FIU Week 3 Family Therapy Discussion

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Strategic Treatment Plan
Create a Strategic Family Treatment Plan utilizing the following case example:
A family was referred to the Parent and Child Development Center by Carin, Hannah
Holmes’ maternal Aunt, who is concerned that Hannah seems so withdrawn. Carin, who
is unable to drive, has never met Julia but recalls Jordyn and Jorge as nice children who
used to come to visit often. Carin says “maybe it is normal for Hannah to be so busy
with 3 kids now, but she calls less often and does not sound like herself when she does
call”. Hannah agreed to an initial visit by a Family Specialist Social Worker
Holmes Family:
Hiram – 45
Hannah – 44
Jorge – 5
Jordyn – 3
Julia – 18 mos.






The Holmes family live in a suburban neighborhood outside of Lexington, KY.
Hiram works approximately 50 hours a week as a mid-level executive at an
insurance company; Hannah was trained as a dental hygienist, but has stayed at
home since the birth of Jorge; finances are somewhat strained as they bought a
huge house 3 years ago and are now having trouble making house payments.
Contemplating trying to sell and move closer to Jorge’s job downtown.
Married for 12 years.
Not active in church, though starting to look for church home for kids (come from
different backgrounds – he Jewish, she Catholic – sometimes experience conflict
on faith traditions; looking for common ground for support; tried going to different
places, did not like what they have found so far after 4 different visits “We are
pretty discouraged” – looking for support on this topic)
The family of origin: Hiram’s family of origin – he was an only child; father died
from heart disease when he was 50, as did his grandfather at 48. Mother was
emotionally somewhat absent, often volunteering rather than spending time with
Hiram, Hiram largely raised himself. Little other family connections. Hannah
comes from a large family where she is the middle of 8 children (7 girls and 1
son) – brother was the youngest and is “spoiled”, but lives near Hannah and is
helpful to the Holmes around the house – fixes things. Hannah competes with
her sisters for her parent’s attention. She does not often tell her problems to her
family for fear she will sound “needy”. Hannah is very close to an Aunt who lives
in Nebraska – they talk on the phone several times a week.
Health – Hiram is about 50 pounds overweight and very worried about family
health history, but has “no time” to work out or take walks. Hannah walked every
day with a next door neighbor and the kids but the neighbor moved away last
year just after Julia was born. Hannah finds herself having a very hard time
losing the “baby weight” and reports that she often sits around watching TV
rather than walking or cleaning. Playing with the kids is getting harder for her to

do – “it takes too much energy”. She has felt this way since shortly after Julia
was born. She is still nursing Julia. She quit nursing Jorge and Jordyn when both
were 12 months old.
Children:
o Jorge: Active 5 year old – runs a lot, good on stairs, loves stacking blocks,
does not always take directions well. Listens very well to Hiram, but
recently has started defying Hannah. Seeks attention a lot – hides behind
mother’s legs when asked questions. Goes to preschool half-days
(afternoons) and will be in Kindergarten in the fall. Very bossy of Jordyn,
says little about Julia, has thrown blocks at Julia. Followed normal
development stages of walking and talking. Prescribed glasses at age 3.
o Jordyn: precocious 3-year old, very friendly to strangers – she sat on your
lap immediately – very attention seeking. Good motor skills and advanced
verbal skills – speaks very clearly. Brings everything to Hannah, even
before asked. Hiram describes her as a “little mother”. Caters to Julia.
Very caring. Followed normal developmental stages of walking and
talking. No major illnesses.
o Julia: 18 mo. old – not walking yet. Some crawling; poor coordination and
leg strength; shows little curiosity, babbles; can sit up without much help,
beginning to use her thumb to pick up objects, drops one object when
handed another, looks to Jordyn when she needs something, watches
Jorge a lot, but little communication. Very attached to Jordyn, not as much
to her mother or father. Father sometimes plays peekaboo, but she is not
interested unless he is touching her hands or arms, otherwise, she ignores
him. Has not been to the doctor since she was 9 months old.
Structural Discussion Forum
Discuss and review Structural Family Therapy. Which population or demographic do
you feel this type of treatment would work best and why? Would this type of treatment
be beneficial or work with diverse populations? Provide support with case examples (not
from the text).

