Hernandez Family Assessment Essay

Hernandez Family Assessment Essay

Assessment begins informally when the therapist first meets the client. According to Nichols, (2013), assessment aims to help the therapist decode the challenges and defenses that occur during the ongoing course of trying to help the family members open up to one another. Nichols & Tafuri (2013) noted that the goal of assessment is not just to gather information but rather, it should be an active and dynamic process in which the therapist explores the presenting complaint, does not accept it at face value but examine the possibility that the family interactions might influence the presenting complaint. The subsequent paragraphs will present a family assessment of the Hernandez family.

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Demographic information

Juan Hernandez is a Hispanic male who is married to Elena Hernandez a Latina female. They both have two children named Juan Jr. who is 6 years-old and Alberto who is 8 years old. Low socioeconomic status and a working-class family Hernandez Family Assessment Essay.

Presenting problem

The social worker requested parenting classes and therapy for Juan and Elena because she believes their style of discipline is too harsh.

History or present illness

The clients present with concerns of their two children being taken away because the social worker thinks their discipline style is harsh. They portray themselves as excellent parents, and they verbalize the fact that disciplining a child is very necessary. They stated they were brought up that way and it is part of their culture. The client reports that he was punished severely by his mother and father while he was growing up and that did not break him. Hernandez Family Assessment Essay.

Past psychiatric history

The client denies any past psychiatric history. He states his father has been of sound mental health. Both Juan and Elena were punished severely as kids.

Medical history

Juan Hernandez denies any medical history. Need to be added.

Substance use history

No history of substance abuse reported. Need to be added.

Developmental history

Juan and Elena Hernandez reported normal development. She reported both of her sons met their developmental milestones. Need to be added.

Family psychiatric history

No psychiatric history reported. Need to be added. Hernandez Family Assessment Essay.

Psychosocial History

A heterosexual couple, married. Juan Hernandez works full-time and overtime to be able to provide for his family. Need to be added.

History of abuse and/or trauma

Both clients reported receiving similar harsh disciplinary treatment from their parents. Juan Hernandez stated that when his dad was mad at him, he will send him to get books from the encyclopedia and hold them on his hands until he will tell him to stop. He also stated those caused so much pain on his arms, and he felt like his hands will break off. He also indicated his mother did the same thing. To him, books only meant one thing “misery.” He ended by saying “I guess I inherited it from then.” Elena also described her childhood with one word “misery.” Both clients deny any physical abuse. Hernandez Family Assessment Essay.

Review of systems

Gen:  Denies any fever, chills or sweats

Head: normocephalic. Denies any head injury

ENT: Denies any tinnitus or ear tubes.

Denies any nosebleeds, epistaxis, nasal discharge

Neck: Denies any stiffness or swelling

Cardiopulmonary: Denies dyspnea, tachycardia, chest pain, palpitations or orthopnea

GI: denies any decrease in appetite

GU: denies urgency or frequency

MS: Denies joint pain

Heme/Skin: Denies any bleeding or bruising, pruritis and rash

Neuro: Denies muscle weakness and paresthesia

Psych: denies any SI/HI ideation

Mental status exam

Appearance: both clients look appropriate for their age, well-groomed and in no acute distress.

Mental status exam

Both clients are alert and oriented to time, person, place, and situation. Well groomed, good eye contact. Juan Hernandez appears agitated about attending parenting classes because he would instead work overtime to care for his family. Elena, on the other hand, is more accepting and willing to compromise if her privacy is guaranteed and if the classes will prevent her from losing her children.

Differential diagnosis

  • Stress and aggressive disorder
  • Post-traumatic stress disorder

A client is diagnosed with PTSD when they have been exposed to an intense or prolonged psychological distress (American Psychiatric Association, 2013). In the case scenario above, both clients described their childhood as “miserable.” The goal of therapy is to assist the clients to change the behavior which as Juan stated: “I think I inherited it from my parents.” Hence the question “is the discipline meted on their children justified or do the parents have stress or anger issues that play a role in their method of discipline? According to Coleman (2018) in the process of disciplining a child, parents who are fraught with stress and anger could cross the line from discipline to abuse. Hernandez Family Assessment Essay.

Case Formulation

The clients were referred for parenting classes because the social worker believed their discipline method was too harsh.  During the therapy sessions, both clients verbalized the fact that they were punished severely by their parent’s during childhood. The goal of the therapist is to explore their parenting styles and create awareness about other discipline techniques.

Treatment Plan

  • Family therapy and group therapy once a week
  • Cognitive behavioral therapy
  • Behavioral and learning theory

Family-Directed Structural Therapy (FDST) is an approach to family therapy that is concretely organized, easily administered and family progress is easily measurable. According to Mclendon, Mclendon, & Petr (2005), FDST approach to therapy aims to accentuate families strength and decrease family conflict. Some of the critical issues that are explored during family therapy are commitment, empowerment, and consistency. CBT can be incorporated into family therapy to address caregivers behavior and consequences such as behavior and emotional adjustment that might occur as a result of these behaviors.

References

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

Coleman, P. (2018). What is the Difference Between Discipline and Abuse? It’s all about what transpires in the moment. Retrieved from https://www.fatherly.com/parenting/what-is-the-difference-between-discipline-and-abuse/

Mclendon, D., Mclendon, T., & Petr, C. G. (2005). Family-Directed Structural Therapy. Journal of Marital and Family Therapy, 31(4), 327-339. doi:10.1111/j.1752-0606.2005.tb01574.x

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

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

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

 

Introduction

Hernandez family has health patterns which are  essential in evaluating the models of provision of health care for the in-depth look and overall examination of health situation of the family.

