Inside Out: A Systemic Assessment of Family and Child

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Inside Out: A Systemic Assessment of a Family and Child

Do you wonder the way our minds deal with emotions? It is often perceived that people develop a connection memory and emotion when unconscious. Therefore, the attentiveness and attunement of others is important in the structure and wiring of our brains. The brain as an organ develops on the structure and interactions we have with others, moreover, it is considered as a social organ. This means that our memories and emotions are a collection of different parenting styles and skills, genetics, and relationships (Carr, 2009).

To understand the functioning of the human brain, the development stages, abuse, emotional regulation, stress and impacts of early trauma, neuroscience has taken the lead. Infants need connections with their caregivers early in order to organize the functions of their brains and for proper and effective development. This essay is focused on exploring how young children are impacted by risk factors, different parenting styles and the impact a therapist has when working with families that have young children.

Inside out, the film chosen in this essay explores the life of Riley, an 11-year-old girl who had to migrate due to her father’s new job from Minnesota to San Francisco in California. From the movie, we see how different types of emotions are stored by the mind to develop memories; moreover, we see the relationship between emotions to memory. Riley is attached to memories like fear, anger, disgust and sadness; moreover, she had trouble regulating her emotions since moving to San Francisco. A child is often influenced when the family moves to a new location especially when the child had lived in a stable environment for long (Carr, 2018). For the past 11 years, Riley had lived in a stable environment; however, the move brings obstacles and challenges considering she struggles to regain stability.

The family is seeking counselling services for the daughter considering she has been angry, not been herself since migrating, and withdrawn. The family consists of Rick who is 39, Rhonda 35 and Riley who is 11 years; moreover, it is a Caucasian family. Rhonda admits that Riley has not been the fun girl she was in Minnesota, furthermore, she has been giving her parents short responses and has been having angry outbursts. Rhonda also states that Riley had energy and was happy about moving at first, but all this changed once they moved. On the other hand, Rick admits that he has been away at work especially at night due to his new position, moreover, he barely spends time with his family. Rhonda claims that she has been busy around the house and does not pay attention to Riley. The only source of income the family has comes from Ricky considering that Rhonda is a stay at home mother. Rhonda has tried making friends through doing things she loves like hockey. Riley used to ice skate and play hockey in Minnesota; however, she has not managed to do those activities in California the way she did with friends and family.

Developmental Issues and Risk Factors

Everyone in the community has a family they belong; therefore, the structure of family will shape their development either healthy or unhealthy. The four parenting styles include the authoritarian, authoritative, neglecting-uninvolved, and permissive. These parenting styles can be the underlining factor considering they are different. Moreover, there are also two types of families, which are the extended and the nuclear. In an extended family, the father, mother and children live together with other relatives while the nuclear consists of the father, mother and children. Both healthy and unhealthy developments can occur given these types of families and parenting systems.

In Riley’s family system, it can be concluded that she is in the middle childhood phase where friendship is important for development. Riley needs friends to fill the vacuum of lacking siblings considering she is an only child. Moreover, the attachment developed between parents and children is essential for social development since the attachment is vital for the development of adolescents. Attachment also helps in social development. Riley’s parents are trying to teach her open communication and boost her confidence by encouraging her to explore her new community hence build friendships. Making friendship would benefit her considering she would not keep to herself and will reduce stress.

The Anderson family is facing the challenge of culture change by moving to San Francisco. Negative risk factors can lead to unhealthy family system. Among the risk factors include abuse, disorganized culture, neglect, poverty, the absence of parents and harsh discipline. Risk factors can break up a family hence causing negative outcomes on children. The development of a family can be affected by these risk factors; moreover, a child’s development and the skills needed may be hampered. The risk of new environment affects Riley and her family considering she is in middle childhood. On the other hand, she knows her parents are worried due to her recent attitude. Riley misses the attention she had in Minnesota from her best friend Meg and her family who are also faced with the challenge of new environment. Riley does not know how to act on her new feelings of rejection and is not able to voice her sentiments. Movement of a family affects the behavior of a child (O'Brien, 2012). Furthermore, if she feels her parents are stressed, then it can affect her feelings too. The inability to understand the move could make Riley unsure of how to regulate her mood. These feelings make her confused and does not know how to act.

