Grand Canyon University: PCN-521
PCN-521 Module 8:Vargas Case Study Discharge Summary Outline
Directions: Review the Vargas Family Case study again in its entirety. Consider the progress over the past eight sessions. Complete the sections outline below as your discharge summary for the Vargas family.
A brief summary of what was going on with the family at the onset of counseling:
The Vargas family is having family issues, which are attributed to Frank who is their son. Frank has been involved in several issues in school and with his mother due to his hyperactivity and inattentiveness behaviors. His mother is concerned about his behavior and even assumes that Frank might have ADHD. However, his father says that Frank is okay and normal. This has caused problems between Bob and Elizabeth due to the different perspectives about their son’s behavior. Frank has also problems with his teachers but still his father does not think that Frank has a problem. Heidi who is Frank’s sister is close to her mother, as she feels neglected by her father who spends most of the time with Frank. Frank and Heidi have also issues with each other with Frank most of the times harassing Heidi and down looking her achievements in school where she receives regular gold stars.
A review of the initial treatment goals:
The initial treatment goals were to address Frank’s behavior, which were attributed to the marital problems between Bob and Elizabeth (Goldenberg & Goldenberg, 2013). Frank could not be attentive and listen to instructions of his teachers as well as his mother. This led to Frank having several altercations with his teachers in school. Frank would blurt out answers without waiting his turn and is always getting hurt. Due to these symptoms and behavior changes, his mother thought that Frank has ADHD but did not get support from her husband Bob who says that Frank is a normal boy. The second treatment goal was to address the marital issues, which Bob and Elizabeth are having due to Frank’s behaviors (Goldenberg ; Goldenberg, 2013).
Theories and interventions used
In the first week, the counselor applied the psychodynamic approach, which involved meeting the Vargas family to determine what problems had led the family to seek counseling services (Escudero ; Friedlander, 2017). This theory is based on the assumption that most of the issues are caused by the unconscious mind of the client, as is the case in the Vargas family (Escudero ; Friedlander, 2017). This theory was applied in the Vargas family to build an alliance with the family, which is important to help the family as well as the counselor to determine the underlying issues (Escudero ; Friedlander, 2017). This will also bring the family together in identifying a solution to the current problems faced by the family and set what goals they need to achieve at the end of the counseling process (Escudero ; Friedlander, 2017).
In the second session, it is evident that the Vargas family is experiencing certain problems, which involve Frank’s behavior change, which has caused other problems in school and between Bob and Elizabeth. The psychoanalytic theory is used to determine how the problems are maintained (Wegman, 2014). This theory is based on the assumption that individuals have unconscious thoughts, which affect the behavior of the individuals. The theory aims at transferring these thoughts to the conscious mind where an individual can be able to address these thoughts, which may be negative thoughts affecting the behavior of the individual (Wegman, 2014).
In this session, the cognitive behavioral theory was implemented to provide interventions to help in determining the relationship between thoughts and behaviors (Wegman, 2014). Information collected using this approach was used to develop new behaviors. Experiments were done to test the client’s thoughts, which included testing Frank’s thoughts and why he is behaving in a certain manner (Wegman, 2014). Any deficit in skills was addressed through skills training to improve how the clients adopted to new behaviors. The counselor in the implementation of this intervention helped he Vargas family members to understand their thoughts and feelings and how to change destructive or negative thoughts into positive thoughts (Wegman, 2014).
In this session, the counselor used the family genogram, which was used to bring a deep insight on the family backgrounds and the family relationships (Goldenberg & Goldenberg, 2013). This is important in enabling a counselor to make informed decisions as the Vargas family genogram indicated the emotional and biological relationships between the members of the family (Goldenberg & Goldenberg, 2013). Medical history information was also provided by the family genogram as well as any individual behaviors. Past family issues are also identified through this tool (Goldenberg & Goldenberg, 2013). This information helps a counselor in making accurate diagnosis as well as treatment plans, which is important in providing effective interventions to address the underlying family issues (Goldenberg & Goldenberg, 2013).
In this session, the counselor used structural family therapy to understand the functioning of the family (Charura & Paul, 2014). The structural family therapy is an intervention, which is used in counseling to understand the patterns of family interactions and the problems, which are as a result of these interactions (Charura & Paul, 2014). This intervention is based on the fact that changing the family structure is the first step in addressing family issues instead of focusing on a single individual. This is applied by improving communications and interactions between family members and creating healthy family boundaries, which are essential in restoring peace and unity in a family setting (Charura & Paul, 2014).
