MOTHER AND DAUGHTER: A CULTURAL TALE VIDEO

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Mother and Daughter: A Cultural Tale video

Mother and Daughter: A Cultural Tale video
Mother and Daughter: A Cultural Tale video
FAMILY ASSESSMENT
Assessment is as essential to family therapy as it is to individual therapy. Although families often present with one person identified as the “problem,” the assessment process will help you better understand family roles and determine whether the identified problem client is in fact the root of the family’s issues.
To prepare:
Review this week’s Learning Resources and reflect on the insights they provide on family assessment. Be sure to review the resource on psychotherapy genograms.
Download the Comprehensive Psychiatric Evaluation Note Template and review the requirements of the documentation. There is also an exemplar provided with detailed guidance and examples.
View the Mother and Daughter: A Cultural Tale video in the Learning Resources and consider how you might assess the family in the case study.
THE ASSIGNMENT
Document the following for the family in the video, using the Comprehensive Evaluation Note Template:
Chief complaint
History of present illness
Past psychiatric history
Substance use history
Family psychiatric/substance use history
Psychosocial history/Developmental history
Medical history
Review of systems (ROS)
Physical assessment (if applicable)
Mental status exam
Differential diagnosis—Include a minimum of three differential diagnoses and include how you derived each diagnosis in accordance with DSM-5-TR diagnostic criteria
Case formulation and treatment plan
Include a psychotherapy genogram for the family
Note: For any item you are unable to address from the video, explain how you would gather this information and why it is important for diagnosis and treatment planning.
 
