Assignment: Theoretical Systemic Case Conceptualization

Cross-Theoretical Systemic Case Conceptualization 3.0

For use with individual, couple, or family clients

Date:       Clinician:       Client/Case #:      

Introduction to Client & Significant Others

Identify significant persons in client’s relational/family life who will be mentioned in case conceptualization:

Adults/Parents: Select identifier/abbreviation for use in rest of case conceptualization

: Age:       Occupation:       Other:

: Age:       Occupation:       Other:

Children/Adult Children: Select identifier/abbreviation for use in rest of case conceptualization

: Age:      Grade: Other:

: Age:      Grade: Other:

: Age:      Grade: Other:

: Age:      Grade: Other:

Others: Identify all:

Presenting Concerns

Describe each significant person’s description of the problem:

:

:

:

:

Additional:

Broader System: Description of problem from extended family, referring party, school, legal system, etc.:

Extended Family:

Name:

Name:

Background Information

Trauma/Abuse History (recent and past):      

Substance Use/Abuse (current and past; self, family of origin, significant others):      

Precipitating Events (recent life changes, first symptoms, stressors, etc.):      

Related Historical Background (family history, related issues, previous counseling, medical/mental health history, etc.):      

Client/Family Strengths and Social Location

Strengths and Resources:

Personal:      

Relational/Social:      

Spiritual:      

Based on the client’s social location—age, gender race, ethnicity, sexual orientation, gender identity, social class, religion, geographic region, language, family configuration, abilities, etc.–identify potential resources and challenges:

Unique Resources:

Potential Challenges:

Family Structure

Family Life Cycle Stage (Check all that apply):

|_| Single Adult

|_| Committed Couple

|_| Family with Young Children

|_| Family with Adolescent Children

|_| Divorce

|_| Blended Family

|_| Launching Children

|_| Later Life

Describe struggles with mastering developmental tasks in one or more of these stages:

Boundaries with/between:

Primary couple |_| Enmeshed |_| Clear |_| Disengaged |_| NA Example:

& Children |_| Enmeshed |_| Clear |_| Disengaged |_| NA Example:

& Children |_| Enmeshed |_| Clear |_| Disengaged |_| NA Example:

Siblings |_| Enmeshed |_| Clear |_| Disengaged |_| NA Example:

Extended Family |_| Enmeshed |_| Clear |_| Disengaged |_| NA Example:

Friends/Peers/Others |_| Enmeshed |_| Clear |_| Disengaged |_| NA Example:

Triangles/Coalitions:

|_| Cross-generational coalitions: Describe:

|_| Other coalitions:

Hierarchy between Parents and Children: |_| NA

: |_|Effective |_|Insufficient (permissive) |_| Excessive (authoritarian) |_| Inconsistent

: |_|Effective |_|Insufficient (permissive) |_| Excessive (authoritarian) |_| Inconsistent

Description/Example to illustrate hierarchy:      

Complementary Patterns between       and      :

|_| Pursuer/distancer

|_| Over/under-functioner

|_| Emotional/logical

|_| Good/bad parent

|_| Other:

Example of pattern:

Interactional Patterns

Primary Pathologizing Interpersonal Pattern (PIPs; A B): Describe dynamic of primary PIP:

|_| Pursuing/Distancing |_| Criticizing/Defending |_| Controlling/Resisting |_| Other:

Describe Start of Tension:

Describe Conflict/Symptom Escalation:

Describe Return to “Normal”/Homeostasis:

Hypothesized homeostatic function of presenting problem: How might the symptom serve to maintain connection, create independence/distance, establish influence, reestablish connection, or otherwise help organize the family?

Intergenerational & Attachment Patterns

Construct a family genogram and include all relevant information including:

· Names, ages and birth/death dates

· Relational patterns

· Occupations

· Psychiatric disorders and alcohol/substance abuse

· Abuse history

· Personality adjectives

Genogram should be attached to report. Summarize key findings below:

Substance/Alcohol Abuse: |_| NA |_| History:

Sexual/Physical/Emotional Abuse: |_| NA |_| History:

Parent/Child Relations: |_| NA |_| History:

Physical/Mental Disorders: |_| NA |_| History:

History Related to Presenting Problem: |_| NA |_| History:

Describe family strengths, such as the capacity to self-regulate and to effectively manage stress:

Describe typical attachment behavior when person does not feel secure in relationships; include Satir survival stances (placating, blaming, superreasonable, and irrelevant) used in description.

:: |_| Anxious |_| Avoidant |_| Anxious/Avoidant. Frequency: Describe:

:: |_| Anxious |_| Avoidant |_| Anxious/Avoidant. Frequency: Describe:

:: |_| Anxious |_| Avoidant |_| Anxious/Avoidant. Frequency: Describe:

:: |_| Anxious |_| Avoidant |_| Anxious/Avoidant. Frequency: Describe:

Additional:

Solution-Based Assessment

Attempted Solutions that DIDN’T work:

1.

2.

3.

Exceptions and Unique Outcomes (Solutions that DID work): Times, places, relationships, contexts, etc., when problem is less of a problem; behaviors that seem to make things even slightly better:

1.

2.

3.

Miracle Question/Answer: If the problem were to be resolved overnight, what would client be doing differently the next day? (Describe in terms of doing X rather than not doing Y):

1.

2.

3.

Postmodern: Social Location and Dominant Discourses

Describe the client(s) overall social location (the groups a person belongs to based on diversity factors) and influential dominant discourses related to presenting concerns:

· Ethnic, Race, Class, Immigration Status, and Religious Discourses: How do key cultural discourses inform client identity(ies), what is perceived as the problem, and possible solutions (specify ethnicity, e.g. Italian American rather than White or Caucasian)?

· Gender and Sexuality Discourses : How do gender and sexuality discourses inform identity(ies), what is perceived as a problem and the possible solutions? Do these intersect with ethnicity and/or religion? 

· Community, School, Work and/or Extended Family Discourses : How do other important community discourses inform identity(ies), what is perceived as a problem and the possible solutions? 

· Identity Narratives : How has the problem shaped each significant person’s identity?

Client Perspectives (Optional)

Areas of Agreement: Based on what the client(s) has(ve) said, what parts of the above assessment do they agree with or are likely to agree with?      

Areas of Disagreement: What parts do they disagree with or are likely to disagree with? Why?      

How do you plan to respectfully work with areas of potential disagreement?      

	[Type text]

	1 © 2016. Diane R. Gehart, Ph.D. All rights reserved. www.masteringcompetencies.org

Collepals.com Plagiarism Free Papers

Are you looking for custom essay writing service or even dissertation writing services? Just request for our write my paper service, and we'll match you with the best essay writer in your subject! With an exceptional team of professional academic experts in a wide range of subjects, we can guarantee you an unrivaled quality of custom-written papers.

Get ZERO PLAGIARISM, HUMAN WRITTEN ESSAYS

Why Hire Collepals.com writers to do your paper?

Quality- We are experienced and have access to ample research materials.

We write plagiarism Free Content

Confidential- We never share or sell your personal information to third parties.

Support-Chat with us today! We are always waiting to answer all your questions.