Assessment Tools

The most important way of collecting information about a person and his family is through assessment and counselling. These tools aid in exploring the family background, their history, and importantly the patterns within the family. The use of genograms in family therapy aid in exploring the generational patterns that may have taken place. Every information must be gathered when looking at the family. Additional information must be created once a genogram is created in case it has relevance to the treatment. Information on Rick and Rhonda’s parents, the relationship they had, their experiences growing up, and the type of childhood they had growing up when creating a genogram (Firmin, 2017).

The genogram reveals that Rick’s parents valued hard work and work ethics while Rhonda’s parents had struggles in their marriage. Rhonda would keep to herself and had different outbursts and struggled with depression considering her parents struggled in marriage (Kazdin, Whitley & Marciano, 2006). Different parenting skills and types of attachments a family can have are shown in the genogram; moreover, it defined and showed generational parenting skills. The animal genogram is important in Riley’s situation as it will make her choose the animal that represents her family and she can also be playful with the genogram. This will help show her perspective and how she views the people related to her, additionally, she can explain why she has chosen the animal she chooses.

Ethical and Legal Requirements

It is essential that the therapist include counselor responsibilities, legal issues, client’s rights, and counselor competency. The 1.3 Multiple Relationships code must never be violated. Family therapists avoid exploiting dependency and trust of their client considering they are aware of their influence. When the therapist decides to help a family financially can be violation of the code. Therapists are not allowed to have any relationships with their clients apart from patient therapists or any type of help that is not within the practice is a violation. This follows as such help may turn the relationship into personal.

Practicing in accordance with the set ethical standards is vital to avoid any issues regarding malpractice, which may arise. Moreover, having any relations apart from the professional one is prohibited considering the patient may not take seriously the help being provided (Høglend, 2014). Judgment of a therapist reported of malpractice is often in line with the actions that the others within the profession may take. Probable comparison if often made when ethical standards are violated. Therefore, maintaining ethical standards in accordance to AAMFT code of ethics is important. Ethical standards guide every profession hence following these guidelines is key to the prosperity of the practice.

Impact of Therapist

Availability of the therapist is vital to build a rapport with the client so that they can administer proper help. A sense of trust is key when building a relationship between the family and the therapist. A healthy relationship between the family and the therapist shows the authenticity of the therapist. Moreover, therapists must keep their feelings from their conversations with the family or their clients to make sound judgment and administer required help. The personal feelings of the therapist must not affect the decision they make especially if they had similar experiences growing up. The therapist has a great impact on influencing the development of the family and that of Riley.

Conclusion

From the systemic assessment of Riley’s family, it is evident that Riley is in the middle-childhood development stage, which needs proper care and attention. Among the challenges Riley faces include adjustment to a new environment, trying to understand her emotions from the move hence is suffering and has stress dealing with facts of the movement. On the other hand, Riley’s parents Rick and Rhonda have shown concerns due to Riley’s behaviors and occasional outbursts. The behaviors Riley is displaying currently are as result of the generational background considering Rhonda had similar behaviors growing up. The therapist has the responsibility of trying to understand every member of the family, what they are experiencing and their reaction to the environment they have moved to from Minnesota. The therapist has a crucial role in ensuring the family transitions smoothly. Moreover, the therapist will help Riley develop well despite of the migration challenges and the confusion. The therapist observing the codes of ethics set by the AAMFT is vital as it will ensure the family gets the necessary help.

