Week 2: Comprehensive Psychiatric Family Assessment
Marly Delatour Gabriel
College of Nursing-PMHNP, Walden University
NRNP 6645: Psychopathology and Diagnostic Reasoning
Dr. Abit, CLara
September 8th, 2024
, Evaluation Note
CC (chief complaint): “ I like to learn to live my life alone.”
HPI: Patti is a 40-year-old mother of five, an Iranian immigrant who came to the United States
12 years ago with four of her children, two daughters and two sons, and left behind one daughter
when she was 8 years old. The daughters are now 24, 23, and 21; the sons are 18 and 15. The
two older girls had medical visas, and the two sons are American citizens. Patti worried about
leaving her middle daughter behind with her father. However, she couldn't get a visa. Patti has
been in an abusive and controlling arranged marriage since she was 14 years old. Her husband
wanted her to go back to Iran, but she decided to stay in the US and raise her children. Since
then, the husband remarried twice. Patti brought her 21-year-old daughter to live with them two
years ago. The family was happy to be together until the middle daughter revealed that she was
sexually and physically abused by her father. When confronted about the abuse, the father yelled
and screamed, and they left it at that. The 18-year-old son no longer speaks to his father. The
initial visit was to deal with the sexual abuse as a family. They had two sessions; then, the
mother was referred to Psychiatry for hopelessness and helplessness after becoming disabled
from two failed foot surgeries. The middle daughter doesn't think that therapy can help and
prefers to have the money. She eloped with a friend's son and now lives with her husband. The
two oldest soon followed and moved out on their own, living in Pattin with her two sons. The
18- year-old is in high school, and assuming the 15-year-old is also in high school, but is giving
problems. The oldest daughter feels like the father figure because while her mother works as a
caregiver, she has to manage the house and take care of her siblings. As per her 23-year-old
daughter, who is in the appointment with her today, Patti is demanding that she doesn't want to
do anything for herself. She believes her mother is too young to depend on them since they have
to live their lives, too. She thinks that they are no longer in Iran. They have to live the American
way by going out on their own and doing things for themselves. She reports calling her mother 6
days a week, and she stops by, but her mother is not satisfied. The mother wants her to sleep
over, but she doesn't want to because of the two dogs. She states it's not in her culture to have
dogs in the house, which leaves dog hair everywhere. Patti thinks her children abandoned her,
and they are not doing enough. She also feels that she should be able to make decisions about
their lives. Her children think that Patti is holding them back and she should be more
independent. Patti was then referred to psychiatry for hopelessness and helplessness after two
failed feet surgeries. Their goal is to "get alone."
Past Psychiatric History:
• General Statement: The patient first entered psychiatry a year and half ago due to
the middle daughter alledgly being sexually and physically abused .
• Caregivers (if applicable):
• Hospitalizations: No history of hospitalization reported.
Page 2 of 8
Marly Delatour Gabriel
College of Nursing-PMHNP, Walden University
NRNP 6645: Psychopathology and Diagnostic Reasoning
Dr. Abit, CLara
September 8th, 2024
, Evaluation Note
CC (chief complaint): “ I like to learn to live my life alone.”
HPI: Patti is a 40-year-old mother of five, an Iranian immigrant who came to the United States
12 years ago with four of her children, two daughters and two sons, and left behind one daughter
when she was 8 years old. The daughters are now 24, 23, and 21; the sons are 18 and 15. The
two older girls had medical visas, and the two sons are American citizens. Patti worried about
leaving her middle daughter behind with her father. However, she couldn't get a visa. Patti has
been in an abusive and controlling arranged marriage since she was 14 years old. Her husband
wanted her to go back to Iran, but she decided to stay in the US and raise her children. Since
then, the husband remarried twice. Patti brought her 21-year-old daughter to live with them two
years ago. The family was happy to be together until the middle daughter revealed that she was
sexually and physically abused by her father. When confronted about the abuse, the father yelled
and screamed, and they left it at that. The 18-year-old son no longer speaks to his father. The
initial visit was to deal with the sexual abuse as a family. They had two sessions; then, the
mother was referred to Psychiatry for hopelessness and helplessness after becoming disabled
from two failed foot surgeries. The middle daughter doesn't think that therapy can help and
prefers to have the money. She eloped with a friend's son and now lives with her husband. The
two oldest soon followed and moved out on their own, living in Pattin with her two sons. The
18- year-old is in high school, and assuming the 15-year-old is also in high school, but is giving
problems. The oldest daughter feels like the father figure because while her mother works as a
caregiver, she has to manage the house and take care of her siblings. As per her 23-year-old
daughter, who is in the appointment with her today, Patti is demanding that she doesn't want to
do anything for herself. She believes her mother is too young to depend on them since they have
to live their lives, too. She thinks that they are no longer in Iran. They have to live the American
way by going out on their own and doing things for themselves. She reports calling her mother 6
days a week, and she stops by, but her mother is not satisfied. The mother wants her to sleep
over, but she doesn't want to because of the two dogs. She states it's not in her culture to have
dogs in the house, which leaves dog hair everywhere. Patti thinks her children abandoned her,
and they are not doing enough. She also feels that she should be able to make decisions about
their lives. Her children think that Patti is holding them back and she should be more
independent. Patti was then referred to psychiatry for hopelessness and helplessness after two
failed feet surgeries. Their goal is to "get alone."
Past Psychiatric History:
• General Statement: The patient first entered psychiatry a year and half ago due to
the middle daughter alledgly being sexually and physically abused .
• Caregivers (if applicable):
• Hospitalizations: No history of hospitalization reported.
Page 2 of 8
