[Solved] NUR 650

Assignment Prompt & Instructions

**files (2)**

– ## NUR650Diss1-7.pdf

– ## NUR650W1respose.pdf

**## NUR650Diss1-7.pdf**

NUR650 Discussions

Submission Instructions:

Your initial post should be at least 500 words, formatted and cited in the current APA style

Provide support for your work from at least 2 academic sources less than 5 years old.

Wk1 Tom’s Parents are Fighting

After studying Module 1: Lecture Materials & Resources, discuss the following:

Tom is a 16-year-old who comes to you to evaluate his lack of attention because his grades are
progressively getting worse. When you ask about stress in his life, he notes that his parents are
always fighting, and this upsets him. He believes that they fight more when they have been
drinking, and he believes that his father is the heavier drinker of the two, but he cannot quantify
either parent's use.

• What information would be most critical for the group leader to collect in the first visit?
• What is the primary goal for group treatment of this patient’s family problem based on

US group therapy best practices?
• Which harm reduction strategies would you recommend?
• Identify your city. Then refer this patient to three support groups near you that promote

positive health outcomes for this patient. What was your rationale for choosing these
three agencies?

W2 Harriet Needs Surgery

After studying Module 2: Lecture Materials & Resources, discuss the following:

Harriet is a 51-year-old married woman with a past history of alcohol and cocaine abuse. She has
been attending AA and NA meetings regularly and does not report urges to drink or use drugs
during the 4 years you have been her psychiatric mental health nurse practitioner. She needs
carpal tunnel surgery and the typical regimen during recovery is oxycodone 15 mg per day.

• What information would be most critical for the group leader to collect in the first visit?
• What is the primary goal for the treatment of this patient’s family problem, based on the

US clinical guidelines?

[https://stu.instructure.com/courses/50346/pages/module-1-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-1-lecture-materials-and-resources)

[https://stu.instructure.com/courses/50346/pages/module-2-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-2-lecture-materials-and-resources)

• Discuss one curative factor the group would observe during the initial, middle and
termination phases in group therapy?

• Identify your city. Then refer this patient to three agencies near you that would support
positive health outcomes for this patient. (These agencies must not have been used in past
discussion posts). What was your rationale for choosing these three agencies?

W3 Motivational Interview with Mary

After studying Module 3: Lecture Materials & Resources, discuss the following:

Mary is 27 years old and has had a history of alcohol dependence for several years. Mary has a
daughter Kylie, aged 3 years, who displays signs of fetal alcohol syndrome. Social work services
have been involved with Mary and Kylie since her birth, culminating in Kylie being looked after
by the local authority as a result of Mary arriving to collect Kylie from the local nursery while
significantly under the influence of alcohol. Mary has demonstrated ambivalence regarding her
ability to control her alcohol use. Mary has referred herself to a local counseling agency as
suggested by the social worker and her PCP.

• Discuss how you might use the principles of motivational interviewing with Mary.
• Provide a detailed overview of how the interview may progress. Include each step of

motivational interviewing in your discussion.
• Describe how a provider would recognize this patient is ready to change. Use principles

of motivational interviewing to support your answer.

W4 Richard is Motivated

After studying Module 4: Lecture Materials & Resources, discuss the following:

Richard is a 62-year-old single man who says that his substance dependence and his bipolar
disorder both emerged in his late teens. He says that he started to drink to “feel better” when his
episodes of depression made it hard for him to interact with his peers. He also states that alcohol
and cocaine are a natural part of his manic episodes. He also notes that coming off the cocaine
and binge drinking contribute to low mood, but he has not responded well to referrals to AA and
past inpatient stays have led to only temporary abstinence. Yet, Richard is now trying to forge a
closer relationship with his adult children, and he says he is especially motivated to get a better
handle on both his bipolar disorder and his substance use. He has been more compliant with his
mood stabilizing and antidepressant medication, and his psychiatric provider would like his dual
diagnoses addressed with psychotherapy.

• What diagnostic information would be most critical to collect in the first visit?

[https://stu.instructure.com/courses/50346/pages/module-3-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-3-lecture-materials-and-resources)

[https://stu.instructure.com/courses/50346/pages/module-4-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-4-lecture-materials-and-resources)

• Which diagnostic measures are recommended by the US clinical guidelines for the
treatment of this patient’s family problem?

• Which evidence based harm reduction strategies would you recommend to treat this
patient?

• Identify your city. Then refer this patient to three agencies near you that would support
positive health outcomes for this patient. (These agencies must not have been used in
past discussion posts). What was your rationale for choosing these three agencies?