References

Carr, A. (2009). The effectiveness of family therapy and systemic interventions for child-focused problems. Journal of Family Therapy, 31(1), 3-45. doi: 10.1111/j.1467-6427.2008.00451.x

Carr, A. (2018). Family therapy and systemic interventions for child-focused problems: the current evidence base. Journal of Family Therapy. doi: 10.1111/1467-6427.12226

Firmin, C. (2017). Contextualizing case reviews: A methodology for developing systemic safeguarding practices. Child & Family Social Work, 23(1), 45-52. doi: 10.1111/cfs.12382

Høglend, P. (2014). Exploration of the Patient-Therapist Relationship in Psychotherapy. American Journal of Psychiatry, 171(10), 1056-1066. doi: 10.1176/appi.ajp.2014.14010121

Kazdin, A., Whitley, M., & Marciano, P. (2006). Child-therapist and parent-therapist alliance and therapeutic change in the treatment of children referred for oppositional, aggressive, and antisocial behavior. Journal of Child Psychology and Psychiatry, 47(5), 436-445. doi: 10.1111/j.1469-7610.2005.01475.x

O'Brien, V. (2012). Responding to the call: a conceptual model for kinship care assessment. Child & Family Social Work, 19(3), 355-366. doi: 10.1111/cfs.12025

Systemic Diagnosis and Intervention Application

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Introduction

In this assignment, a short summary of the previous research will be provided. In an effort to understand the interactions between the family members, the essay will explore the interactional patterns. Moreover, the essay will explore the development of the lifespan as a family and the family's development stages. In accordance with the DSM-5, the essay will provide a diagnosis and explanations regarding the diagnosis will follow. Specific interventions and goals, which need implementing will be identified using the narrative approach, furthermore, they will be implemented in line with the legal approach that may affect the family counsellor. Finally, the essay will give a clear description of family dynamics and the various underlying factors that contribute to the challenges affecting the family using a concise genogram. The genogram is effective in portraying the family line and the possible challenges.

Brief Summary of Assessed Risk Factors

From the movie “Inside Out”, the focus is solely on the Riley who is the main actor and the various challenges she faced due to her family moving to a new location. In the movie, it is clear that some of the emotions Riley struggled include Fear, Disgust, Anger, Sadness, and Joy, moreover, she had a hard time managing her emotions. The problem from the movie was due to her inability to adapt to the new environment. Additionally, she found it difficult to openly express herself to her parents. The imbalance in emotions caused her to have patterns of dysfunctional communication. Riley never wanted to participate in any activity and inability to adapt to her new environment, which are clear signs of lacking social connectedness. The behaviors portrayed by Riley have resulted in a great imbalance within the family daily activities. The fact that Riley is in the adolescence stage presents some physical factors considering that at this phase; she is experiencing some emotional changes.

Family Transition throughout Developmental stages in Life Span

Riley's family is currently in the transformation phase of the development stage and having a daughter who is in adolescence often presents numerous challenges to the family. Families often have traditional and normal settings hence adolescents often exhibit behaviors, which may violate the settings within the family and community (Miccucci, 2009). Therefore, families that were previously functioning well may find it hard facing this stage considering the stressors. In the scenario, this is clearly the issue presenting a challenge. The career change of Riley's father catapulted the move. Moreover, there were also signs of family discord during the big move. Furthermore, children who transition to the adolescent stage may also cause stress to the parents in an effort to resolve the changes caused. Therefore, the therapist has a responsibility of acknowledging that each member of the family may be experiencing something different hence formulate a strategy of helping them.

Key Aspects of Family Relationship

In an analysis of the family, it is clear that aspects such as supportiveness, warmth, responsive interaction between Riley and her parents are key in the family’s relationship. Aspects like a warm and supportive family may influence the children’s subjective assessment of life stressors. On the other hand, positive emotions are vital since they are internal resources meant to reduce the challenges the family faces. A good relationship between Riley and the family may act as barriers to the negative effects of stress.

