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{"id":81959,"date":"2023-05-18T22:57:20","date_gmt":"2023-05-18T22:57:20","guid":{"rendered":"https:\/\/nursingwritersbureau.com\/?p=81959"},"modified":"2023-05-18T22:57:20","modified_gmt":"2023-05-18T22:57:20","slug":"psychology-vargas-family-case-study-eighth-session","status":"publish","type":"post","link":"https:\/\/nursingwritersbureau.com\/psychology-vargas-family-case-study-eighth-session\/","title":{"rendered":"Psychology Vargas Family Case Study: Eighth Session"},"content":{"rendered":"Read the entire “Vargas Family Case Study” (all eight sections). Consider the progress (or lack thereof) over the past eight sessions. Using the “Discharge Summary Outline” template; include the following in your outline:A brief summary of what was going on with the familyA review of the initial treatment goalsTheories and interventions usedA brief discharge summary for the family treatmentClinical recommendations for sustained improvement or referrals for additional servicesWhile APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.This assignment uses a scoring guide. Please review the scoring guide prior to beginning the assignment to become familiar with the expectations for successful completion.Attached is an outline that needs to be followed.Bob and Elizabeth Vargas have been married for 10 years. They have two children, Frank (8) and Heidi (6). Bob teaches high school PE and coaches football, wrestling, and baseball. Elizabeth recently quit her job where she was an attorney in a law firm that specializes in Family Law. She enjoyed her work, had a passion for adoption cases, but decided to stay home for a few years while the kids were young. Elizabeth believes that Frank might have ADHD. She complains that he cannot sit still, does not listen, is forgetful, and is always getting hurt. She believes that much of these injuries are due to Frank\u2019s impulsivity. Elizabeth suggests you talk to Frank\u2019s teachers who have noticed that he has trouble waiting his turn, will often blurt out answers without raising his hand, and frequently loses things. Elizabeth acknowledges that Frank has always been an active child, but believes these behaviors, including picking on his little sister, are getting worse. Bob seems to be amused by these anecdotes and accuses Elizabeth of \u201coverreacting,\u201d stating that, \u201cBoys will be boys.\u201d Bob suggests you talk to his parents, both retired teachers, who agree with him and don\u2019t think there\u2019s anything wrong with Frankie. You notice Heidi sitting close to Elizabeth, playing on her mother\u2019s cell phone. She glances up occasionally when her brother approaches, but is otherwise engrossed with the game. Frankie began the meeting sitting between his parents, but noticed Legos in the corner and was immediately attracted to them. He interrupts several times to share stories about his teacher, classmates, and his grandparents, despite numerous reprimands from his mother. After a few minutes, Frank asks to use his Dad\u2019s phone (in a hurry, Bob had left it in the car), wanders around the office, looks out the window and comments on a squirrel, then grabs the phone from his sister who, of course, protests. After Elizabeth had quieted the commotion, you question any recent changes. Bob and Elizabeth both acknowledge an increase in marital tension and admit to having several arguments a week, some in front of the children. Bob blames Elizabeth for being \u201ctoo high-strung\u201d and says she just needs to relax. Elizabeth says she is unable to relax, fearing Frankie will end up damaging things or hurting himself or Heidi. She says that if Frankie would be able to control his behaviors, their marriage would improve dramatically. This, they report, is the reason for seeking therapy for Frankie.Vargas Case Study: Topic 2Elizabeth arrives on time with Frank and Heidi for the second session. Elizabeth appears somewhat frazzled and tells you that she had just heard from Bob who said he would be \u201ca little late\u201d because he \u201clost track of time.\u201d You note Elizabeth\u2019s frustration, which she confirms by saying this is \u201ctypical.\u201d She proceeds to share that she feels \u201ccompletely disregarded,\u201d especially after having shared with Bob the night before how important these sessions are to her. You notice that Heidi seems upset as well and looks as if she has been crying. You ask her how her day is going and she tearfully tells you that Frankie tore up her school paper with the gold star on it. Elizabeth elaborates that Frank had become angry and ripped up the picture that Heidi was proudly sharing with her. Frank, who had gone directly to the Legos, appears oblivious to the others in the room. When you ask him about his sister\u2019s sadness, he replies, \u201cWho cares? She always gets gold stars!