In this session, the counselor used experimental interventions to address the Vargas family problems. During this time, the counselor has already determined the emotional issues affecting the Vargas family (Thompson et al., 2011). The three experimental interventions include the play therapy, which is important in helping clients to express their emotional issues and bring about a positive change in the Vargas family (Thompson et al., 2011). This intervention is also important in improving communication in the Vargas family, which is an issue affecting the family and has contributed to the development of the issues faced by the Vargas family (Thompson et al., 2011).
The second intervention is the adventure therapy, which is meant to help the Vargas family in developing problem-solving skills, which will help them in addressing future problems (Thompson et al., 2011). The counselor will conduct group assessment on how the family members support each other and implement strategies as a family. The third intervention is expressive therapy which is an intervention meant to encourage the Vargas family members to express their feelings and emotions by using creative art (Thompson et al., 2011). This intervention will help the Vargas family in expressing their feelings and emotions without fear, which will lead to the family to address any negative issues immediately (Thompson et al., 2011).
In this session, the counselor applied the Solution-Focused Brief Therapy to identify a solution to specific presenting problems. This therapy involves the client in the counseling process, which enables the counselor to make accurate and suitable decisions to fit the client (Metcalf, 2017). The counselor engaged the Vargas family during the counseling process where he/she was able to identify the issues facing the family and developed informed solutions to address the issues (Metcalf, 2017).
In this session, the counselor used narrative therapy to address the issues that the Vargas family is having due to Geoff’s drug overdose issue. This therapy approach focuses on being respectful to clients and not blaming clients for family problems (Metcalf, 2017). This model also believes that individuals have the ability and skills to address most of the issues, which affect them. Counselors use this approach by redirecting conversations to a positive direction (Metcalf, 2017). Due to the crisis affecting the Vargas family, it is important for the counselor to help the family and consider the different perspectives of the Vargas family members who are trying to help Geoff as well as Katie’s perspective. This will help the family members to understand each other and the different perspectives of the different individuals (Metcalf, 2017).
A brief discharge summary for the family treatment:
At the beginning of the counseling process, the Vargas family had sought interventions to address their son’s behavior change, which had led to the problems experienced by the family. However, as the counseling process continued, it was clear that there were other issues affecting the Vargas family, which had led to the problems between Bob and Elizabeth. Other members of the Vargas had also issues, which include the issue of Geoff, which led to a family crisis. This led to a change of the treatment goals to include the development of clear family boundaries and the creation of a support system. As the counseling process ended, it was clear that the Vargas family had improved their relationships and had become closer where they were able to help each other and express themselves freely.
Clinical recommendations for sustained improvement or referrals for additional services:
To maintain the achieved goals and encourage positive relationships in the Vargas family, one of the recommendations would include the implementation of the cognitive behavioral therapy, which is aimed at maintaining positive thoughts (Craske ; American Psychological Association, 2017). This approach is also useful in creating new positive behaviors which is important in helping the family members in adopting new healthy behaviors. This will enable Bob to support Elizabeth in addressing any negative behavior affecting their son as she feels that her efforts to help Frank are not appreciated by Bob (Craske ; American Psychological Association, 2017).
Charura, D., ; Paul, S. (2014). The therapeutic relationship handbook: Theory and practice. Maidenhead: McGraw Hill Education/Open University Press.
Craske, M. G., ; American Psychological Association. (2017). Cognitive-behavioral therapy. Washington, DC: American Psychological Association.
Escudero, V., ; Friedlander, M. L. (2017). Therapeutic alliances with families: Empowering clients in challenging cases. Cham, Switzerland: Springer Verlag.
Goldenberg, I., ; Goldenberg, H. (2013). Family therapy: An overview. Belmont, CA: Brooks/Cole, Cengage Learning.
Metcalf, L. (2017). Solution Focused Narrative Therapy. New York: Springer Publishing Company.
Thompson, S., Bender, K., Cardoso, B., ; Flynn, P. (2011). Experiential activities in family therapy: perceptions of caregivers and youth. Journal of Child and Family Studies, 20 (5), 560
Wegman, C. (2014). Psychoanalysis and Cognitive Psychology: A Formalization of Freud’s Earliest Theory. Saint Louis: Elsevier Science.