Posted: April 29th, 2021

W2Familyclass essay

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

Detailed Assessment of the Hernandez Family
E
U
Psychotherapy with Groups and Families
NURS-6650
D
, 2020.

Assessment of The Hernandez Family
This practitioner will discuss a comprehensive assessment of the Hernandez family. Mr. Hernandez has a wife and two children. The family is of Latino/Hispanic American descendant. Related vital information about the Hernandez family will be retrieved and assessed while establishing an emphasis on their psychosocial history. This paper will determine their understanding of the presenting problem and appropriate psychiatric diagnosis to facilitate an effective treatment plan.
Demographic information
The Hernandez family consists of four, Juan, the father; Elena has the wife and mother’s role to the children. Juan JR. is the first son and is 8yrs old, and Alberto is the second son and is 6yrs old. Hernandez’s family are Latino American, have low-income jobs, with Juan picking up extra shifts. Together they work to support their family and provide the children with the essential needs.
Presenting problem
The ACS is scrutinizing their parenting styles, thereby recommending both parents to attend a parenting class. Both parents believe in their capabilities as good parents to raise the children in the most appropriate manners and methods utilized by their parents. Juan and Elena do not understand the need for parenting class and therefore have little or no insight. They believe both the children merit the appropriate punishment when they fail to observe the rules. They do not think they punish the boys too hard (Laureate Education, 2013a).
History of present illness
Both Juan and Elena discipline the boys when they feel the boys deserve some hard punishment for failing to adhere to the rules. Both Juan and Elena report to the therapist received punishments from their parents when they misbehave, even though the punishment was painful and brought feelings of misery. In their insight, they both believe it is the standard way to rear up descent children because it worked out well for their parents.
Past psychiatric history
In the childhood phase, Juan and Elena experienced physical abuse from their parents, consequently leading to psychiatric problems/disorders that have not been diagnosed. Juan verbalized his dad made him stretch both arms and carry books that cause both arms to hurt, and he hated those books.
Medical history
None reported.
Substance use history
None reported
Developmental history
No development delays reported, Alberto and Juan Jr achieved typical milestones
Family psychiatric history
Elena and Juan may have undiagnosed trauma or psychiatric disorder due to physical abuse they experienced from both their parent; although both have poor insight psychologically, the impact of the abuse has affected them emotionally and mentally.
Psychosocial history
The Hernandez are work low paid jobs to sustain and provide for the family. Juan puts in an extra shift to keep up with the demands in the home.
History of abuse and trauma
At the childhood stage, Elena and Juan have physical maltreatment from their parents as a disciplinary action or corporate punishment for misbehaving.
Review of systems
Cardiovascular: Negative
Constitutional: Negative
Endocrine: Negative
ENMT: Negative
Eyes: Negative
Genitourinary: Negative
Gastrointestinal: Negative
Skin: negative
Neurological: Negative
Musculoskeletal: Negative
Respiratory: Negative
Physical assessment
Gait & Station: normal gait and station
Muscle Strength & Tone, Other Motor Abnormalities: normal: can use all four extremities & no tremor or rigidity
Other Physical Findings: in no apparent distress physically
Mental status exam
The Hernandez is alert and oriented x 4. The Hernandez presents with normal affect, judgment, and attention. The Hernandez have little or no insight into the style of their discipline’s impact on their boys’ emotional and mental development.

Differential diagnosis
Child abuse:
Child abuse is when an injury is inflicted on a child by the parents or caregiver by purposefully acting or deliberating refraining from acting with resultant emotional harm, serious injury, or possibly the risk of severe injury or death to a child. Abuse comes in diverse forms, including deliberately neglecting children, inflicting physical injury, sexual abuse, and mental escapade (Childhelp.org, 2019: 2024 – Online Assignment Homework Writing Help Service By Expert Research Writers). Child abuse not effectively and professionally managed will consequently result in physical health problems in adolescents and adulthood. Individuals who go through post-traumatic stress reactions (PTSR), can later on in phase of life experience physical health complaints (Rueness et al., 2019: 2024 – Online Assignment Homework Writing Help Service By Expert Research Writers).