\u201dAs you were about to further explore these feelings, Bob arrives stating, \u201cShe probably told you I\u2019m always late, but hey, at least I\u2019m consistent.\u201d You notice Elizabeth\u2019s eye rolling and direct your attention to the children, asking them about what brought them to your office. Heidi says, \u201cI\u2019m good but Frankie\u2019s bad at school, and it makes Mommy and Daddy fight.\u201d Frank, who had helped himself to one of your books to use as a car ramp argues, \u201cI hate school. It\u2019s boring and my teacher is mean.\u201d Bob attributes Frank\u2019s boredom to being \u201ctoo smart for the second grade\u2026what do they expect?\u201d Elizabeth responds that they, like her, expect him to follow rules and be respectful, and suggests that Bob should share those same expectations. Bob dismisses Elizabeth\u2019s concerns by saying, \u201cHe\u2019s a normal boy, not like all your friends from work who you say are \u2018creative.\u2019\u201dYou notice Elizabeth\u2019s reaction and decide to redirect your attention to Frank. You ask him what bothers him most about school, to which he replies, \u201cI get in trouble, then I don\u2019t get to have all the recess time, then I can\u2019t play soccer because they already started and they won\u2019t let me play.\u201d You notice Frank\u2019s interest in sports and probe for more information. You learn that he is quite athletic and has been asked to join a competitive youth soccer team that plays on Saturdays and Sundays. You discover another source of discord when Elizabeth shares that Bob \u201cfeels strongly\u201d that Sundays are to be spent only at church and with family. Bob confirms that after church on Sundays, they spend the rest of the day with his parents, siblings, nieces, and nephews. Elizabeth says that Sunday mornings are the only time she gets to be by herself and that she typically joins the family around 1:00 p.m. Bob adds, \u201cApparently Liz needs time to herself more than she needs God and her family,\u201d and suggests she should appreciate his family more because \u201cit\u2019s the only family she has.\u201dAs the session comes to a close, you share your observations of the family by noting their common goal of wanting to enjoy family time together. You also suggest that while Frank\u2019s behavior challenges are troubling, perhaps you could focus next week on learning more about each parent\u2019s family of origin in hopes of gaining a better understanding of the couple\u2019s relationship.Vargas Case Study: Topic 3Bob and Elizabeth arrive together for the third session. As planned, you remind the couple that the goal of today\u2019s session is to gather information about their families of origin. Bob begins by telling you about his older sister, Katie, who is 36 and lives nearby with her three children. Katie\u2019s husband, Steve, died suddenly last year at the age of 40 when the car he was driving hit a block wall. Elizabeth speculates that Steve was intoxicated at the time, but Bob vehemently denies this allegation. He warns Elizabeth to \u201cnever again\u201d suggest alcohol was involved. You note Bob\u2019s strong response and learn that his own biological father, whom his mother divorced when Bob was three and Katie was five, had been an alcoholic. When asked about his father, Bob says, \u201cHis name is Tim, and I haven\u2019t seen him since the divorce.\u201d Bob shares that he only remembers frequently hiding under the bed with Katie to stay safe from his violent rages. He adds that 5 years after the divorce, his mother, Linda, married Noel who has been \u201cthe only dad I\u2019ve ever known.\u201d He insists that his sister married \u201ca devout Christian who never touched alcohol\u201d and attributed the 3:00 a.m. tragedy to fatigue. He adds that a few days before the accident, Katie had complained to him that her husband had been working many late nights and \u201cjust wasn\u2019t himself.\u201d Bob speaks fondly of his sister and confirms that they have always been \u201cvery close.\u201dFrom Elizabeth, who is 31 years old, you learn that she was adopted by her parents, Rita and Gary, who were in their late 40s at the time. They were first generation immigrants who had no family in the United States. Their biological daughter, Susan, had died 10 years earlier after Rita accidentally ran over the 5-year-old while backing out of the driveway. Elizabeth surmises that her mother never fully recovered from this traumatic incident and remained distant and withdrawn throughout Elizabeth\u2019s life. Elizabeth describes her father, Gary, as \u201ca hard worker, smart, and always serious.\u201d She shares that most of her family memories were of times spent with her dad in his study, surrounded by books. She states, \u201cHe could find the answer to all of my questions in one his many books.