psychotherapy with multiple modalities midterm exam week 6,
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Psychotherapy_with_multiple_modalities
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NRNP 6645 - WEEK 2 ASSIGNMENT 1
Psychotherapeutic Approaches
&Family Assessment
NRNP - 6645
Psychotherapy
with Multiple
Modalities
,NRNP 6645 - WEEK 2 ASSIGNMENT 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
, NRNP 6645 - WEEK 2 ASSIGNMENT 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.
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