W5 Pretty Serious Partying

After studying Module 5: Lecture Materials & Resources, discuss the following:

Jackie is a 31-year-old pregnant patient (2nd child, two different fathers) single mother of a 6-
year-old who is coming for prenatal care since she suspects she is pregnant. She is no longer with
the father of Robby, her firstborn. She indicates "pretty serious partying" with the likely father of
the baby. By pretty serious partying she means 10-12 drinks per occasion, one to two times per
week, plus intermittent methamphetamine use.

• Which clinical information would be most critical for you to collect in the first visit?
• What are the greatest risk factors for substance use disorder for this patient?
• Which harm reduction strategies would you recommend?
• Identify your city. Then refer this patient to three agencies near you that would support

positive health outcomes for this patient. (These agencies must not have been used in
past discussion posts). What was your rationale for choosing these three agencies?

W6 Toneika

After studying Module 6: Lecture Materials & Resources, discuss the following:

Tomeika is a three-year-old girl. She was recently diagnosed with autism spectrum disorder
(ASD).
Tomeika is able to make many vocalizations and is able to say one recognizable word. Tomeika
will say “juice”, which she pronounces as “oos.” Throughout the day, Tomeika cries and falls to
the floor to gain access to food, obtain a favorite toy, or when she wants to be picked up. Her
parents, Mr. and Mrs. Williams, would like for Tomeika to communicate her desires with words,
but do not know how to help her. Tomeika recently began attending an early childhood special
education classroom for learners with ASD in the County Public School System for six hours a
day, four days a week. On Wednesdays, Tomeika and her peers do not go to school. Instead, on
this day, Tomeika’s interventionist, Mrs. Dell, has parent conferences in her students’ homes.

[https://stu.instructure.com/courses/50346/pages/module-5-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-5-lecture-materials-and-resources)

[https://stu.instructure.com/courses/50346/pages/module-6-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-6-lecture-materials-and-resources)

During the conferences, Mrs. Dell discusses educational programming, learner progress, areas of
concern, and also provides training to parents.

• Which diagnostic information would be most critical for you to collect in the first visit?
• What is the primary goal for the treatment of this patient’s family problem based on

current US clinical practice guidelines?
• Which complementary and alternative medication treatments would you recommend?
• Identify your city. Then refer this patient to three agencies near you that would support

positive health outcomes for this patient. (These agencies must not have been used in
past discussion posts). What was your rationale for choosing these three agencies?

W7 Hip Fracture

After studying Module 7: Lecture Materials & Resources, discuss the following:

The patient is a 71-year-old widowed man who is seen regularly in the clinic for health
maintenance and follow-up of his chronic insomnia and anxiety. He has regular prescriptions for
triazolam (Halcion) and clonazepam (Klonopin) for these problems. Recently he has been
reporting frequent episodes of losing his balance and falling, and eight weeks ago was
hospitalized for a hip fracture sustained during one of these falls resulting in hip surgery. On this
visit, he also complains of becoming increasingly confused.

• What information would be most critical for you to collect in the first visit?
• What is the primary goal for the treatment of this patient?
• Identify potential obstacles for change. Which educational approach would the PMHNP

provide to overcome these obstacles?
• How would you teach the patient about the Beers list and Halcion?
• Discuss a medication in detail that could be safely substituted to treat insomnia in

geriatric patients.

[https://stu.instructure.com/courses/50346/pages/module-7-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-7-lecture-materials-and-resources)

**## NUR650W1respose.pdf**

Dailys Prado Bravo

St. Thomas University

NUR 650

Dr PetitHomme

March 2026

Adolescents who present with declining academic performance and lack of attention
require a comprehensive psychosocial evaluation. In Tom’s case, his report of parental conflict
and suspected alcohol misuse suggests that family stressors may be contributing to his
symptoms. Family substance use and interpersonal conflict are well-documented risk factors for
emotional distress, impaired concentration, and academic difficulties in adolescents (Substance
Abuse and Mental Health Services Administration [SAMHSA], 2023).

Critical Information to Collect During the First Visit

During the initial visit, the group leader should prioritize gathering several categories of
information. First, a comprehensive psychosocial assessment is essential. This should include
Tom’s academic history, attention and concentration symptoms, mood, sleep patterns, and any
history of anxiety or depression. Screening for attention-deficit/hyperactivity disorder (ADHD)
and trauma-related symptoms may also be necessary.

