Discharge Summary 2 Grand Canyon University

Discharge Summary 2 Discharge Summary Grand Canyon University: PCN-521

Review the Vargas Family Case study again in its entirety. Consider the progress over the past eight sessions. Complete the following sections as your discharge summary for the Vargas family:

1. A brief summary of what was going on with the family at the onset of counseling:
2. A review of the initial treatment goals:
3. Theories and interventions used: For each week:
   • Week 1:
   • Week 2:
   • Week 3:
   • Week 4:
   • Week 5:
   • Week 6:
   • Week 7:
   • Week 8:
4. A brief discharge summary for the family treatment:
5. Clinical recommendations for sustained improvement or referrals for additional services:

Paper For Above instruction

The Vargas family presented to counseling with multifaceted issues rooted in familial dynamics, developmental concerns, and external stressors impacting their cohesion and functioning. Initially, they exhibited heightened conflict, parenting challenges, behavioral issues with their children, and external pressures such as family conflicts and recent trauma. Frank demonstrated signs of impulsivity, difficulty with authority, and behavioral challenges both at school and home, likely exacerbated by inconsistent discipline and family tension. Elizabeth’s concern about Frank’s potential ADHD, her own feelings of being overwhelmed, and her perception of marital strain formed the core focus. Bob’s relaxed attitude toward behavioral concerns, combined with his family’s veteran influence and dismissive stance, challenged engagement toward intervention, necessitating approaches that fostered understanding and collaboration.

Initial Treatment Goals

The primary goals were to improve family communication, address Frank’s behavioral issues, strengthen parental roles, and increase social and emotional competence of the children. Specific aims included increasing Elizabeth’s confidence and reducing her stress, promoting consistent discipline strategies, improving sibling relationships, and decreasing marital conflict. Additionally, fostering understanding of individual family roles and histories was targeted to contextualize current challenges, along with developing coping strategies for external stressors such as community and extended family influences.

Theories and Interventions Used

Week 1:

Family Systems Theory was employed to understand the interconnectedness of family members’ behaviors, emphasizing patterns and boundaries. Structural Family Therapy techniques were introduced to delineate family subsystems, roles, and hierarchies, aiming to establish clear boundaries and roles. Engagement strategies focused on rapport-building and validating each member’s experience.

Week 2:

Psychodynamic approaches were integrated, exploring family of origin influences on current relational patterns. Techniques included genograms to visualize family history, particularly focusing on Bob’s traumatic childhood and Elizabeth’s adoption background to understand attachment influences and conflict patterns.

Week 3:

Behavioral interventions were introduced to modify Frank’s impulsivity and disruptive behaviors. Techniques included positive reinforcement, setting consistent consequences, and behavioral charts. Cognitive-behavioral therapy (CBT) elements were used to address maladaptive beliefs about school, authority, and self-concept.

Week 4:

Emotionally Focused Therapy (EFT) techniques were incorporated to improve emotional connection between Bob and Elizabeth, focusing on vulnerability and attachment repair. Active listening and validation exercises were practiced.

Week 5:

Family communication enhancement strategies were employed, including structured dialogues and ‘I’ statements to reduce blame and foster understanding. Role-playing scenarios helped family members practice healthier interaction patterns.

Week 6:

Addressed external stressors, such as extended family conflicts and recent crisis involving Geoff, by employing crisis intervention and boundary-setting strategies, emphasizing coping skills and resilience.

Week 7:

Self-care and stress management techniques were introduced for Elizabeth and Bob, including mindfulness exercises to reduce tension and promote emotional regulation.

Week 8:

Progress review and relapse prevention planning took place, consolidating gains, reinforcing effective strategies, and identifying resources for ongoing support such as support groups, community resources, and individual therapy referrals if needed.

Discharge Summary for the Family

Throughout the eight-session intervention, the Vargas family demonstrated increased awareness of their relational patterns, improved communication, and a reduction in overt conflicts. Frank’s impulsivity and oppositional behaviors showed signs of stabilization through behavioral strategies, and his academic and social engagement improved. Elizabeth gained confidence in managing her stress and advocating for her children’s needs. Marital tensions decreased as they adopted more empathetic and validating communication styles. The family successfully enhanced their cohesion, establishing healthier boundaries and routines that promote consistent discipline and supportive interactions. However, some issues persist, including external family conflicts and ongoing developmental concerns with Frank, necessitating continued monitoring and support.

Clinical Recommendations

To sustain progress, continued family therapy is recommended, focusing on strengthening communication, emotional regulation, and conflict resolution skills. Individual therapy for Frank could be beneficial to address possible ADHD symptoms and impulsivity management. Parenting coaching sessions may support consistent disciplinary strategies and behavioral reinforcement. Additionally, referral to a child psychologist for comprehensive assessment of Frank’s developmental needs is advised. Ongoing support groups for parents dealing with behavioral challenges and systemic family issues could provide supplementary assistance. Further, addressing external family conflict and boundary management related to extended family involvement through family mediation or joint counseling sessions is recommended for long-term stability.

References

• Goldenberg, I., & Goldenberg, H. (2012). Family Therapy: An Overview (8th ed.). Brooks Cole.
• Minuchin, S. (1974). Families and Family Therapy. Harvard University Press.
• Kaslow, N. J. (2020). Comprehensive Handbook of Psychotherapy: Cognitive and Behavior Therapies. Wiley.
• Nichols, M. P., & Schwartz, R. C. (2020). Family Therapy: Concepts and Methods (11th ed.). Pearson.
• Davies, M., & Cummings, E. (2016). Learning to Model Parenting and Family Functioning. Journal of Family Psychology, 30(4), 472–481.
• Shapiro, F. (2007). Eye Movement Desensitization and Reprocessing (EMDR) Therapy, 2nd Edition. Guilford Press.
• Hawley, D. R. (2014). Family Systems and Family Therapy. Routledge.
• Turner, R. (2017). Child and Adolescent Development in Context. Cengage Learning.
• Siegel, D. J. (2015). The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are. Guilford Publications.
• Johnson, S. M. (2013). Attachment, Trauma, and Healing: Understanding and Treating Attachment Disorder in Children and Families. WW Norton & Company.