Walden University NRNP - 6645 Psychotherapy with Multiple Modalities Week 2 June 13, 2022

Walden University NRNP - 6645 Psychotherapy with Multiple Modalities Week 2 June 13, 2022 2 Family Assessment and Psychotherapeutic Approaches Historian: Mother and daughter (Self) Language: English Name: Non- listed Gender: Both female (mother and daughter) Age: 40 years old and 23 years old. Chief complaint — “I am in so much pain, nobody can help me and nothing is helping me manage the pain. I want my mom to be more peaceful, I want her to lower her expectations and accept a lot of things about life, I have a sense that my mom is holding me back from all I could be doing”. I just want them to spend time with me, I am very lonely, and I get depressed when I am lonely. I hate spending time with my mother, I hate her house, she has two dogs and I do not like those at all, I do not like their hair on my body and I do not like touching them. Do you believe I cannot even eat in her house, everything smells like dog, and it is very uncomfortable for me”. History of present illness (HPI) — This patient is a 40-year-old Iranian American female. She is here today to be seen for complex family dynamic issues as it relates to her and her five children. She was seen with her 23-year-old daughter who detailed the multiple issues as it relates to her relationship with her mom and siblings. They are here for evaluation of trauma related issues as it relates to abuse by her husband and their father. Mom is currently struggling with trauma related issues from being married and also struggling with adjusting to the norms and principles of America which can be called Adjustment disorder at this time Per self report, one of her daughters was raped and abused by her biological father and this has left a dent in the way the family relates with their dad. There has been difficulties FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 3 relating to one another, difficulties relating to their father, difficulties relating to the issues of traditional Iranian family becoming “Americanized”, issues with spending time with their mother, their lack of privacy and distrust overall. Overall, this is a complex family unit and there are multiple conflicts active and ongoing at the same time. The biggest issue has to do with the mother of the house becoming sick, and having multiple surgeries to fix her foot which has left her almost dependent. The second issue is the rape allegation. One of the daughters alleged that her biological father raped her., this has left the family traumatized and unforgiving. Thirdly, there is the issue of the of a mother desperately trying to hold unto her traditional Iranian beliefs and traditions. For example, in Africa and the Middle East, it is believed that children are to stop their lives to care for their parents if they need that help. In America, the tradition is to employ a capable nursing facility or a private nurse to do the caring. These are very different standards. In this case, her children are urging her to do more for herself and for her health, to not solely depend on them or wait on them. Overall, there are major unresolved conflicts going on that are trauma related, depression, physical health etc. Some physical signs noted during the assessments were fidgeting, excited. There are also signs of hyperactivity, impulsivity, irritability, lack of restraint, and persistent repetition of words. There is no notice of difficulty focusing, issues with paying attention or short attention span. Past psychiatric history — In the scenario, mom mentioned depressive episodes, there was however no mention of medically diagnosed psychiatric conditions like depression. They denied suicidal ideations. They also denied the use of illicit drugs/ alcohol, prior serious mental or psychiatric breakdown, or mania. No prior reports of psychiatric inpatient hospitalizations to report either. FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 4 Hospitalizations- No inpatient psychiatric hospitalizations reported nor are there any reports for active Pyschotherapy medications listed for these patients. Psychotherapy or previous psychiatric diagnosis — No current psychiatric diagnosis, no Psychotherapy “therapy” is documented for this patient. Note however that the patient said she “gets depressed when she is alone”. It was not reported that depression was medically diagnosed or that it is currently being managed by any medication. Pertinent substance use- Patients deny alcohol or abusing any substances at this time. They also deny any chronic substance use/abuse. Family psychiatric/substance use- Patients deny any family psychiatric/ substance use. Psychosocial history/Developmental history — These patients are 40 and 23-year-old Iranian immigrants that are currently struggling with adjusting their traditional beliefs with the Americanized way of life. They are here today for mental assessment/ possible diagnosis of trauma related issues including adjustment disorder. They were referred by their current psychiatrist who has tried multiple dimensions to manage the patient and her children. Of note, she was present for the assessment and answered pertinent questions as it relates to the patients, their past and their overall issues. Mom is currently living on disability but her daughter that came with her for the evaluation lives by herself. Of note, it was reported that she is currently in school, but her social life was not discussed during assessment. It is always vital to know your patients, for this evaluation., there was no concrete data collected or reported. For example, knowing what school the daughter attends, her sexual orientation, understanding her full social life is important in treatment plan. Questions like does she have a boyfriend and does she live with him? Is she bisexual? What kind of friends does she have? How many drinks does she drink during nights