Respond  by providing feedback on each  colleague’s therapeutic approach based on a narrative family  therapeutic perspective. Support your feedback with evidence-based  literature and/or your own experiences with clients. 

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I am addressing the case of a family called X. The family has five members and the man recently lost his job after the organization he worked for closed in Atlanta. The man is also become alcoholic and violent due to the wrangles. The wife also reported episodes of domestic abuse in the local police department severally. On the other hand, the wife works in a store and her wages are hardly enough to pay the family bills. Due to their condition, the family moved to a cheaper house studio since they can no longer afford the rent.

In will uses a systematic therapeutic approach on the family. Systematic approach is ideal since it is a derivative of other models. The model has phase like social step, problem phase, Interaction, goal and task setting (Taylor, 2017). In the social stage, I will interact with each of the family members in regular activities. During the phase, I will inform the family members about the purpose of the therapy and the contributions in the exercise. The stage will also enable me to make observations about the interactions about the phase (Taylor, 2017). The problem stage I will pose a question to each of the members of the family to understand if the problems exist. In the next phase, the interactional stage allows the members to discuss problems like alcoholism and how to pay the bills (Shapiro, 2018).  I will use the interaction phase to understand some of the dynamics like the hierarchies, collaboration and the communication sequence. The goal-setting phase will involve highlighting the problems and what could be done. I will work with the family members to bring forward solutions to the problems. When the family is involved in decision making compliance is high (Shapiro, 2018).  I will also use the phrase to define the parameters of the study. Lastly, is the task setting stage- that will involve wrapping the session by making a decision (Shapiro, 2018). I will offer the solutions and homework to the family. The solutions will involve increasing communications in the family. Another solution is the man looking for a means of living that could sustain the family.  

The systematic therapeutic Approach is efficient since it will replace gendered and stereotyped roles and behaviors that are flexible and offer deep breadth. The therapy will also involve a redistribution of power and providing an equitable balance while at the same time enhances communication between the family members.

However, the woman often exhibits social behavior. Antisocial behavior could alter a systematic therapeutic approach. The behavior typically limits their conversations.

References

Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy. Basic Principles, Protocols, and Procedures, Ed, 2.

Taylor, D. (2017). Treating sexual trauma through couple’s therapy.

• Select a client whom you have observed or counseled at your practicum site.
• Review pages 137–142 of the Wheeler text and the Hernandez Family Genogram video in this week’s Learning Resources. Reflect on elements of writing a Comprehensive Client Assessment and creating a genogram for the client you selected.

The Assignment

Part 1: Comprehensive Client Family Assessment

With this client in mind, address the following in a Comprehensive ClientAssessment (without violating HIPAA regulations):

• 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/trauma
• Review of systems
• Physical assessment
• Mental status exam
• Differential diagnosis
• Case formulation
• Treatment plan

Part 2: Family Genogram

Prepare a genogram for the client you selected. The genogram should extend back by at least three generations (great grandparents, grandparents, and parents).

Patient 

D.H, 26-year-old male Hispanic, was admitted from home from the ED for inpatient psychiatric evaluation and treatment. Allergies to latex, shrimps. He has a history for depression, PTSD, paranoia, anxiety and pseudo-seizures.

Chief complain: Pt has neglected his ADLS and hygiene, not slept and eaten in the past few days before his admission. Pt expressed he has no motivation to live, admits suicidal ideation with no plan, denies homicidal ideation, auditory and visual hallucinations. He stated, “the recent anxiety and depression is from working from home due to COVID, I usually work at the warehouse as a call center representative.”  The pt lives with spouse and after he signed the release of information form, pt’s spouse was unavailable when called.

The individual counselling therapy, bio/psychosocial was completed as pt was cooperative, redirectable despite having racing thoughts. He admitted to sexual abuse at 5 years old by the maid but stated he didn’t want to talk about it. The pt was easily distracted, showed signs of depression. He has had 1 prior hospitalizations for mental problems but stated “I was anxious and wanted to calm down at that time.” Pt admits to alcohol use, but no usage lately, also admits to marijuana use 6 months ago.

Dx: Risk for suicide, danger to self, depression, Unspecified Bipolar disorder and related disorder, Major depressive disorder w/o psychosis features, unspecified trauma disorder, unspecified anxiety disorder.

Psychosocial and contextual factors– trauma, marital stress, substance use

Meds: Sertraline 100mg PO qAM, Zyprexa 5mg QAM PO, Xanax 0.25mg PO q6h PRN for anxiety.

Treatment plan:

Problems: Suicide ideation w/o plan Goals: no SI.   Modalities: medication and therapy Problems: Anxiety   Goals: decrease anxiety.   Modalities: medication and therapy

Problems: Insomnia  Goals: Improve sleep   Modalities: medication and therapy

Medication Plan: Initiate Seroquel 50mg at HS for mania and Prazosin 1mg at HS for trauma.

Activity therapy: Engage pt in group focused therapy, improve coping skills and managing moods. 

 What quality standards or performance measures guide your role or specialty as an advanced registered nurse? Using these standards, discuss how informatics can be used to improve quality of care. Make sure to discuss meaningful use and incorporate the topic materials, such as the American Health Information Management Association (AHIMA) and Information Governance websites in your response.

Assignment:

Write  a scholarly paper in which you apply the concepts of epidemiology and  nursing research to a communicable disease. Choose one communicable  disease.

Epidemiology Paper Requirements

Include the following in your assignment:

1. A  thorough description of the disease including causes, mode of  transmission, symptoms, treatment and complications. Discuss the  demographic most affected-incidence, prevalence, morbidity and  mortality.
    
2. What are the determinants of health affecting this disease? https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health.
    
3. Identify the epidemiologic triad including host, agent and environmental factors as related to this disease.
    
4. Discuss  the role of the public health nurse in relation to this disease. How is  the public health nurse involved in finding, reporting, collection and  analysis of data and follow up?
    

A minimum of three references is required. The written essay should be at least 1250 words in length.

APA format is required.