Emotional/Physical trauma:
Juan and Elena experienced emotional and physical trauma, judging from their perception and style of discipline. Juan verbalized feelings of hurt and misery and how he hated those books that inflict hurts in his arms afterward; even though it has been several years, the occurrence took place.
Trauma is an emotional and mental response to a horrible event; it includes long term reactions like flashbacks, emotional manifestations, and physical symptoms. Children respond to a traumatic experience in different ways. Some individuals may show immediate manifestations and effects of the impact, whereas others may not display any symptoms until later in life after the event (apa.org, 2020). The Hernandez are now exposing their children to the trauma they passed through at childhood by using the exact methods in disciplining the boys after misbehaving.

Child maltreatment:
Child maltreatment is abuse and neglect that occurs in children that are less than 18 years of age. It comes in various forms, including purposefully child neglect, physical harm, sexual abuse, commercial and emotional exploitation of the child with consequences of actual or potential harm to the health of the child, ability of the child to function normally in the society and develop with dignity in the context of a relationship of responsibility, trust or power (World Health Organization,2020). Maltreatment causes stress with resultant disruption in brain development at the early stage. Extreme stress can impair the development of the nervous and immune systems.
Case Formulation:
The ACS determines the Hernandez uses a brutal form of punishment on their children in the name of discipline after assessing the family. The ACS recommendation was to enroll Hernandez in a parental training class to develop positive parenting skills. The Hernandez have poor insight in their method of discipline; therefore, they believe there is no need for them to participate in the class; plus the fact that attending the class will be a waste of time and loss of income that would impact the family budget/expenses due to cut in their work hours.
Treatment plan:
The therapeutic modality suitable for the Hernandez family is trauma-focus cognitive behavioral therapy. The trauma focus cognitive behavioral therapy reinforces the development of precise assessment and coping strategies that empower children who pass through abuse to readjust and handle trauma-related experiences and emotional reactions appropriately. The children will benefit from engaging in an exposure-based segment of the therapeutic modality after establishing coping skills (De-Arellano et al., 2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). The treatment plan that will benefit the Hernandez family is Trauma focus on cognitive behavioral therapy. The trauma-focus cognitive behavior therapy enhances and fosters the development of sensitive assessment and coping strategies that enable children to readjust and handle trauma-related distress and emotional reactions adequately. According to de Arellano et al. (2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay), the children will need to participate in the therapy treatment exposure-based components after acquiring coping skills.
The parenting class will help the Hernandez gain insight into their parenting styles to understand and develop effective parenting
Parents who are experiencing financial difficulties or who have experienced child maltreatment as a child need support to respond appropriately to challenging child behavior. The Hernandez will profit from parental coaching specializing in integrating child maltreatment mediation to empower them to limit and restrict inappropriate challenging behaviors in less complicated and more sensitive ways (van IJzendoorn et al., 2020).

References:

American Psychological Association (2020). Trauma. Retrieved from
https://www.apa.org/topics/trauma/
Childhelp (2019: 2024 – Online Assignment Homework Writing Help Service By Expert Research Writers). Issues of child abuse. Retrieved from https://www.childhelp.org/child-
abuse/
De Arellano et al, (2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). Trauma-focused cognitive-behavioral therapy for children and
adolescents: assessing the evidence. Psychiatric services (Washington, D.C.), 65(5), 591–
602. https://doi.org/10.1176/appi.ps.201300255.
Laureate Education (Producer). (2013a). Hernandez family> Sessions 1—6 [Video file]. Author: Baltimore, MD.
Rueness, J., Myhre, M. C., Strøm, I. F., Wentzel-Larsen, T., Dyb, G., & Thoresen, S. (2019: 2024 – Online Assignment Homework Writing Help Service By Expert Research Writers). The
mediating role of posttraumatic stress reactions in the relationship between child abuse and physical health complaints in adolescence and young adulthood. European journal of psychotraumatology, 10(1), 1608719. https://doi.org/10.1080/20008198.2019: 2024 – Online Assignment Homework Writing Help Service By Expert Research Writers.1608719
Van IJzendoorn, M. H., Bakermans-Kranenburg, M. J., Coughlan, B., & Reijman, S. (2020).
Annual Research Review: Umbrella synthesis of meta-analyses on child maltreatment antecedents and interventions: differential susceptibility perspective on risk and resilience. Journal of child psychology and psychiatry, and allied disciplines, 61(3), 272–290. https://doi.org/10.1111/jcpp.13147
World Health Organization (2020). Child maltreatment. Retrieved from
https://www.who.int/news-room/fact-sheets/detail/child-maltreatment

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