\u201d Elizabeth describes herself as the \u201cquiet, bookish type\u201d and attributes her love for books to her father. Like her father in his study, Elizabeth remembers spending most of her adolescence alone in her room, reading, so she would not upset her mother. Looking back, Elizabeth tells you she recognizes her mother\u2019s struggle with depression, \u201cbut as a kid, I thought it was me.\u201dYou comment on the vastly different childhood experiences and normalize the potential for relationship challenges under these circumstances. Acknowledging the differences, Elizabeth remarks that Bob\u2019s relationship with his family was one of the things that she was attracted to early in their relationship. Bob agrees with her and comments that Katie and Elizabeth are very close, \u201ceach being the sister neither one of them ever had.\u201dVargas Case Study: Topic 4The Vargas family arrives for the fourth session at separate times. You have been chatting with Elizabeth and Heidi about Frank\u2019s recent school suspension when Bob and Frank enter. They are having an animated conversation, laughing hysterically, and Heidi comments on how Frank is wearing socks, not the rain boots he left the house in. Bob and Frank proceed to share the story about how Frank\u2019s top scoop of ice cream just fell into his boot when Elizabeth interrupts. She questions Bob and appears surprised to learn that instead of going to work with Bob who had agreed to \u201cput him to work\u201d as a consequence of his suspension, the two of them had spent the day having fun. Frank talks about his new bike and had begun a story about the movie they saw when he looks at his dad and instantly stops talking. You notice Bob\u2019s stern look when Frank apologizes stating, \u201cI forgot I\u2019m not supposed to tell.\u201dThe tense silence is broken by Heidi who begins to tell her parents that she got another gold star on her spelling test, the teacher picked her to be the helper, she scored two soccer goals at recess, and made three new friends. You notice that Frank has squeezed into the same chair next to Bob; Heidi scoots closer to her mother on the couch. You note Elizabeth\u2019s distress and invite Bob to comment. Bob minimizes the incident that resulted in Frank\u2019s suspension and accuses Elizabeth of \u201coverreacting.\u201d Frank agrees that \u201cMom always gets mad\u201d and begins recounting the \u201cfunny\u201d incident that was, according to him and Bob, \u201cno big deal.\u201dVargas Case Study: Topic 5The Vargas family arrives to their fifth session together and on time. As a follow-up to the last session\u2019s focus on the family structure, you decide to consider a strategic approach this week. To check in, you invite them to share any feedback from last week\u2019s session. Bob reports that he apologized to Elizabeth for \u201cmishandling the suspension thing\u201d then complains that Elizabeth is still \u201cholding a grudge.\u201d He admits that he often does not understand why she gets so upset and that he wants her to be happy. Elizabeth acknowledges that the apology \u201cis a start\u201d and suggests that the reason Bob doesn\u2019t understand is that he \u201cdoesn\u2019t ever listen\u201d to her. Bob tells Elizabeth that he listens, but gets frustrated because he doesn\u2019t know how to \u201cfix it.\u201dYou notice Frank and Heidi sitting together, quietly looking at a book while their parents talk. You inquire about any noticeable changes made during the week. Both parents claim to have made an effort to avoid raising his\/her voice and report being pleased with their conduct. When asked about the children, Elizabeth reports noticing improvement. Bob, however, expresses frustration with Frank\u2019s constant need of redirection and numerous reminders to complete his chores. Bob also noted an increase in Heidi\u2019s demands for attention.Vargas Case Study: Topic SixThe Vargas family arrives five minutes late for their sixth session. Elizabeth apologizes for their tardiness and complains that they had come from an event hosted by her former employer and were having an argument in the parking lot. You notice the children appear somewhat disheveled with red cheeks and grass-stained clothing. They excitedly share stories of coming from a \u201cbig picnic\u201d where they \u201cplayed lots of games and made new friends.\u201d Frank tells you that he was playing Kick Ball and that his team was winning. Smiling and tousling Frank\u2019s hair, Bob adds that he and Frank were \u201can unstoppable force\u201d who dominated each event at the picnic. Bob and Frank were in the middle of a celebratory high-five when Heidi tells her dad that she wishes he would have been on her soccer team. While still engaged in the celebration with Frank, Bob replies, \u201cMe too; maybe next time.