There is other de-escalation of conflict techniques, which may prove essential in this scenario. Techniques that may help children regulate the negative effect in order to help resolve conflict such as parenting styles. From this film, it is clear that Riley's parents are trying to shield her from the negativity. The parents’ technique of shielding Riley from the negativity was making an effort to make things appear positive. They encouraged her to focus on the bright side of the situation. Despite the efforts made by the parents, Riley was clearly unable to regulate her emotions due to the move resulting in adjustment disorder.

DSM-5 Diagnosis

From the challenges Riley has presented in the movie, it would be proper to diagnose her with Acute Adjustment Disorder which is very common, however, there may be a great variance due to population function and the methods employed (Association, 2013). People may experience many symptoms of adjustment disorder hence having effects in their lives. In the event an individual has a hard time coping with sad events in life, adjustment disorder may portray symptoms including hopelessness, overwhelming feelings, and sadness. In the movie, Riley exhibits some of these symptoms, additionally, they are having a negative impact on her body, mind and emotions.

The Child Behavior Checklist/4-18 and 1991 Profile (CBCL/4-18) is one vital assessment tool that may be used in this scenario since it has a checklist consisting of 113-item behavior problems combining it with another checklist of seven-part social competency (Achenbach, 1980-1994). The assessment tool is efficient as it measures the emotions and behavioral problems of an adolescent. Furthermore, it is the responsibility of either the parents or the surrogate parents to complete the tool. The tool uses simple wording in the process of defining challenges faced by the parents. In some instances, the CBCL tool is hand scored. The CBCL/4-18 scores include: (a) three competence scales (Social, Activities, and School), (b) a total competence scale score, (c) the eight syndrome scales including: Attention Problems, Aggressive Behavior, Social Problems, Delinquent Behavior, Somatic Complaints, Problems regarding thoughts, Withdrawal, and Depression or anxiety, (d) Problem Internalizing scale score and Externalizing problems score, and (f) The total problem scale score (Achenbach, 1980-1994).

Narrative Theory as it informs Interventions and Treatment Goals

The best recommendation for Riley and her family during therapy would be the narrative approach since her diagnosis is the acute adjustment disorder. The narrative models are vital considering that they help the patient by drawing out their strengths. In this type of therapy, the person's problems are separated from them hence examining and evaluating the problem based on how they evaluate themselves (Gehart, 2014). Moreover, the in the narrative approach, the person is made to acknowledge that the problem is not part of them or their lives hence they have the capability of overcoming the challenge. The approach helps considering that once someone changes their perception; they have the capability of writing positive outcomes that help the family.

The therapist may consider using an intervention that maps the problem's influence. In mapping the influence, the role of the therapist is to ensure they collect adequate information including how the problem affects the client's life and the people around them, and the thought line of the client towards the problem. Additionally, the therapist ensures the patient does not feel worse by mapping a person's influence (Gehart, 2014). The therapist should ask Riley questions to know her perception regarding the problem and the current situation. This would help Riley, to understand and explore the influence of the challenge she is currently facing, moreover, it will help encourage her that she is capable of overcoming it. The narrative approach would help Riley learn about the alternative stories and her views regarding her life. The therapist has a role of encouraging Riley, and that she is the master of her own destiny. The therapist would also help Riley form another narrative regarding her life. The narrative Riley needs to form is that of positivity.

Effectiveness Research on Narrative Approach

Narrative therapy focuses on restoration (Shapiro, 2015). In this process, the therapist guides clients on how they construct meanings to their lives (Shapiro, 2015). Moreover, the approach there is no adherence to specific notations and predefined goals (Guise, 2015; Gurman, Lebow, & Snyder, 2015). The narrative approach believes that clients are the masters of their own stories (Gurman, Lebow, & Snyder, 2015). The approach creates preferred realities that enhance new behaviors, self-concept and outcomes (Shapiro, 2015). The approach aims to disrupt the patterns of dysfunction in relationships. In the movie, the move poses dysfunction within the family hence the approach disrupts the patterns exhibited. Riley will be in a position to identify problems and explore the unique outcomes. This approach is very effective and led to improved outcomes in the family relationship (Carr, 2009).