Demographic Information

The Hernandez is a typical family that consists of three children, father, and mother. Like any form of belief, the family has its values and beliefs. After carrying out an intensive examination of the family, members of the family care for each other deeply (American College of Sports Medicine Ed, 2013).

Physical Assessment

Seeking of physical help has been established as a norm where people such as Elena are the primary providers of health care. The members do not have a regimen of carrying out physical activities. The mother is left behind because of hypertension, high cholesterol level, and borderline hypertension Hernandez Family Assessment Essay.

Psychosocial History

The family is highly sociable, and it ensures that the family members communicate well thus creating good relationships with everyone. The members of the family have strong interaction bonds where they talk and respect each other’s opinions. There are annual check-ups where everybody has an examination on hearing, eye and sight (Heyward & Gibson, 2014). The use of Acne is highly discouraged from the family because of its impacts on children’s self-esteem. It is clear that children who have Acne are required to on constant medical check-up that ensure any negative effects are controlled.

 

Medical History

The medical history of the family suffers because of the stretched schedule of the father and mother. It has become difficult for the family to seek medical check-ups on a daily basis. Children are taken for medical check-ups when they face any disorder because of the increased nutrition risks. The family has lived a healthy life for a long time and monitoring of sons life (Weber & Kelley, 2013). Elena shows that their sons will be given good life when she is near her parents. Hernandez Family Assessment Essay.

Substance Use History

The family advocates against substance abuse and there have been no issues surrounding substance abuse within the family members. The mother and father have shown their children on how to live responsibly thus avoiding any form of family conflicts. Any child who is found to use any substance abuse will lead to the denting the family’s reputation.

Developmental History

The Hernandez family has an irregular and profoundly disturbed form of development. Mother and father have a demanding schedule that mostly causes them to work for an extended period until nighttime. Due to lack of adequate sleep, the mother always feels sleepy and always overwhelmed with many responsibilities (Gurland et al., 2013). So that they can realize their development agenda, the father helps in conducting household activities. The children of the family have the belief of education as the only form where they can get the required development.

History of Abuse and Trauma

The father suffers from depression because of the increased work schedule. Juan Hernandez states that she punishes her son so that they would understand what should be done. She perceives such form of action as the right thing to be done by parents. Children were raised the way they were initially brought up (American College of Sports Medicine Ed, 2013).

Mental Status Exam

Hernandez family has a lot of health risks which are acknowledged mainly by the mother. Health issues relating to psychological status have received attention from both the mother and father because they are the man providers of the family. They have been able to give solutions to problems facing the family (Hoge et al., 2014). Carrying out an appropriate diagnosis of Hernandez family will be critical for maintaining the stable mental status of Hernandez family.

Review of Systems

The family of Hernandez has worked to ensure that homemade meals are prepared where they can form health choices. The father and mother have managed to establish a well-documented plan where every member of the family is allocated a certain task making them have a required and specialized self-care Hernandez Family Assessment Essay.

Differential Diagnosis

The family members have devised a mechanism of having medical checkups after every one month. There have never been issues of health problems because of the physical schedule where solutions to members of the family are provided with the required patterns of metabolic provisions. The diagnosis has helped in preventing any form of the disease that may affect any member of the family (Hoge et al., 2014).

Case Formulation

The Hernandez family advocates for the protection of the children by advocating for abstinence. The mother has the responsibility of handling any stressful event that may be caused forward and copies them by use of prayers. The children are made to have more books for maintenance of their education level, and some of the work was inherited their grandparents.

Treatment Plan

The family has had a smooth schedule of planning for their future medication. Hernandez family is encouraged to use an appropriate form of treatment scheme where each is given the priority of consuming enough water that is concerned with elucidating all the time. Children enjoy drinking juice that has become a standard form treatment when faced with any form of human problem (Gurland et al., 2013) Hernandez Family Assessment Essay.

Family Psychiatric History

There has been no psychiatric problem before in the family of Hernandez. The family is committed to ensuring that enough support is given to the child during family members hospitalization. The family has displayed a strong familial bond that will be critical when they will be treating their children lead by the father and mother (Heyward & Gibson, 2014).

References

American College of Sports Medicine (Ed.). (2013). ACSM’s health-related health assessment manual. Lippincott Williams & Wilkins..

Gurland, B., Kuriansky, J., Sharpe, L., Simon, R., Stiller, P., & Birkett, P. (2013). The Comprehensive Assessment and Referral Evaluation (CARE)—rationale, development and reliability. The International Journal of Aging and Human Development8(1), 9-42.

Heyward, V. H., & Gibson, A. (2014). Advanced health assessment and prescription 7th edition.

Hoge, C. W., Lesikar, S. E., Guevara, R., Lange, J., Brundage, J. F., Engel Jr, C. C., … & Orman, D. T. (2014). Mental disorders among US military personnel in the 1990s: association with high levels of health care utilization and early military attrition. American Journal of Psychiatry159(9), 1576-1583.

Weber, J. R., & Kelley, J. H. (2013). Health assessment in nursing. Lippincott Williams & Wilkins Hernandez Family Assessment Essay.

 

Assignment 1: Hernandez Family Assessment

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. 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:

Review this week’s Learning Resources and reflect on the insights they provide on family assessment.

View the Hernandez Family: Sessions 1-6 videos, and consider how you might assess the family in the case study.

Note: For guidance on writing a comprehensive client assessment, refer to pages 137–142 of Wheeler (2014) in this week’s Learning Resources.

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 Hernandez Family Assessment Essay