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Systemic Diagnosis and Intervention Application

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Introduction

In this assignment, a short summary of the previous research will be provided. In an effort to understand the interactions between the family members, the essay will explore the interactional patterns. Moreover, the essay will explore the development of the lifespan as a family and the family's development stages. In accordance with the DSM-5, the essay will provide a diagnosis and explanations regarding the diagnosis will follow. Specific interventions and goals, which need implementing will be identified using the narrative approach, furthermore, they will be implemented in line with the legal approach that may affect the family counsellor. Finally, the essay will give a clear description of family dynamics and the various underlying factors that contribute to the challenges affecting the family using a concise genogram. The genogram is effective in portraying the family line and the possible challenges.

Brief Summary of Assessed Risk Factors

From the movie “Inside Out”, the focus is solely on the Riley who is the main actor and the various challenges she faced due to her family moving to a new location. In the movie, it is clear that some of the emotions Riley struggled include Fear, Disgust, Anger, Sadness, and Joy, moreover, she had a hard time managing her emotions. The problem from the movie was due to her inability to adapt to the new environment. Additionally, she found it difficult to openly express herself to her parents. The imbalance in emotions caused her to have patterns of dysfunctional communication. Riley never wanted to participate in any activity and inability to adapt to her new environment, which are clear signs of lacking social connectedness. The behaviors portrayed by Riley have resulted in a great imbalance within the family daily activities. The fact that Riley is in the adolescence stage presents some physical factors considering that at this phase; she is experiencing some emotional changes.

Family Transition throughout Developmental stages in Life Span

Riley's family is currently in the transformation phase of the development stage and having a daughter who is in adolescence often presents numerous challenges to the family. Families often have traditional and normal settings hence adolescents often exhibit behaviors, which may violate the settings within the family and community (Miccucci, 2009). Therefore, families that were previously functioning well may find it hard facing this stage considering the stressors. In the scenario, this is clearly the issue presenting a challenge. The career change of Riley's father catapulted the move. Moreover, there were also signs of family discord during the big move. Furthermore, children who transition to the adolescent stage may also cause stress to the parents in an effort to resolve the changes caused. Therefore, the therapist has a responsibility of acknowledging that each member of the family may be experiencing something different hence formulate a strategy of helping them.

Key Aspects of Family Relationship

In an analysis of the family, it is clear that aspects such as supportiveness, warmth, responsive interaction between Riley and her parents are key in the family’s relationship. Aspects like a warm and supportive family may influence the children’s subjective assessment of life stressors. On the other hand, positive emotions are vital since they are internal resources meant to reduce the challenges the family faces. A good relationship between Riley and the family may act as barriers to the negative effects of stress.

There is other de-escalation of conflict techniques, which may prove essential in this scenario. Techniques that may help children regulate the negative effect in order to help resolve conflict such as parenting styles. From this film, it is clear that Riley's parents are trying to shield her from the negativity. The parents’ technique of shielding Riley from the negativity was making an effort to make things appear positive. They encouraged her to focus on the bright side of the situation. Despite the efforts made by the parents, Riley was clearly unable to regulate her emotions due to the move resulting in adjustment disorder.

DSM-5 Diagnosis

From the challenges Riley has presented in the movie, it would be proper to diagnose her with Acute Adjustment Disorder which is very common, however, there may be a great variance due to population function and the methods employed (Association, 2013). People may experience many symptoms of adjustment disorder hence having effects in their lives. In the event an individual has a hard time coping with sad events in life, adjustment disorder may portray symptoms including hopelessness, overwhelming feelings, and sadness. In the movie, Riley exhibits some of these symptoms, additionally, they are having a negative impact on her body, mind and emotions.

