NRNP-6645 Mother and Daughter a Cultural Tale Video Family Assessment Assignment
NRNP-6645 Mother and Daughter a Cultural Tale Video Family Assessment Assignment
NRNP/PRAC 6645 Comprehensive Psychiatric
Evaluation Note Template
CC (chief complaint): Mother: dependent on kids, depression, abuse from marriage and pain issues from past surgeries. The daughter Wants independence from her mom and thinks the mom needs to adapt and let her kids live their lives.
HPI: 40-year-old Iranian mother and her 23-year-old daughter present for therapy consultation. There is a conflict with the expectation of the mother-daughter relationship. The mother wants her kids to be around because she gets lonely and depressed when alone. On the other hand, her daughter and kids feel too smothered by the mom and want their independence from her. The daughter feels she is at the age to grow and find herself, while the mom is heavily influenced by her Iranian culture.
ORDER AN ESSAY HERE
Past Psychiatric History: The mother admits to depression but is not specific if diagnosed by a psychiatrist.
General Statement: Mother complains of loneliness and depression and seek more time with her adult kids. Adult kids seeking independence from mom.
Caregivers (if applicable): None both adults and lives independently
Hospitalizations: Mother noted past surgeries. No known past psychiatric hospitalizations
Medication trials: None
Psychotherapy or Previous Psychiatric Diagnosis: None stated.
Substance Current Use and History: No stated substance use or history from both mom and daughter
Family Psychiatric/Substance Use History: No stated substance use or history in the family
Psychosocial History: Patients are a 40 year old Iranian female with no educational history and her 23 year old daughter. The mother get married at the age of 16 and her husband was chosen for her by her family. Patient stated that her husband was verbally and physically abusive to her. She has 5 children with her husband. The two youngest children currently live with her at home. Mom complains of depression but unknown if ever officially diagnosed. Abusive husband who tries to control her even though they don’t live together .
Medical History:
Current Medications: Did not report medication during therapy
Allergies: No known allergies reported
Reproductive Hx: Mom has 5 children. Three Daugthers 24, 23, and 21 Two sons ages 18 and 15.
ROS: No systems assessment done in video.
GENERAL: Mom appeared overweight and looks older for her age. Daughther looks to be in good health. No personal health information provided
HEENT: N/A
SKIN: N/A
CARDIOVASCULAR: N/A
RESPIRATORY: N/A
GASTROINTESTINAL: N/A
GENITOURINARY: N/A
NEUROLOGICAL: N/A
MUSCULOSKELETAL: N/A
HEMATOLOGIC: N/A
LYMPHATICS: N/A
ENDOCRINOLOGIC: N/A
Physical exam: No physical examination performed in video
Diagnostic results: No lab results discussed during the session.
Assessment
Mental Status Examination: Both mother and daughter were alert and oriented to self, place and time. Mom was overweight and appeared older than her stated age. Daugther look to be in good physical health. Both appeared stressed about the current mother daughter relationship .
Differential Diagnoses:
The three differential Diagnoses I came up with for this patient case are:
Post-Traumatic Stress Disorder
Persistent depressive disorder (PDD)
Dissociative disorders
Post-Traumatic Stress Disorder (PTSD) is my first potential diagnosis for this patient. PTSD occurs following a traumatic incident. The patient experienced both physical and verbal abuse during her merrage and living with her husband. According to DSM-V, PTSD is characterized by physical symptoms, including fatigue or sleep disturbances (Rumball et al., 2020). People with this disorder also experience stress reactions such as irritability. The patient is experiencing all these symptoms, increasing the likelihood of a PTSD diagnosis. The patient did complain of fatigue and depression. The daughter reported that her mom is sometimes very irritable. After reviewing PTSD, the client qualifies to be diagnosed with this condition.
Persistent depressive disorder (PDD), also known as dysthymia, is the second differential diagnosis I chose for this patient. PDD is a long-lasting but milder form of depression. This mood disorder is characterized by a mild form of various depression symptoms, including hopelessness, low self-esteem, an overall feeling of inadequacy, anger, sadness, general discontent, irritability, excess sleepiness or insomnia, slow activity, or indecisiveness (Ogundele, 2018). According to Miller (2019), depression can also occur after a traumatic event or events. The data collected in the video shows that the patient can be diagnosed with this condition.
Dissociative disorders are also a possible differential diagnosis for this patient. This condition presents symptoms similar to PTSD, and the causes are due to past traumas (“Chapter dissociative reactions in PTSD,” 2019). The patient has past traumas that are impacting her relationship with her family. Dissociative disorders can be a possible diagnosis for this patient as well.
Case Formulation and Treatment Plan
The best treatment plan for this patient is to address her PTSD condition. Treatment should include individual therapy, group therapy with her kids, antianxiety and antidepressant medications. Some approaches that might be good options for this patient include exposure therapy, anxiety management/relaxation training, cognitive-behavioral therapy (CBT), and supportive psychotherapy” (Piotrowski & Range, 2020). The mother will need to see a provider that can prescribe her some medications. The daughter should be evaluated independently and provided with appropriate resources.
Reflections
This was an interesting case. The patient will benefit from seeing a mental health provider for evaluation and starting medication. I think she will benefit from taking medications to help with her possible diagnosis of PTSD and Depression. She should also continue her psychotherapy.
References
Miller, L. (2019). PTSD and other traumatic disability syndromes: Differential diagnosis. SpringerBriefs in Psychology, 25-42. https://doi.org/10.1007/978-3-319-09081-8_3
Piotrowski, N. A., PhD, & Range, L. M., PhD. (2020). Post-traumatic stress disorder. Magill’s
Medical Guide
Rumball, F., Happé, F., & Grey, N. (2020). Experience of trauma and PTSD symptoms in autistic adults: risk of PTSD development following DSM‐5 and non‐DSM‐5 traumatic life events. Autism Research, 13(12), 2122-2132 NRNP-6645 Mother and Daughter a Cultural Tale Video Family Assessment Assignment.
Ogundele, M. O. (2018). Behavioral and emotional disorders in childhood: A brief overview for pediatricians. World journal of clinical pediatrics, 7(1), 9. Doi: 10.5409/wjcp.v7.i1.9
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. NRNP-6645 Mother and Daughter a Cultural Tale Video Family Assessment Assignment
