​Comprehensive Client Family Assessment Demographic information: Latino American family. Low socioeconomic status, working class. Presenting problem: “Social worker believes our discipline style is too harsh and we need parenting classes” History of Present Illness: Both clients present to the office with concerns regarding their children being “taken away” by social services as she believes they parent too harshly. They adamantly proclaim that they are very good, loving parents but believe that when a child is not following the rules, strict and physical discipline is necessary. They both explain that they were brought up this way and that physical or emotional abuse is not present. They explain that this is part of their culture and all they know is right. The social worker referred to the family as “those Mexicans” and seemed to be bias towards the family. Also, she seemed to not consider any alternative for the family after they requested it based on their working schedule and after explaining their cultural belief system. Past Psychiatric History: “Needs to be added to” Medical History: “Needs to be added to” Substance Abuse History: No indication for substance abuse. “Needs to be added to” Developmental history: Parents report that their two sons all have met their milestones throughout their development and are ages 6 and 8 years old. “Needs to be added to” Family psychiatric history: “Needs to be added to”. Psychosocial history: Male client works full-time and overtime to provide for the family. “Needs to be added to”. History of abuse/trauma: Based on the genogram created, both clients father and mother have a history of disciplining their children similarly. They both would require the clients to hold encyclopedias out in front of them until their arms “felt like they were going to fall off”. Both clients report this type of discipline as being miserable and that they inherited this from their parents. No physical or mental abuse of concern. Review of Systems: HEENT:​ No loss of vision or hearing. No sign of congestion, sore throat, or runny nose. SKIN:​ Cool and dry skin with no signs of wounds or lesions. CARDIOVASCULAR:​ No complaints of chest pain, tightness, discomfort or palpitations. S1, S2 heard upon auscultation. 2+ pedal and radial pulses. No weight gain and no edema. RESPIRATORY:​ Clear lung sounds with no adventitious sounds. No rhonchi or wheezes auscultated, and chest is symmetrical. No cough present. GASTROINTESTINAL:​ No nausea, emesis, or diarrhea. Abdomen soft, no distention, no discomfort on palpation. Bowel sounds present in all four quadrants. GENITOURINARY:​ No burning or discomfort when urinating. NEUROLOGICAL:​ No double vision, headaches, seizures. No loss of memory. Alert and oriented x person, place and time. Agitation present in male client. MUSCULOSKELETAL:​ No joint or muscles pain. No g.

1. Comprehensive Client Family Assessment
Demographic information: Latino American family. Low
socioeconomic status, working class.
Presenting problem: “Social worker believes our discipline style
is too harsh and we need
parenting classes”
History of Present Illness: Both clients present to the office
with concerns regarding their
children being “taken away” by social services as she believes
they parent too harshly. They
adamantly proclaim that they are very good, loving parents but
believe that when a child is not
following the rules, strict and physical discipline is necessary.
They both explain that they were
brought up this way and that physical or emotional abuse is not
present. They explain that this is
part of their culture and all they know is right. The social
worker referred to the family as “those
Mexicans” and seemed to be bias towards the family. Also, she

2. seemed to not consider any
alternative for the family after they requested it based on their
working schedule and after
explaining their cultural belief system.
Past Psychiatric History: “Needs to be added to”
Medical History: “Needs to be added to”
Substance Abuse History: No indication for substance abuse.
“Needs to be added to”
Developmental history: Parents report that their two sons all
have met their milestones
throughout their development and are ages 6 and 8 years old.
“Needs to be added to”
Family psychiatric history: “Needs to be added to”.
Psychosocial history: Male client works full-time and overtime
to provide for the family. “Needs

3. to be added to”.
History of abuse/trauma: Based on the genogram created, both
clients father and mother have a
history of disciplining their children similarly. They both would
require the clients to hold
encyclopedias out in front of them until their arms “felt like
they were going to fall off”. Both
clients report this type of discipline as being miserable and that
they inherited this from their
parents. No physical or mental abuse of concern.
Review of Systems:
HEENT: No loss of vision or hearing. No sign of congestion,
sore throat, or runny nose.
SKIN: Cool and dry skin with no signs of wounds or lesions.
CARDIOVASCULAR: No complaints of chest pain, tightness,
discomfort or palpitations. S1,
S2 heard upon auscultation. 2+ pedal and radial pulses. No
weight gain and no edema.
RESPIRATORY: Clear lung sounds with no adventitious
sounds. No rhonchi or wheezes
auscultated, and chest is symmetrical. No cough present.
GASTROINTESTINAL: No nausea, emesis, or diarrhea.
Abdomen soft, no distention, no
discomfort on palpation. Bowel sounds present in all four
quadrants.
GENITOURINARY: No burning or discomfort when urinating.