\u201dElizabeth states she was \u201cpleasantly surprised\u201d that Bob was enjoying himself, given his strong personal opinion of many of her friends, who are gay. Bob insists that the picnic was \u201cjust okay,\u201d and that he \u201cwas just trying to be nice.\u201d He tells you he doesn\u2019t have \u201canything against gays,\u201d but that \u201cthey just make me uncomfortable.\u201d Heidi reminds him that he agreed to have her new friend, Dani \u201cand her two daddies,\u201d over for a barbeque. You comment that the family\u2019s mood has changed from how they arrived. Frank explains that his mother got angry at him and admits to running away and hiding from his mother when she said it was time to leave the picnic. Elizabeth immediately denies being mad at him. You ask Frank what made him think his mother was mad, and he replied, \u201cHer eyes were squinty and she had a mean voice.\u201d When asked if his dad was also angry, Frank replies, \u201cHe saw me in my hiding place; he was smiling. Then in the car, he yelled at me to \u2018listen to your mother.\u2019\u201dElizabeth shot Bob an angry look when Heidi shares that she was having fun playing soccer and that she didn\u2019t want to leave either. She adds, \u201cI always listen because I don\u2019t want Mommy to be sad.\u201d She proceeds to blame her brother for \u201cmaking Mommy and Daddy fight\u201d to which Frank makes a counter-accusation, blaming Heidi for the parental discord. Elizabeth and Bob exchange angry looks, then Bob assures Heidi that, \u201cIt wasn\u2019t all your fault.\u201dVargas Case Study: Topic 7Since the last session, you received a call from Elizabeth who stated her family was in crisis. She reported that her nephew Geoff, the 15-year-old stepson of Bob\u2019s sister, Katie, had nearly overdosed. She said that the family had noticed some changes with Geoff since his father\u2019s recent death, but attributed the poor mood and slipping grades to the normal effects of grief. Elizabeth said that Geoff had never used drugs, as far as anybody in the family knew, and that the overdose was \u201ca total surprise.\u201d Elizabeth reported that after learning of this, Bob\u2019s mother, Linda, called the school counselor but complained to Katie that \u201cshe was not at all helpful,\u201d and told Katie exactly how she should handle it. Katie spoke with the school counselor who told her that she was not allowed to speak with Linda due to matters of confidentiality. Elizabeth informed you that Katie had shared her frustration with the school counselor\u2019s suggestions to help him \u201cget his mind off the sadness,\u201d and believed he needed more help. You learned that Bob\u2019s father, Tim, was trying his best to help, and that Elizabeth felt his intrusion was making matters worse. Among other things, Tim had taken Geoff out of school on a week-long camping trip against Katie\u2019s wishes. Elizabeth said that the involvement of Linda and Tim, despite their good intentions, had begun to cause widespread family strife and asked if you could possibly see the entire family.Vargas Case Study: Topic 8This session with the Vargas family includes Elizabeth, Bob, Frank, and Heidi. You begin by inviting Bob and Elizabeth to sit together on the couch and follow up on the events described to you in the phone call with Elizabeth You learn that there are ongoing concerns regarding Geoff\u2019s safety, as well as with maintaining boundaries with their extended family members. Elizabeth tells you that Bob \u201chad strong words\u201d with his parents, who were initially quite upset. Bob confirms this and states that despite the difficulty, \u201cthey need to butt out.\u201d You validate Bob\u2019s struggle and reframe this as bravery. You note the family\u2019s willingness to seek help as a significant strength. Bob expresses concern for his sister having recently lost her husband and nearly losing her son. He shares how unfortunate it is that something bad had to happen to help him realize how fortunate he is. Bob states that he admires his sister\u2019s strength, and becomes tearful as he tells Elizabeth that he cannot imagine what it would be like to lose her. He expresses belief that it would be \u201cimpossible\u201d for him to be a single parent and tells his wife that he realizes he has been taking her for granted. Elizabeth receives these words with quiet gratitude, providing comfort, being sensitive to Bob\u2019s vulnerability. Bob wipes his tears and apologizes for what he calls \u201cfalling apart.\u201d You notice Frank and Heidi settle in closer to their parents. Eventually, the therapeutic silence is broken when Frank hands his dad a tissue and says, \u201cIt\u2019s okay for boys to cry. Mom says so.\u201d<\/p>\n \n
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