The clinician should assess family functioning and parental alcohol use. Important
information includes the frequency and intensity of parental conflicts, whether alcohol is
involved in arguments, the quantity and frequency of each parent’s alcohol consumption, and
whether Tom has experienced emotional or physical harm related to these conflicts. Adolescents
exposed to parental alcohol misuse are at higher risk for psychological distress and behavioral
problems (Windle et al., 2021).

Safety and coping mechanisms must be evaluated. The clinician should assess whether
Tom feels safe at home, whether domestic violence is present, and what coping strategies he
currently uses to deal with stress. Screening for suicidal ideation or self-harm behaviors is also
critical. Finally, identifying protective factors, such as supportive relatives, school counselors,
mentors, or extracurricular activities, can guide intervention planning.

Primary Goal of Group Treatment

Based on U.S. group therapy best practices, the primary goal of treatment would be to
improve family functioning and reduce the negative impact of parental substance use on the
adolescent. Group therapy can help families develop healthier communication patterns, improve
emotional regulation, and increase awareness of the impact of alcohol misuse on family

[https://stu.instructure.com/courses/50346/users/33214](https://stu.instructure.com/courses/50346/users/33214)

relationships. Psychoeducational family groups and support groups have been shown to improve
coping skills among adolescents affected by parental substance use (SAMHSA, 2023).
Ultimately, the goal is to strengthen resilience, promote healthy family interactions, and reduce
psychological stress for the adolescent.

Harm Reduction Strategies

Harm reduction strategies focus on minimizing the negative consequences of substance
use rather than requiring immediate abstinence. For Tom’s family, several strategies may be
beneficial. First, encouraging parents to monitor and reduce alcohol consumption, particularly
during times when conflict is likely to occur, can decrease family tension. Second, implementing
conflict-management strategies, such as avoiding arguments while drinking and setting family
communication guidelines, may reduce emotional harm to Tom.

Connecting the parents with alcohol education programs or counseling services can
increase their awareness of how their behavior affects their child. Finally, teaching Tom coping
strategies such as stress management, emotional expression, and seeking support from trusted
adults can reduce the psychological impact of family conflict.

Local Support Groups

Because I am located in Miramar, Miami, Florida, the following support groups in the area
would be appropriate referrals:

1. Al-Anon Family Groups – Fort Lauderdale Area
Al-Anon provides peer support for individuals affected by someone else’s drinking. Teen-
focused groups such as Alateen can help adolescents share experiences, develop coping skills,
and reduce feelings of isolation.

2. Alcoholics Anonymous (AA) – Broward County Intergroup
AA meetings provide structured peer support for individuals struggling with alcohol use.
Referring Tom’s parents to AA may help them address problematic drinking behaviors and
reduce alcohol-related conflict within the home.

3. NAMI Broward County Family Support Groups
The National Alliance on Mental Illness (NAMI) offers family education and support groups that
help families manage mental health stressors and improve communication. These programs can
support both Tom and his parents by promoting healthier family dynamics.

The rationale for selecting these organizations is that they are evidence-based, widely
accessible, free or low-cost, and provide both family-focused and substance-use-specific support.
Access to community support networks can significantly improve outcomes for adolescents
living in households affected by substance use.

Tom’s declining academic performance may be closely related to the stress associated with
parental conflict and possible alcohol misuse. A thorough assessment, family-centered group
therapy, and harm reduction strategies can help address the underlying issues affecting his
attention and emotional well-being. Connecting the family with community support groups may
further strengthen coping skills and promote healthier family relationships.

Arlette Del Pino Vento

Discussion 1
NUR 650 Psychiatric Management IV

Dr. PetitHomme PMHNP-BC
03/15/2026

The process of assessing adolescents who show reduced school achievement and problems with
focusing needs to include both possible neurodevelopmental conditions and environmental
stressor effects. Tom's family situation includes parental alcohol-related fights which he
describes as a common occurrence that leads to family stress which impacts his school
performance and focus. The group leader needs to gather essential information about Tom's
complete family situation and his current emotional state and the alcohol consumption habits
present in his home. The clinician should investigate how frequently parents engage in conflicts
which escalate into dangerous confrontations and analyze how Tom behaves or reacts during
these situations. The alcohol consumption patterns at home need to be established through an
assessment which includes the drinking frequency of both parents and their drinking behavior
during conflicts and any situations where Tom has experienced danger due to their actions. The
clinician needs to evaluate anxiety symptoms along with depression and sleep problems and
concentration difficulties because adolescents who experience ongoing familial disputes will
develop emotional health issues. The process of identifying Tom's academic decline needs to
establish its starting point while tracking teacher observations of his attention issues to evaluate
whether school stress drives his academic challenges or whether assessment for attention-deficit/
hyperactivity disorder is needed. The clinician needs to identify specific protective factors which
include supportive peers and trusted adults and extracurricular activities as stress management
resources for Tom to handle his stress.
The primary goal of group treatment in this situation would be to address the family
dynamics that are contributing to Tom's distress while the group establishes better ways for
family members to communicate and decreases the harmful effects of alcohol use on their family
relationships. Family-focused group therapy approaches in the United States often aim to help
family members recognize how their interactions affect one another and to develop more
constructive ways of managing conflict. In this case, the goal would not only be to support Tom
emotionally but also to help the parents recognize how their alcohol use and arguments may be