4. NEUROLOGICAL: No double vision, headaches, seizures. No
loss of memory. Alert and
oriented x person, place and time. Agitation present in male
client.
MUSCULOSKELETAL: No joint or muscles pain. No
generalized weakness.
HEMATOLOGIC: No signs of bleed, no history of anemia. No
dizziness or lightheadedness
upon standing.
LYMPHATICS: Lymph nodes normal in size on palpation. No
history of splenectomy.
PSYCHIATRIC: “Needs to be added to”
ENDOCRINOLOGIC: No history of diabetes. Fatigue noted. No
heat or cold intolerance. No
brittleness of skin and hair noted.
Physical Assessment:
Vital signs: BP: 145/89, Pulse: 104, Resp: 22, Temp: 97.9,
Oxygen Saturation 92% on RA,
Neck: Negative jugular vein distension.
Chest/Lungs: Clear and with no crackles, rhonchi or wheezing.
Thorax symmetrical.
Heart/Peripheral Vascular: S1, S2, and S3 heart with no murmur
present, pulses+2 bilateral pedal
and +2 radial pulses.
ABD: Abdomen soft and nondistended, regular bowel sounds
heard in all 4 quads.
Skin/Lymph Nodes: No edema in bilateral extremities, no
clubbing, or cyanosis; no palpable
nodes, cool and dry skin.

5. · Mental status exam: Both clients alert and oriented to
person, place and time. Hygiene and
apparel appropriate. Both clients conduct good eye contact and
participate in conversation. Male
client seems to be agitated at times regarding having to take
parenting classes while the female
client is more accepting. Attention is intact and both speak
clearly and offer information freely.
No paranoia, hallucinations or delusional activity noted. Both
clients willing to participate with
interventions to complete the parenting classes.
Differential Diagnosis
The main focus with these parents is deciding whether or not
their discipline is
considered appropriate or abusive. As discipline is the system
of teaching a child what is good
and bad, punishment and appraisal is consistent with the
processes of this teaching (Discipline,
parenting styles and abuse, 2017). One key way to distinguish
punishment vs abuse is by
examining if the parent has anger that plays a role in the
administration of punishment

6. (Discipline, parenting styles and abuse, 2017). In the case of the
Hernandez family, culture plays
a role in their beliefs for punishment and their expectations of
their children. Typically, if the
punishment is not in an extreme, nor anger used, then the
punishment would not be considered
abusive. Although, clients of different backgrounds and belief
systems are encouraged to accept
dominant cultures around them and be open minded. Based on
this families cultural belief
system and practices, the fact there is no sign of physical abuse
on the children, nor complaints
of neglect or emotional abuse I would advise the parents that
there parenting style isn’t
considered abusive but being open minded regarding other
techniques is always helpful
(Coleman, et al., 2010).
Individualized Treatment Plan
Conducting a cultural formulation interview (CFI) is one of the
most important aspects of
a mental health assessment. Assessing the client's values,
practices, background, influence of

7. family, cultural identity, and their conceptualization of distress
all lead to the framework needed
to personalize a treatment plan that is tailored to a certain
family, according to the DSM, (2013).
Structural family therapy and group therapy are chosen to assist
the family in exploring their
parenting styles by offering a framework to address problems in
the home. By utilizing the
structural family therapy approach, power structures,
imperceptible rules, communication
patterns and boundaries are able to be assessed which can lead
to an increased obedience of the
children and decreased need for punishment, according to
Wheeler, (2014). The main goal of
therapy for this family would be to create an effective structure
with clear boundaries, open
communication, direct, clear rules where roles are flexible
(Wheeler, 2014).
References
American Psychiatric Association. (2013). Diagnostic and
statistical manual of mental

8. disorders (5th ed.). Washington, DC: Author.
Coleman, D. L., Dodge, K. A., & Campbell, S. K. (2010).
WHERE AND HOW TO DRAW THE LINE
BETWEEN REASONABLE CORPORAL PUNISHMENT AND
ABUSE. Law and Contemporary
Problems, 73(2), 107–166.
Discipline, parenting styles and abuse. (2017). Pa Family
Support Alliance: Protecting Children
from Abuse. Retrieved from
http://www.pa-fsa.org/Parents-Caregivers/Preventing-Child-
Abuse-Neglect/Discipline-Pa
renting-Styles-and-Abuse
Petiprin, A. (2016). Psychiatric and mental health nursing.
Nursing Theory. Retrieved
from http://www.nursing-theory.org/theories-and-
models/erickson-modeling-and-
role-modeling-theory.php
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced
practice psychiatric nurse: A how-to
guide for evidence-based practice (2nd ed.). New York, NY:

9. Springer Publishing
Company.
Scanned by CamScanner
36388 Topic: week 2 assignment 2
Number of Pages: 5 (Double Spaced)
Number of sources: 4
Writing Style: APA
Type of document: Essay

10. Academic Level:Master
Category: Psychology
Language Style: English (U.S.)
Order Instructions: Attached
I will upload an example and basically just take that
information and re word it and use some of the references below
and use references that are less than 5 years old
The Assignment
Address in a comprehensive client assessment of the Hernandez
family the following:
Demographic information
Presenting problem
History or present illness
Past psychiatric history
Medical history
Substance use history
Developmental history
Family psychiatric history

11. Psychosocial history
History of abuse and/or trauma
Review of systems
Physical assessment
Mental status exam
Differential diagnosis
Case formulation
Treatment plan
Note: Any item you are unable to address from the video should
be marked “needs to be added to” as you would in an actual
comprehensive client assessment
Learning Resources
Note: To access this week’s required library resources, please
click on the link to the Course Readings List, found in the
Course Materials section of your Syllabus.
Required Readings
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced
practice psychiatric nurse: A how-to guide for evidence-based
practice. New York, NY: Springer.
Chapter 12, “Family Therapy” (pp. 429–468)
Nichols, M. (2014). The essentials of family therapy (6th ed.).
Boston, MA: Pearson.

12. Chapter 3, “Basic Techniques of Family Therapy” (pp. 29–48)
Chapter 4, “The Fundamental Concepts of Family Therapy” (pp.
49–68)
American Psychiatric Association. (2013). Diagnostic and
statistical manual of mental disorders (5th ed.). Washington,
DC: Author.
Note: It is highly recommended that you use this resource as a
reference guide throughout the course. Retrieved from Walden
Library databases.
L’Abate, L. (2015). Highlights from 60 years of practice,
research, and teaching in family therapy. American Journal of
Family Therapy, 43(2), 180–196.
doi:10.1080/01926187.2014.1002367
Note: Retrieved from Walden Library databases.
Mojta, C., Falconier, M. K., & Huebner, A. J. (2014). Fostering
self-awareness in novice therapists using internal family
systems therapy. American Journal of Family Therapy, 42(1),
67–78. doi:10.1080/01926187.2013.772870
Note: Retrieved from Walden Library databases.
Nichols, M., & Tafuri, S. (2013). Techniques of structural
family assessment: A qualitative analysis of how experts
promote a systemic perspective. Family Process, 52(2), 207–
215. doi:10.1111/famp.12025
Note: Retrieved from Walden Library databases.
Papero, D. V. (2014). Assisting the two-person system: An

13. approach based on the Bowen theory. Australian & New
Zealand Journal of Family Therapy, 35(4), 386–397.
doi:10.1002/anzf.1079
Note: Retrieved from Walden Library databases.
Document: Group Therapy Progress Note
Required Media
Laureate Education (Producer). (2013a). Hernandez family>
Sessions 1—6 [Video file]. Author: Baltimore, MD.
Accessible player
Accessible player
Accessible player
Accessible player
Accessible player
Accessible player
Psychotherapy.net (Producer). (2006). Tools and techniques for
family therapy. [Video file]. Mill Valley, CA: Author.
Note: You will access this media from the Walden Library
databases. The approximate length of this media piece is 52
minutes.
Assignment 1: Hernandez Family Assessment
Assessment is as essential to family therapy as it is to
individual therapy. Although families often present with one

14. 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. As you examine the Hernandez Family: Sessions 1-6
videos in this week’s Learning Resources, consider how you
might assess and treat the client family.
Learning Objectives
Students will:
Assess client families presenting for psychotherapy
To prepare:
Review this week’s Learning Resources and reflect on the
insights they provide on family assessment.
View the Hernandez Family: Sessions 1-6 videos, and consider
how you might assess the family in the case study.
Note: For guidance on writing a comprehensive client
assessment, refer to pages 137–142 of Wheeler (2014) in this
week’s Learning Resources