Psychotherapy with Multiple Modalities WK2 Assignment 
 Subjective:
CC (chief complaint):
The mother reports that she is experiencing a lot of pain, and she feels nobody is helping her manage the pain. Her daughter Sharleen indicates that she desires to make her mother peaceful and wants her to lower expectations and accept that life has changed. She adds that she has a feeling that her mother is holding her back from all she could be doing. The mother wants her daughters to always spend time with her and sometimes gets depressed when she is lonely. Sharleen admits that she hates spending time with her mother in the house since her mother has two dogs, which she does not like. She does not like touching the dogs or having their hair on her body. She adds that she cannot have a meal at her mother’s house since eevryting there smells like the dogs, making her uncomfortable. Sharleen complains that her mother is too quick to take action due to her high expectations. There is also a complaint that one of the siblings was raped by her biological father, which has affected her mental health. As the complaints are presented, it is noted that Patti and Sharleen are not always in common agreement, and Gonzalo Baciga is even worried about the mother and daughter.
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HPI:
The said patient is a female from Iran-America and is 40-year-old. She wants to be examined for complicated family dynamics problems regarding her children and her. Her 23-year-old daughter discussed the various issues concerning her relationship with her mother and family. They want to be evaluated for trauma-related concerns related to domestic violence caused by their father Mother and Daughter: A Cultural Tale video. The lady admits that apart from the violence, their mother is adjusting to America’s norms, an adjustment disorder.
They admit that there is a lot of family conflict, especially with their father, who once raped one of her daughters. The significant problem is that the mother is falling ill and has undergone several surgeries on her foot. A second issue relates to the rape case by the father. The third issue is the difference in beliefs and traditions as the mother wants her children to look after her, while the children prefer employing a nursng facilty to care. Generally, the issues are unresolved and cause depression and trauma. Fumbling and enthusiasm were two visible symptoms observed during the assessments. Other signs noted include; impulsivity, hyperactivity, often repeating words, and irritability. There is no evidence of an inability to focus, possessing a short memory, or paying attention.
Past Psychiatric History:
The mother described depressing moments in this case but did not indicate psychiatric illnesses such as depression. They disputed thoughts of suicide. Additionally, they denied having ever used illegal substances, suffering from a significant mental illness, or having insanity.
Hospitalizations: No previous reports mentioned acute admissions for mental illness.
Psychotherapy or Previous Psychiatric Diagnosis:
There is no recorded current mental diagnosis or psychotherapeutic treatment for the patient. However, it was earlier indicated that the mother becomes depressed whenever she is lonely. Additionally, they did not mention any medicine for depression.
Substance Current Use and History: No reported abuse of substances at the moment.
Family Psychiatric/Substance Use History: No substance use or psychiatric is reported.
Psychosocial History:
The daughter and mother are both struggling to adjust to a new way of life. They have visited the institution for mental assessment diagnosis of any trauma disorder and adjustment disorder. Their current psychiatrist was presented, too, and participated in answering some questions related to the patients’ past issues. The mother, who is living on disability, was brought by her daughter, a school-going girl. There were no details about the girl’s school that were collected. No information was revealed concerning the daughter thought it might be important if she could report any. Unnikrishnan et al. (2021) indicate that patient information is necessary for creating a full treatment plan. The family denied both current and medical history. The assessment only revealed the mother’s surgery without mentioning its reason. It would be imperative to ask questions that would help dig deep into patients’ health histories.
Medical History:
Current Medications: None mentioned
Allergies: Not known
Reproductive Hx: Not known for the children, but the mother has six children
Objective:
Review of systems (ROS)
Skin-reported no issue
Respiratory system– no shortness of breath, cough, or sneezing.
Cardiovascular system- no chest pains reported
Gastrointestinal-no constipation, abdominal pains, or diarrhea
Hematologic– no easy bleeding or anemia
Genitourinary-no hematuria or flank pain
Neurological– no dizziness, headaches, ataxia, or paralysis
Endocrine system– no polyuria, diabetes, polyphagia, or polydipsia.
Assessment:
Mental Status Examination:
The mother is an Iranian female aged 40 years, and her Americanized Iranian daughter is aged 23. Due to early and abusive marriage stress, the mother looks older than she should. The daughter looks at the mother’s stated age and seems not concerned. They are cooperating with the examiner. They are cleanly dressed, and there is no abnormal mental activity. However, they are both restless, anxious, and irritated. They deny any auditory or visual hallucinations or delusions. They have clear and loud speeches though the volume and tones are normal (Mitchell et al., 2021). Their thought process is logical, and their goals are driven.
Some evidence of fidgeting, impulsivity, excitability, and annoyance are visible, including an aggressive tone with some repetitions. When spoken to, they looked present-minded. Cognitively, they have remote and recent memories intact, normal concentration, average insight, and all attention, judgment, and abstraction unbroken (Watkins et al., 2018).
Differential Diagnoses:
POST-TRAUMATIC STRESS DISORDER- PTSD; ICD-10 CODE: F.43
The post-traumatic disorder can follow a traumatic experience such as a physical assault or military combat. Although stress always follows trauma, PSTD victims relieve trauma with their minds and start distancing themselves from friends and family. They also may begin experiencing prolonged anger. Individuals that have faced or experienced life-threatening events form the majority of these victims. There is no specific or fixed prevalence for the condition, for it affects both men and women, young and aged. Traumatic stress lead to physiopathological and psychoemotional consequences. PTSD is psychologically correlated with general physical impairments that alter daily life and the mind. The condition is common to those who face terror or get exposed to environmental toxins (Mitchell et al., 2021) Mother and Daughter: A Cultural Tale video.
People who have experienced scary, shocking, and other dangerous occurrences have too fearful scars to forget the trauma they went through. Notably, 95% of individuals experience different reactions after life-threatening trauma, although most recover fully. Those who continue experiencing the trauma are diagnosed with PSTD to avoid feeling stressed or uncomfortable even when there is no danger around. Some signs of this disorder include extreme anger, fear, guilt, shame, or negative emotional thoughts.
Reflections:
From the look of this topic’s assignment, PSTD is a disorder most folks have incorrectly related. Sustainability and formation of PSTD are re-associated with many neurotransmitters. Dopamine contributes a lot to this class. Given that patients with PTSD are predisposed to obesity, these patients must understand the dangers of being overweight, which predisposes them to be chronic and acute illnesses such as diabetes, obstructive sleep apnea, hyperlipidemia, cardiovascular disease, chronic obstructive pulmonary disease, rheumatoid arthritis, and so on. “PTSD is related to an elevated incidence of type II diabetes mellitus,” according to the study (Watkins et al., 2018).
There is a link between PTSD and severe health difficulties throughout the lifespan. Including activities that, regardless of their results, can trigger high-risk behavior. Substance misuse, binge eating, obesity, and inappropriate/unsafe sexual conduct are all highly risky behaviors that may be engaged as a result of PTSD. It is consequently critical to teach these patients about the need for modern contraception, healthy eating habits, and physical activity (Watkins et al., 2018). Clinicians and their clients may discuss healthy patient behaviors, healthy meals, and exercises to maintain good health and prevent illnesses and consequences.
Case Formulation Treatment Plan;
PSTD victims are treated with psychotherapy, medications, or both because everyone is unique and people are affected differently; these people should be assigned an experienced manager with enough knowledge about the condition. Some victims are required to try different medications and therefore require the attention of a professional nurse practitioner. The condition tends to reoccur and needs to be treated from its root cause. The mother exhibits symptoms and signs of social skills and is aware of her worsening depressive issues.
20mg Prozac daily
15mg BID Buspar
Management of stress
Nutrition and diet specialist
Side effects of medications and their overall expectations.
 