https://courses.campbellsville.edu/mod/url/view.php?id=3142843
https://courses.campbellsville.edu/mod/url/view.php?id=3142844
Quick Guide to Goals, Objectives & Interventions
January 2013
Quick Guide
to Developing Goals, Objectives, and Interventions
I. Some considerations when developing goals
 Solicit the life-role goal statement at the very beginning of Individualized
Recovery Plan (IRP) Planning. This conversation should be informed by the
assessment process as well as your relationship and previous conversations with
the Personalized Recovery Oriented Services (PROS) participant.

Don’t be concerned about whether or not the goal is “realistic.” Identifying a goal is a
process that you and the person will work on together. Your conversation with the person
can focus on teasing out what the person would like to accomplish in his or her life.
 Goal setting is a collaborative process – it offers an important opportunity for you to partner
with people and motivate them in treatment and with their lives.
 Encourage the PROS participant to prioritize and identify just a few key goal areas on the
plan. Having too many goals may feel overwhelming to the person and may make the IRP
overly complicated and unwieldy.
 Some questions to ask if the person has “no” goals:
o
Steer the conversation to a discussion of the person’s strengths. Use
some of the strengths identified in the assessments as a place to begin.
o
Ask the person to visualize an “ideal day.” What would this look like?
What would the person be doing? Who would he or she be with?
o
Ask the person to imagine that all the challenges of today have
disappeared as if by magic. What would this be like? What would the
person be doing/feeling?
o
If a person focuses his or her goals on symptoms (“I want to feel less
depressed”), the conversation can explore topics such as “If you were
less depressed, what might you be doing? How would you spend your
time? How would life be different for you?”
1
Quick Guide to Goals, Objectives & Interventions
January 2013
Goal Statements: Traditional Treatment Plan vs Person Centered IRP
Kathy’s Goals in a
Traditional Treatment Plan
Kathy’s Goals in a
Person-Centered IRP
Patient will be med-compliant over next 3
months.
I want to have enough energy to focus on my
job. I don’t want to feel dopey all the time.
Patient will refrain from verbal and physical
aggression
I need to get along better with my co-workers.
My boss said I could lose my job if I don’t
figure this out.
Patient will increase insight regarding mental
illness and demonstrate realistic expectations.
I want to finish my General Education
Diploma (GED) but I’m not sure where to
start.
Patient will decrease denial of substance abuse
and achieve and maintain abstinence.
I don’t know how to cope with what I have
been through. I need to figure out other ways
of coping.
2
Quick Guide to Goals, Objectives & Interventions
January 2013
II. Guidelines for Objectives:
 Objectives are SMART:
o Simple or straightforward,
o Measurable,
o Achievable,
o Realistic,
o Time framed
 Objectives can be also be remembered via RUMBA:
o Realistic,
o Understandable,
o Measurable,
o Behavioral
o Attainable
WHAT?
ACTION
WORD
PERSON’S
NAME
Jane
+
Will
manage
anxiety
+
By using
the
coping
skill of
deep
breathing
HOW
MEASURED?
WHEN?
+
Once a
day in
response
to anxiety
for
6 months
+
As reported
by herself in
Wellness Self
Management
group
OBJECTIVE
=
3
Quick Guide to Goals, Objectives & Interventions
January 2013
III. Tips for Developing Interventions: Using the 5 W’s

Who is providing the intervention?
 Include the name of the person providing the intervention and his or her
relationship to the person

What is the modality that will be used?
 Group therapy? Individual therapy?

Where will the intervention be provided?
 Include the name of the PROS Service and the location where it will be provided

When will the intervention be provided?
 Include both the frequency and the duration of the intervention, i.e. weekly for
three months

Why is the intervention being provided?
 What is the purpose for providing the intervention? What mental health barrier is
being addressed?
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