The Family Psychiatric Assessment

The Family Psychiatric Assessment

The Diagnostic and statistical manual of mental disorders 5th edition of the American psychiatric association focuses on patient's interpersonal relationships to diagnose mental illnesses. Unlike most systemic diseases, psychiatric illness history taking and mental status examination derive their basis and concepts from the patient's family history, birth, milestones, education history, social history, occupational and psychosexual history. This paper focuses on assessing a family within which a member was diagnosed with anxiety disorder and multiple psychiatric illness risk factors.

Family assessment form

Conduction of family assessment helped me utilize the assessment tools and theories that were taught in class. While doing the family assessment, I applied the Friedman Family Assessment Model in gathering the information about the family and exhaust the interceptions that are likely to enable the interactions between the family members and the health care provider or the family therapist. Outlined below is the information that was obtained from the family.

1. Name of the Family: Johnson family; This name has been modified for privacy and confidentiality protection

2. Family Address:43002 Amlin, Franklin County, Ohio. Address modified for confidentiality and privacy protection.

3. The composition of the family has been shown in the genogram

4. Family Form: The family form revealed a mixture of stepfamily and a blended type. Mr. Johnson has two children he had with his previous wife before they divorced, while Mrs. Johnson has one child she got from her last relationship before she got married to Mr. Johnson. Together, Mr. and Mrs. Johnson have two children.

5. The Cultural Background: The Johnson family is identified as Black-American or Blac-Caucasian.

6. Religion: Johnson's is a Christian family from a catholic denomination.

7. Social group: Johnson's family is an upper middle-working class.

Background family information

Mr. Johnson is a 60-year-old male from African-American cultural background; he works with a textile company in Ohio state. Mrs. Johnson is a 56-year-old female from an African-American origin envelope manufacturing company in Ohio. The couple both have a blended family comprising two 27 and 21 years old and three sons 35, 25, and 19 years old. All the children have their birth and life in Franklin, Ohio. The couple has both been married for 30 years. Mrs. Johnson was married before she got engaged with Mr. Johnson; she was a single mother of one, a child she gave birth to while in her previous marriage. Mr. Johnson grew up in a stepfamily with a step farther. Mrs. Johnson's mother passed on when she was two years old; she was raised by her uncle and aunt, who later died in a car accident, leaving her at the age of 22 years; she was forced to live on her while in university. The oldest son, 35, lives in New York, married with two children. The son is currently working as a lecturer at a university. The elder daughter, 27, lives in North Carolina, just concluded her master's degree, and is now in a relationship but not married yet. The other three children are currently studying two 25 and 19 in the university while 21 in a college, both children are healthy and doing well. The Johnson family lives in a mid-sized house in Ohio; they have lived in this house for 21 years.

GenogramMrs. Johnson

56-year, Hypertensive

Mr. Johnson

60 years, diabetic

The genogram applied proved very effective in the assessment and analysis of the family concerns. The orientation of the genogram was adopted from the Bowen family theory from many generations behind (Majhi et al., 2018). Mr. Johnson was diagnosed with anxiety disorder, has a history of diabetes. Mrs. Johnson has a history of hypertension with no known psychiatric illness. This genogram representation provides a visual perception of the Johnson family system.

Interpersonal interaction recording

I had an interactive session with Mrs. Johnson where she revealed a few aspects and issues concerning the family. The conversation was recorded as follows.

Psychiatrist: in general, tell me the issues you think concerns your family

Mrs. Johnson: First, I did not bond with my biological parents when growing a child; I have always felt that attachment guilt in me; sometimes, I have to choose sides in my current family. I have to do more for my children not to experience whatever I went through as a child. I am devoted to maintaining my family bond and providing the motherly attachment I did not receive while growing with my children.

Psychiatrist: Now that you mentioned your childhood, would you please tell me more about it.

Mrs. Johnson: so, what exactly do you want to know about my childhood? Be more specific, please.

Psychiatrist: Because sometimes our childhood history greatly influences our adulthood, it would be significant to know how you grew up.

Mrs. Johnson: well, I lost my biological mother at the age of two; I was informed she succumbed to long-standing tuberculosis; I had to stay with my uncles and aunt while my elder brother stayed with our uncle. My sister, who was the second born, stayed with our father. Growing up with my aunt was stressful; she was a strict woman, and sometimes I wished I had a mother.

Psychiatrist: I understand and am sorry for all you went through. Would you please tell me more about your auntie?

Mrs. Johnson: well, my auntie was this kind of a strict person; I sometimes felt she treated me as if I didn't belong to that family. I grew up with my four cousins. My uncle was too harsh to the point of leading my elder cousin to commit suicide. My auntie was another hell altogether; she constantly treated me with so much hatred, imposed heavy chores on me. When I got pregnant at the university, she told me never to step my foot in her house, not until they died in a car accident I didn't visit.

Psychiatrist: do you feel the need to continue talking about your cousins and your other siblings?