References
Mitchell, J. M., Bogenschutz, M., Lilienstein, A., Harrison, C., Kleiman, S., Parker-Guilbert, K., … & Doblin, R. (2021). MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine, 27(6), 1025-1033.
Unnikrishnan, R., Radha, V., & Mohan, V. (2021). Challenges Involved in Incorporating Personalised Treatment Plan as Routine Care of Patients with Diabetes. Pharmacogenomics and personalized medicine, 14, 327.
Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in behavioral neuroscience, 12, 258.
Mother and Daughter: A Cultural Tale video Transcript
00:00:00TRANSCRIPT OF VIDEO FILE: 
00:00:00_____________________________________________________________________ 
00:00:00BEGIN TRANSCRIPT: 
00:00:00[music] 
00:00:35A MOTHER and A DAUGHTER: 
00:00:35A CULTURAL TALE 
00:00:35AN INTERVIEW WITH 
00:00:35GONZALO BACIGALUPE, PhD 
00:00:35Produced by 
00:00:35Andrews & Clark 
00:00:35Explorations, Inc. 
00:00:35copyright 2003 
00:00:35GONZALO BACIGALUPE When I’m asked to do a consultation, one of the first things I ask is, what will be the most benefit for the client and the therapist and in the case that you’re going to see I’m basically asked to have a reflecting team and what we did was first have an interview with the therapist and the family and ask them what they will find useful for the interview and basically to ask them about the history of the therapy and the history of what are the kinds of things that they have been working on. I ask the reflecting team to come in and I instructed them to think of themselves as so let the god mothers of the therapist, who in a way, put them, himself, or in this case herself at risk in front of her peers and another people. So, I wanted them, the reflecting team to address the therapeutic system as a whole not just to address the family, I wanted them to talk also about the therapist and to be protective of them. I also ask the reflecting team not to be too much of clinician, but to really react on a more personal level around the family. I sometimes reflected on what they were saying to clarify or to expand the idea or how I understood it to give voice to other possibilities, but respecting the personal peace, and then, I ask I ask the family to come back to, in a classical way, to respond to those comments what strike them. In the case that we watch, it seems that the family was dealing with sort of like two forms of trauma and/or three forms of trauma; one is, history of battering the domestic violence, child sexual abuse, a history of immigration that in some ways we lay it to that trauma getting away from it and basically the mother of five children deciding that they need to move out of the home, but in the process leaving one behind who is later on sexually, I mean, raped by the father. And then at the present moment mother dealing with a fairly traumatic illness that have her, very disable, unable to walk and to work. So, it’s sort of like the interview trying to address this different forms of trauma and the way in which the young adults are trying to make sense of their bicultural life and how the whole family is trying to make sense of being bicultural and being immigrants. The session doesn’t end with a need or incredible intervention of my part because I feel that this is the part of the therapist to try to decide, this is the family that’s been working this therapist for year and half. Therefore, they have a relationship I feel that I need to respect and so those are the basic intercomments. So tell me how is it that you came out with the idea of having this interview with me? 
00:04:30Sharleen 
00:04:30Patti 
00:04:30SANDI Okay. I’m going to go back when Patti came in for the first time. She came in because they were chaos at her household. 
00:04:45Sandi – their therapist 
00:04:45SANDI She came to this country twelve years ago with her four children and one was left behind, her daughter who was 10 years old at that time, eight years old at that time, was left behind. Just two years back, finally they were able to get her visa and she brought her to United States. So ever since she came here chaos was created inside the household. 
00:05:20GONZALO BACIGALUPE So I’m clear, Sharleen you are? 
00:05:25SHARLEEN Her daughter. 
00:05:25GONZALO BACIGALUPE Her daughter. And how old are you? 
00:05:25SHARLEEN I’m 23. 
00:05:25GONZALO BACIGALUPE 23, and how old are your siblings? 
00:05:30SHARLEEN 24. 
00:05:30GONZALO BACIGALUPE And that’s sister or brother? 
00:05:35PATTI Sister. 
00:05:35SHARLEEN And then 21-year old sister and 18-year old brother and a 15-year old brother. 
00:05:50GONZALO BACIGALUPE Okay, and which one is the one that stayed there. 
00:05:50SHARLEEN 21. 
00:05:50SANDI 21. 
00:05:50GONZALO BACIGALUPE 21. Okay. All right. Okay. Go ahead, sorry. 
00:05:55SANDI And I met with the entire family for two couple of sessions and she really interested and wanted to be in therapy 21, so. 
00:06:10GONZALO BACIGALUPE What’s her name? 
00:06:10SANDI Shireen. 

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