A+ Paper

Family Assessment Paper


For this paper you may choose either a fictitious family (from a television show etc) or a current case you are working on (ideal).  Do NOT choose your own family or a friend’s family etc.







Phone Number


(for example)


Family Assessment Paper

Amy Wood, Psy.D.

Licensed Clinical Psychologist

57 Exchange Street, Suite 403

Portland, ME04101



II.  Basic Information


Family  Name:

Identified Patient (IP):

Date of Birth (of IP):

Age (IP):

Who decided that the IP above is the IP?

Referral Source:                (Who is referring this client?)

Period of Evaluation:


Referral Context:


This section explains the event that occurred just prior to the family coming to counseling.  In other words, why is this family coming to counseling now?


Disclosure Statement:


Discuss ethical issues including confidentiality, informed consent, dual-role relationships.  Mention that they were discussed with the family and how they reacted (or you think they would react).  Do you have any ethical concerns about this client?

What VALUE concerns do you have working with this family?  What will be tough for you considering what they bring in? Do NOT say none.

Reflect on feminist values as we have discussed in the course.  What applies here for this family?  What will be difficult/hard to balance?


Pertinent Background Information:


History of Living Situation:


Discuss the family’s living situation (currently) and a brief history of where they have lived.


If there is an IP please address


*Who defines them as a problem?


*Description of IP’s ‘problem’


*Academic History:


*Substance Abuse History


*Trauma History:


*Family History of Mental Illness/Substance Abuse/Legal Issues/Physical and Sexual Abuse.


*Past Experiences in counseling:


VI.  Behavioral Observations/Validity of Results/Clinical Interview:


These are your opinions of how the family comes across to you- a basic description of how they affect you.  It also describes what the first session of therapy felt (or might feel) like to the therapist.  Who sat where? Who spoke? Who was silent? Who made eye contact?  Who seemed engaged? Distracted?


VII.      Structural Analysis


Address the following issues in a structural analysis of the family Describe and give examples from the family for each:


Subsystems:  What subsystems exist in the family?

Role Sets


Between subsets

Between members

Structural equilibrium

Examples of deviation from equilibrium

Addressing the 5 pattern variables

Manifest and latent functions of deviance

A summary of the structural issues that are contributing to family dysfunction





VIII.     Treatment Strategy


What theory will you use for treatment? Why?

Discuss how you will construct therapeutic interventions.

Present a small vignette about how this family will present and how you would intervene.  Be detailed in the vignette, “Father said….” Response: “Therapist said….” so that I can get a sense of what it might look like doing therapy with this family using the theory you wish to follow.

The please offer some kind of conclusion, how the family does in treatment, what progress or lack of you saw and how it may terminate.  Just use your imagination given the presenting issues and the treatment approach as to how it might turn out.




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