Assignment

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The patient should be comprehensively assessed before offering the patient and care. Family therapy which is also referred to as family counseling is a form of therapy that is designed to address specific issues that affect the health and functioning of the family (McGoldrick & Hardy, 2019). Therefore, it is important to address and consider all member problems and concerns. Healthcare providers should explore presenting conditions of the patient to be able to determine if they are impacted by family interactions. This paper will be addressing comprehensive family psychiatric evaluation and family therapy. Demographic Data Patti presented to the clinic in the company of her daughter Sharleen. The family had immigrated from Iran to the United States to seek medical help for one of the daughters. Patti had left behind the third-born daughter in Iran with her husband but she later joined the family and they divorced her husband and he remarried. She has had two surgeries on her feet which failed and now she is disabled. History of Presenting Illness Patti is an Iranian immigrant who presented to the clinic in the company of one of her daughters Sharleen after she was referred for psychiatric review. She has been reporting feeling hopeless, helpless, feels that her children are out of control and she cannot be in charge and that her children do not need her anymore. Patti and her daughters have a history of being through traumatic conditions which include immigrating from Iran to the United States, a history of being 3 through battering and domestic violence back in Iran, and her third-born daughter who was left behind when they immigrated was sexually abused by her father. The family as a whole had visited a therapist for two sessions since when her daughter who was left behind joined them two years ago and told them of what she had gone through and she was blaming Patti which resulted in the family having chaos. Patti has a history of undergoing two surgeries on her feet but they failed which resulted in her becoming disabled which resulted in more tension and anxiety in the family. Patti was reported by the family therapist to be living in her traditional ways and her daughters were detaching from her to live their own life and this made her more concerned since in her tradition children are supposed to take care of their parents when sick and in old age. This resulted in arguments since her children report that she should learn to live independently since they also are trying to create their own life. Patti also complains that her children do not spend enough time with her but Sharleen her daughter reports that she tries to visit her almost six days a week but Patti is always on her phone or watching television. Patti reports that she spends a very small amount of time with her which she does not appreciate. Past Psychiatric History Her past psychiatric history has not been documented. Medical History Her past medical history has not been discussed although it should be documented. Substance use History This history and information have not been documented. Family Psychiatric History 4 Patti and her family attended two therapy sessions after which the others stopped but she and Sharleen have been attending therapies for the last one and a half years. Psychosocial History Patti is a single mother of 5 who was born and raised in Iran, she immigrated to the United States to seek medical help for one of her children but she settled here. Her education level was not documented but she is a Muslim but does not attend the mosque due to her disability. She reports that her hobbies include watching religious teachings and playing phone games. She currently lives with her last-born son who is 15 years old but the others live away but they come to visit her regularly. History of Abuse/Trauma Her third-born daughter was sexually abused by her father after she was left behind when they immigrated, and the family has a history of facing battering and physical violence. Review of Systems GENERAL: She denies loss of appetite, fever, weakness, weight changes, chills, fatigue, or intolerance to heat or cold. HEENT: Head- Denies head trauma, dizziness, or headache. Eye: Denies eye discharge, excessive tearing, blurring of vision, double vision, or loss of vision. Ear: Denies ear discharge, loss of hearing, or earache. Nose: Denies rhinorrhea, nasal congestion, or nose bleeding. Throat: She denies painful swallowing or any difficulty in swallowing. SKIN: She denies skin changes, rashes, or itchiness. CARDIOVASCULAR: She denies shortness of breath, palpitations, edema, or chest pains. 5 RESPIRATORY: She denies cough, tachypnea, wheezing, or sputum production. GASTROINTESTINAL: She denies nausea, loss of appetite, abdominal pains, heartburn, vomiting, diarrhea, or constipation. GENITOURINARY: She denies frequency, incontinence, urgency, oliguria, polyuria, burning sensation during micturition, or vaginal discharge. NEUROLOGICAL: She has a disability in both lower limbs but denies syncope, tingling sensation, dizziness, numbness, headache, or ataxia. MUSCULOSKELETAL: She has pain in both feet but denies joint swelling and back pain. HEMATOLOGICAL: She denies anemia, easy bruising, or bleeding. LYMPHATICS: She denies lymphadenopathy or splenectomy. ENDOCRINOLOGIC: She denies recent weight changes, intolerance to cold or heat, polyphagia, polyuria, or excessive sweating. Physical Assessment (if applicable) There is no physical examination that will be necessary for this patient. Mental Status Exam Patti is a woman who is in a good nutritional status, dressed appropriately, well-kempt, with a well-built body. She is alert and oriented to time place and person. She uses a wheelchair since she is disabled on both lower limbs, her speech is comprehensive and fluent and it is in the right tone and volume. She has a normal affect and mood, and her thought process is logical and 6 she is cooperative during the assessment and maintains eye contact. Her intellect is a global impression and her memory both long term and short term is intact. Differential Diagnosis Parent-child relation problem According to Niec et al. (2016), parent-child relation problems refer to communication difficulties and challenges in interactions that occur between parents and children and it can occur at any time of child development. The parents mostly exhibit excessive protection and parenteral pressure which can progress to become arguments and sometimes physical violence. The actions of the parents result in the child avoiding them and the child can become angry, sad, or apathetic against the parent. Disruption of the family by separation and divorce Disruption of the family by separation and divorce results in the development of new roles to family members which can result in the children becoming rebellious and withdrawn (Gager et al., 2016). This results in the family experiencing increased emotional dysregulation and mental health disruption. The patient in the case study has a history of her children becoming withdrawn and there was emotional instability of the majority of family members. The Acculturation difficulty Al Wekhian (2016) highlighted that acculturation difficulty is having problems or inability to adapt to a new culture or environment setting. They can include discrimination, conflicts of cultural beliefs, and/or bias along with other issues that occur as a result of migration 7 and social transplantation. The patient in the case study and her family had immigrated from Iran to the United States and Patti is still holding on to her cultural beliefs and lifestyle. Case Formulation Patti and her daughter Sharleen have been attending therapy for the last one and a half years due to family chaos. Patti has also been feeling helpless, hopeless, and she has been feeling that her children are also out of her control which resulted in them attending family therapy. She complains that with her being disabled and unable to work, she expects her children to be able to assist her as her culture requires them to. Her children have been detaching themselves and they want to start a life on their own which Patti did not agree with. Treatment Plan For the treatment of this family, they will be encouraged to continue with family therapy and the rest of the family members will also be encouraged to attend the sessions. They will be scheduled to have a therapy session every week. The third-born daughter will also be contacted and convinced of the importance of undergoing therapy especially since she was the one who was sexually assaulted. Conclusion Conclusively, when attending to a group of individuals or a family, it is important to consider the feelings and thoughts of every member of the group. Becvar & Becvar (2017) highlighted that during family therapy, healthcare providers should utilize the information provided to be able to diagnose and plan the treatment plan of the patient. Family mental illnesses can result in frustrations and negative interactions among the family members. Family therapy focuses on the emotions and feelings of the family members to ensure that every member 8 is satisfied. For family therapy to be competent, healthcare providers should ensure they assess the family comprehensively to be able to determine the dysfunctional and functional part of the family.