Mrs. Johnson: No, I don't particularly appreciate talking about my past because it hurts me so much; all I want is to speak about is my family.

Sometimes, clients or people do not understand their past or childhood history's impact on their present life or adulthood life. Mrs. Johnson got very defensive and retractive; she did not want to talk about her past but rather her present. It is thus essential letting clients know the relationship of their past to their present predicaments and possibly the impacts on their future. The role of a therapist is to extensively study and explore the issues around the family tree while assessing to identify the risk factors to psychiatric illnesses and generate a treatment plan.

Cultural assessment and family system beliefs

The cultural origin of the Johnson family is that of African-Americans. The family speaks only English and not any other language. Mrs. Johnson reports that she hardly associates with her extended family but rather focusing on her immediate family as everyone prefers staying to themselves. Her husband, Mr. Johnson, also thinks the same way; he is determined to keep his small family together. He only talks to or occasionally visits his brother and sister during the holidays or their birthdays. Mrs. Jonhson considers her family very vital to her because she did not grow in such an environment as a child.

The family life cycle/ Developmental stages

The assessment of the family developmental stages is a crucial process. It enables a therapist to better understand the family by analyzing the issues and the concerns surrounding the family system. Concluding Erickson's developmental stages, Mr. and Mrs. Johnson are both in the middle adulthood developmental stages where the couple focuses on establishing and guiding their next generation, in this case, their children (Melo et al., 2018). From the assessment done, the couple both have a good-paying job, and their primary concern is to guide their children to see them succeed in life. Driving their children comes with teaching them about the decision-making and the impact of their decisions on their future lives. As the generative behavior dictates, an individual can pass the necessary knowledge and skills to obtain the measure of satisfying an achieved role with responsibility and authority within the family. When looking at the children, they are in the young adulthood stage of life; only one is established with a family while the others are yet to get into marriages and show their families. The children who are still in the college levels are still very young, yet to start their careers, and they depend on their parents for their financial needs.

Generally, the family cycle's developmental stages comprise six significant steps: child-bearing, school-age, adolescent, launching, and post-launching stages (Melo et al., 2018). The Johnson family is currently at the launching stage of development. Two of their children are done with college and are not living in their parent's home; the other younger three are away from home in college but still depends on the parents for their financial needs and return to their parents during the holidays. The two couples are determined to support their children in terms of emotional and psychological conditions; they endeavor to see them succeed in life. Mrs. Johnson enjoys raising her children, something she started from the first time she conceived and was devoted to giving her children the best in life as her husband supports her.

The relationship and roles in the family

In Johnson's family, every member is charged with specific roles they play as a family. Mr. Johnson, this was well demonstrated from how each family member interacts with each other from the session and the entire assessment process. Mr. Johnson generally appears to be a reserved person who speaks out whatever he thinks is right but sometimes observes more than he speaks. He plays a significant role as the model of the family and a provider as a man. In terms of financial positions, the couple usually split their financial bills without complaining of the burden; they have been doing this since they got engaged. The couples are deeply in love, and everyone from their neighborhood admires their union and the family. Among the children, the elder son o the family is viewed as a role model to the other children, though sometimes neutral, the other sibling respects and admires how responsible he is. Every difference that results from the family arguments and quarrels is solved amicably, and everyone understands each other. Even though Mr. Johnson is a stepfather to the elder son, they both get along and respect each other. The 27-year-old daughter papers to stay to herself most of the tomes, Mrs. Johnson being her stepmother; the two usually get along perfectly well. The other younger daughter, now 21 years old, is still in her youthful stages and is yet to discover her real identity as a woman; she always comes in and fights for everyone whenever necessary. Even though she could be compassionate and dramatic at times, she is the most loving and caring person the family is gifted. She has one major weakness in coping up with stress and stressful situations as she succumbs quickly.

The youngest child in the family, the 19 years old, is entirely dependent on their parents for everything, including his basic needs. His mother reports being mostly a self-centered individual and sometimes views other siblings with jealousy. A tringle aspect is often encountered when examining or assessing the family; the mother and the elder daughter teamed up against the other family members. It was sorted with peace, and everyone smiled after that. Generally reporting, the couple has a close relationship in which they freely and communicate about their needs and ideas. Most of the family issues and concerns appear to originate from the conflict between the elder daughter and mother; sometimes, they seem not to be on good terms, but as usual, everything is settled at the family level, and everybody laughs after that.

The family system

From my discussion with the family, Mrs. Johnson appeared to have a few unresolved issues with her step-daughter. She exposed how the daughter sometimes gave her hectic time while raising her. she reports how the daughter was always reasonable and intelligent at school, only to change when she gets home. Mrs. Johnson further narrated how raising her was difficult as she would run from home at times or even sneak boys into their home during her teenage ages. The daughter explained how the mother mistreated her with so much hate because she is not her biological daughter; she reports reaching out to her father whenever needed anything. The elder son supported his sister but differentiated her opinion; he views his stepfather as his biological because his birth father is no longer in his life.