking help now and what each member hopes to get from the family therapy experience. Identify strengths and resources that may help this family find relief from the “problem.” Identify interactional patterns between people.

Compose a Clinical Hypothesis (5%). Assess the functioning of this family. The assessment should include the following points: identify ways in which the family relationships are or could be related to the presenting problem in both adaptive and maladaptive ways. Form one tentative clinical hypothesis about what you feel may be the cause of the “problem” within the family. Describe and state your hypothesis clearly.

Determine your Therapeutic Approach (25%). Consider the following family therapy models discussed in class: psychodynamic, systems, structural, strategic, experiential, or solution-focused. Choose one of these models to use as an approach to treatment with the above stated individual or family. Begin by writing a summary statement about the model (include the basic assumptions/concepts of the model). Provide a rationale for choosing this model. Identify the goals of therapy, describe one intervention and specify it to this family. Provide an expected outcome.

Construct a Genogram (20%). A minimum of a 2 generational genogram must be constructed in order to depict the contents of the interview as outlined above. To construct the genogram use standardized genogram symbols and format. Use relationship lines relevant to the IP and the immediate family. Provide a key for all symbols used. Handwritten genograms must be legible.
Design an EcoMap (10%). Identify the social systems relevant to the IP and describe the relationship the IP has with these social systems. Provide a key for all symbols used. Handwritten ecomaps must be legible.

This must be a Scholarly Presentation (15%). The FTWA must be typed and conform to format as outlined in the Publication Manual of the American Psychological Association, Seventh Edition. Refer to the APA Professional Paper posted under FTWA within the N779 BB Course.

Class presentation (5%) is required: FTWA presentations will be on 10/17 on zoom, AND 10/24 ON CAMPUS. Students are expected to attend both days of Class Presentations. 15-20 MINUTES will be allowed. ONLY an INDEX CARD can be used during the presentation (NO laptops, Phones, FTWAs).

The presentation should cover:
1. Brief Overview of the Family Interview and Assessment describing the “Identified Patient” and the “Presenting Problem;”
2. Genogram & Ecomap Discussion: Describe the relationship of the IP and those closest to her/him and Describe the relationship of the IP and the social systems she/he is involved with;
3. Clinical Hypothesis;
4. Name of the Therapeutic Approach chosen and the Reason for choosing this approach;
5. Describe ONE intervention and SPECIFY it to the family;
6. Expected Outcome.

REMINDERS:

Students are required to put the paper through Turnitin® which is accessed within Weekly Materials #6 by 9 am on 10/17. The FTWA paper will be graded in Turnitin. The Similarity Percentage must be below 20% otherwise a resubmission will be required. A late submission to TURNITIN will result in a loss of one point; no TURNITIN submission within one week of the due date will result in a loss of two points. TURNITIN is available NOW.
Students are required to post a PPT copy of their genogram and a PPT copy of their ecomap (which will be referenced during their presentation) within the FTWA discussion board By 9 am on 10/12/17. A late submission to the FTWA DB will result in a loss of one point; no submission within one week of the due date will result in a loss of two points.