The Child Behavior Checklist/4-18 and 1991 Profile (CBCL/4-18) is one vital assessment tool that may be used in this scenario since it has a checklist consisting of 113-item behavior problems combining it with another checklist of seven-part social competency (Achenbach, 1980-1994). The assessment tool is efficient as it measures the emotions and behavioral problems of an adolescent. Furthermore, it is the responsibility of either the parents or the surrogate parents to complete the tool. The tool uses simple wording in the process of defining challenges faced by the parents. In some instances, the CBCL tool is hand scored. The CBCL/4-18 scores include: (a) three competence scales (Social, Activities, and School), (b) a total competence scale score, (c) the eight syndrome scales including: Attention Problems, Aggressive Behavior, Social Problems, Delinquent Behavior, Somatic Complaints, Problems regarding thoughts, Withdrawal, and Depression or anxiety, (d) Problem Internalizing scale score and Externalizing problems score, and (f) The total problem scale score (Achenbach, 1980-1994).

Narrative Theory as it informs Interventions and Treatment Goals

The best recommendation for Riley and her family during therapy would be the narrative approach since her diagnosis is the acute adjustment disorder. The narrative models are vital considering that they help the patient by drawing out their strengths. In this type of therapy, the person's problems are separated from them hence examining and evaluating the problem based on how they evaluate themselves (Gehart, 2014). Moreover, the in the narrative approach, the person is made to acknowledge that the problem is not part of them or their lives hence they have the capability of overcoming the challenge. The approach helps considering that once someone changes their perception; they have the capability of writing positive outcomes that help the family.

The therapist may consider using an intervention that maps the problem's influence. In mapping the influence, the role of the therapist is to ensure they collect adequate information including how the problem affects the client's life and the people around them, and the thought line of the client towards the problem. Additionally, the therapist ensures the patient does not feel worse by mapping a person's influence (Gehart, 2014). The therapist should ask Riley questions to know her perception regarding the problem and the current situation. This would help Riley, to understand and explore the influence of the challenge she is currently facing, moreover, it will help encourage her that she is capable of overcoming it. The narrative approach would help Riley learn about the alternative stories and her views regarding her life. The therapist has a role of encouraging Riley, and that she is the master of her own destiny. The therapist would also help Riley form another narrative regarding her life. The narrative Riley needs to form is that of positivity.

Effectiveness Research on Narrative Approach

Narrative therapy focuses on restoration (Shapiro, 2015). In this process, the therapist guides clients on how they construct meanings to their lives (Shapiro, 2015). Moreover, the approach there is no adherence to specific notations and predefined goals (Guise, 2015; Gurman, Lebow, & Snyder, 2015). The narrative approach believes that clients are the masters of their own stories (Gurman, Lebow, & Snyder, 2015). The approach creates preferred realities that enhance new behaviors, self-concept and outcomes (Shapiro, 2015). The approach aims to disrupt the patterns of dysfunction in relationships. In the movie, the move poses dysfunction within the family hence the approach disrupts the patterns exhibited. Riley will be in a position to identify problems and explore the unique outcomes. This approach is very effective and led to improved outcomes in the family relationship (Carr, 2009).

Ethical and Legal Considerations

There are ethical and legal considerations that have to be followed when working with a family, moreover, Riley is a minor. It is the responsibility of the therapist to ensure that Riley understands the types of limitations and confidentiality and the consent document, additionally, she must know that the information regarding their discussions must be made known to the parents. The therapist must ensure that he/ she remain competent to avoid any implications that may arise due to incompetence. In regards to the law, the therapist must know that laws are above the ethical codes. Additionally, in certain domains, the laws will differ. Therapists have the mandate of ensuring they are well versed with the laws regarding their practice hence respond to any questions that may arise to ensure they protect the child’s interest (Firmin, 2017).

Conclusion

In conclusion, the findings from the previous assignment have proven vital in the current assessment. The diagnosis of Riley found that she had the adjustment disorder; furthermore, the assessment met the DSM-5 guidelines. From the assessment, it was concluded that the best model to help both Riley and the family was the narrative therapy considering the developmental stage the family is currently. The family has faced numerous challenges due to the move; furthermore, every member of the family experienced a different challenge. The narrative model also evaluated Riley's development stage in life and discovered that she was an adolescent phase of life. The intervention would help Riley and her family to discuss unique goals to be achieved and the various interventions available. The model follows both ethical and legal considerations regarding the treatment of Riley, considering that cases of incompetence often arise. Therefore, the narrative approach is essential since its practicality would prove beneficial for both the family and Riley.

Genogram

Disgust