Ethical and Legal Considerations

There are ethical and legal considerations that have to be followed when working with a family, moreover, Riley is a minor. It is the responsibility of the therapist to ensure that Riley understands the types of limitations and confidentiality and the consent document, additionally, she must know that the information regarding their discussions must be made known to the parents. The therapist must ensure that he/ she remain competent to avoid any implications that may arise due to incompetence. In regards to the law, the therapist must know that laws are above the ethical codes. Additionally, in certain domains, the laws will differ. Therapists have the mandate of ensuring they are well versed with the laws regarding their practice hence respond to any questions that may arise to ensure they protect the child’s interest (Firmin, 2017).

Conclusion

In conclusion, the findings from the previous assignment have proven vital in the current assessment. The diagnosis of Riley found that she had the adjustment disorder; furthermore, the assessment met the DSM-5 guidelines. From the assessment, it was concluded that the best model to help both Riley and the family was the narrative therapy considering the developmental stage the family is currently. The family has faced numerous challenges due to the move; furthermore, every member of the family experienced a different challenge. The narrative model also evaluated Riley's development stage in life and discovered that she was an adolescent phase of life. The intervention would help Riley and her family to discuss unique goals to be achieved and the various interventions available. The model follows both ethical and legal considerations regarding the treatment of Riley, considering that cases of incompetence often arise. Therefore, the narrative approach is essential since its practicality would prove beneficial for both the family and Riley.

Genogram

Disgust

Joy

Fear

Sadness

Anger

Riley

Dad

Mom

Key:

Female Married Emotional Connection Family

References

Achenbach, T. M. (1980-1994). Child Behavior Checklist. Mental Measurements Yearbook with Tests in Print, 1-5. Retrieved from http://web.a.ebscohost.com.library.capella.edu/ehost/detail/detail?sid=551f13f3-fd3b-47cd-b2cb-cd94d6be5a8c%40sessionmgr4008&vid=0&hid=4206&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#AN=test.1884&db=mmt

Association, A. P. (2013). Diagnostic and Statistical Manual of Mental Disorders (5 ed.). Arlington: American Psychiatric Association.

Carr, A. (2009). The effectiveness of family therapy and systemic interventions for child-focused problems. Journal Of Family Therapy, 31(1), 3-45. doi: 10.1111/j.1467-6427.2008.00451.x

Firmin, C. (2017). Contextualizing case reviews: A methodology for developing systemic safeguarding practices. Child & Family Social Work, 23(1), 45-52. doi: 10.1111/cfs.12382

Gehart, D. (2014). Mastering Competencies in Family Therapy A Practical Approach To Theories and Clinical Case Documentation. Belmont: Brooks/Cole.

Miccucci, J. A. (2009). The Adolescent in Family Therapy (2 ed.). New York, New York: The Guilford Press.

Identify the developmental issues and analyze the risk factors for the child including a discussion of family and community resilience. Include your reflections on the case family and what you have learned for your own practice. The assignment requires the demonstration of a systemic approach to counseling a child. Using the film “INSIDE OUT”

Project Objectives

· Describe best practices for systemic assessment and diagnosis.

· Apply systemic assessment tools that are multicultural and developmentally appropriate.

· Develop a diagnosis based on relational observations using best practices in systemic assessment.

· Design a developmentally appropriate systemic intervention.

· Apply systemic interventions appropriately.

· Demonstrate thinking, awareness, and behaviors consistent with the legal and ethical guidelines provided by the state of Maryland and by professional associations.

· Cover how your background would impact your work with this family.

· Your reflections on the case family and what you have learned for your own practice.

· Update your genogram (see attachment) and include in the paper. It will not be graded if submitted separate.

Assignment Requirements

0. Written Communication is thoughtful and free of errors that detract from the overall message.

0. APA style and formatting.

0. Minimum of six scholarly sources.

0. Length of paper: 6–8 typed double-spaced pages. Additionally, a title page and references page.

0. Font and font size: Times New Roman, 12 point.