Family Assessment Description Research Paper

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[. . .] "Health is the absence of incurable issues - such as physical, mental and emotional problems." Queried individually, each member agreed with this explanation. Seeking further clarification, I asked Mrs. T to explain what they meant by 'incurable issues'. Her replay was "some physical ailments can be treated and cured such as ear infections that doctors treat with antibiotics. In other cases, such as HIV / AIDS - the sufferer is never able to overcome the disease and can only find a way to extend their life with the aid of medicine." She also stated that they believe cancer is not curable (personal communication, September 24, 2013); a misconception to be sure. It was interesting to note that the family also believed that health was the pursuit of behaviors that ensured maintenance through exercise and healthy eating. This insight was heartening; and I followed up the idea by asking the family to decide if they were healthy according to their own definition. Both parents responded with an immediate and resounding 'No'; after which they elaborated. Mr. T claimed he suffered from diabetes for the past half-decade; but this has not deterred him from continuing to make poor food choices. Mrs. T is a long time insulin-dependent diabetic and also fails to exercise; habits she has picked up since have children. Conversely, both children stated they were not very healthy either and suffered from similar diseases.

Health Issues from the Family's Past

I next asked the family to describe a previous health incident - only if they felt at ease sharing the information. Silence filled the air for a moment and then the daughter remarked that her mother had suffered a miscarriage. Mrs. T provided further information on the subject; explaining she had experienced 3 miscarriages in a row - one was a set of twins -- and hence she was now suffering from Adenocarcinoma ovaries and uterus. Sadness crossed the faces of the whole family; and a somber silence ensured. After a respectful amount of time had passed I asked how the family had handled this series of devastating events. Mr. T replied that it was incomparable as a thing of pain for both adults and Mrs. T interjected that only "through the grace of God and family and church support were they able to get through the experience" (personal communication, September 13, 2013).

The family continued to open about the miscarriages and how they had affected the family. Mrs. T related that her mother came to stay with the family for a while to help tend to the upkeep of the house and child. Too, the family could not help but question the will of God to allow for such devastation. The extended family and church worked hard to keep them uplifted; and Mrs. T actually sought grief counseling to deal with the pain. She stated that "nothing could replace the love she and her husband held for both children (such a poignant thought) but when our youngest was born I put my grief aside to revel in the joy of the birth; I had a reason to smile again." She sagely added that "life is full of disappointments and people must learn to work through the pain to find joy again." Then the family reemphasized the importance of prayer and faith in their lives as a coping strategy; and family affection and support also helped. Again, Mrs. T noted that grief counselors helped her get through this dark period and the family 'came out on the other side' whole and happy.

The Current Health Issues of the Family

The T. family iterated their current health concerns included diabetes - both parents and children have diabetes steadily for the past decade; unhealthy eating is a second problem - their salt intake is much too high. Too, hypertension is a long-standing problem and Mrs. T admits she tends to over season foods with salt when she cooks. Mr. T has had a long standing problem with diabetes; at this point I stopped the interview to take his blood sugar pressure. His random blood sugar was at 245.

Yet another problem plaguing the members of the family is their decided lack of exercise. Both parents admit they rarely engage in any physical fitness activities and as a result they often feel sluggish. Too, it has led to weight gain in both adults and obesity in the daughter. Also, the father's work schedule has led to insomnia issues and he claims he rarely gets enough sleep. The children jumped in at this point mentioning that weight was a family issue. I then asked then to collaboratively identify what they would prioritize as a health issue and they unanimously that diabetes was at the top of the list (personal communication, September 24, 2013).

There is no denying that the entirety of the T. family's health issues are all pressing; according to my assessment diabetes is the most damaging and, therefore, takes priority. After all, each adult has been a decade long diabetic; each claiming they do so to help deal with the stress in their life. Additionally, Mr. T has a family history of hypertension; and it is my hypothesis that there is a direct correlation to this condition and his excessive intske of unhealthy or sweetened food. It was easy to show the family this connection using the sugar stats I had collected on the father. I also showed them some of the clinical proof that diabetes causes a variety of health problems including heart and vascular issues, circulatory problems, organ damage and much more. As I iterated these problems I became more convinced than ever that diabetes truly was the greatest risk factor to the T. family's health as a whole. As if to confirm my assessment; Mrs. T chimed in that of late she has been having trouble catching her breath and was suffering from excessive fatigue - all of which she attributed to her sugar levels.

Adults are inclined to ignore the fact that their eating habits adversely affects the mental health of their children who themselves may suffer from anxiety over worrying about the health of their parents - as today's kids are much more health savvy than in previous generations. Realizing this, only underscored my decision to address diabete as the first issue to tackle. Even a brief visual assessment led me to recognize that both adults appeared much older than their age would belie; and both were overweight as well with the majority of their excess fat settled in their abdomens. The son was not overweight, however, and also showed no other obvious signs of unhealthiness and the daughter was obese. Ultimately, my assessment and that of the family's were identical - we all believed that diabetes was the most urgent health issue that needed to be addressed.

Gordon's Functional Patterns

Formulation

Thus began the process of creating a step-by-step process for helping the adults address the issue of diabetes. Both parents eagerly stated they would like to quit desserts and sweetened foods within a two-month time frame; which would take them into the New Year as healthy eaters. I introduced the SMART goal criteria at this point and assisted them in its use as they created this first aim which read "By January 1, 2014 our intent is to have completely withdrawn from the intake of desserts. We will meet this goal by reducing the number of sweetened foods we eat one per week for 15 weeks. At the end of this time period we will have completed reducing our daily intake of sweetened food."

The parents then turned to the children to help them create a health goal and set up the framework to meet it. For the daughter the goal was to "reach a point where she has completed fifteen hours of exercise using the video game called Just Dance 2. They agreed to do this for half an hour each day - over a thirty day period."

This stage of the assessment required that I draw on verbal therapeutic communication skills - specifically "Questioning" (Fortinash & Holiday Worret, 2008) such as when I asked Mr. T if he understood that the genogram confirmed a history of diabetes in the family and "in light of this and other heart issues; how does this frame your own approach to your health outcomes"? Mr. T seemed visibly uncomfortable with the question; breaking eye contact with me. It was apparent that the directness of my question made him reflect on the state of his health - and realize it was essential for him to modify his behavior. At this point, though, I was a little upset with myself because I think perhaps I had gone a bit too far and was too personal and my questions may have been too invasive.

In the 'Working' phase of this assignment I incorporated the therapeutic verbal technique known as 'Assisting in goal… [END OF PREVIEW]

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