affecting their child. Improving communication, increasing emotional awareness, and
encouraging accountability related to drinking behaviors are all important aspects of treatment.
Research suggests that family-based interventions can significantly improve outcomes for
adolescents experiencing stress related to parental substance use or family conflict because they
address the relational environment rather than focusing solely on the individual adolescent
(Hogue et al., 2021).
Because immediate abstinence from alcohol may not always be realistic, harm reduction
strategies may be a practical starting point for this family. The goal of harm reduction is to
decrease the harmful effects of substance use while supporting users in their progressive
development of better habits. The parents require training about alcohol's ability to escalate
conflicts and cause emotional instability when parents argue with children present. The
recommendation to parents is that they should refrain from drinking alcohol whenever their
family members are present or when disputes arise because this will decrease the severity of
arguments that Tom sees. Parents should be encouraged to become conscious of their drinking
habits because this awareness will help them decide whether to cut back on alcohol or undergo
alcohol screening. The availability of resources which help people develop healthier methods to
cope with stress will decrease their tendency to use alcohol as their main stress relief method.
Harm reduction approaches are widely supported in substance use treatment because they
prioritize safety and incremental improvements rather than requiring immediate complete
abstinence (Collins et al., 2021).
This case is being considered in Miami, Florida, where several support groups are available
that could promote positive health outcomes for Tom and his family.Al-Anon Family Groups
functions as an essential support system for people who need help because their loved ones suffer
from alcohol addiction. Al-Anon meetings enable adolescents and their family members to learn
about addiction while also teaching them how to establish proper boundaries and handle
situations with their family member who consumes alcohol. Alcoholics Anonymous serves as
another essential resource because it provides a broad support network that helps people dealing
with alcohol addiction. If Tom's parents join the meetings then they will learn to identify his
drinking issues while starting their path to recovery. SMART Recovery provides a third choice
which enables people to use cognitive behavioral and motivational strategies for controlling their
addiction problems. The program attracts people who want to use structured methods based on
scientific evidence instead of following the standard twelve-step program. These three agencies
were selected because they offer different types of support that address both the family’s
emotional needs and the parents’ potential substance use concerns. By connecting the family
with community resources that encourage healthier coping, improved communication, and
support for recovery, the overall goal is to reduce the stress in Tom’s home environment and help
restore his ability to focus on school and personal development.

**## NUR650W1respose.pdf**

Dailys Prado Bravo

St. Thomas University

NUR 650

Dr PetitHomme

March 2026

Adolescents who present with declining academic performance and lack of attention
require a comprehensive psychosocial evaluation. In Tom’s case, his report of parental conflict
and suspected alcohol misuse suggests that family stressors may be contributing to his
symptoms. Family substance use and interpersonal conflict are well-documented risk factors for
emotional distress, impaired concentration, and academic difficulties in adolescents (Substance
Abuse and Mental Health Services Administration [SAMHSA], 2023).

Critical Information to Collect During the First Visit

During the initial visit, the group leader should prioritize gathering several categories of
information. First, a comprehensive psychosocial assessment is essential. This should include
Tom’s academic history, attention and concentration symptoms, mood, sleep patterns, and any
history of anxiety or depression. Screening for attention-deficit/hyperactivity disorder (ADHD)
and trauma-related symptoms may also be necessary.

The clinician should assess family functioning and parental alcohol use. Important
information includes the frequency and intensity of parental conflicts, whether alcohol is
involved in arguments, the quantity and frequency of each parent’s alcohol consumption, and
whether Tom has experienced emotional or physical harm related to these conflicts. Adolescents
exposed to parental alcohol misuse are at higher risk for psychological distress and behavioral
problems (Windle et al., 2021).

Safety and coping mechanisms must be evaluated. The clinician should assess whether
Tom feels safe at home, whether domestic violence is present, and what coping strategies he
currently uses to deal with stress. Screening for suicidal ideation or self-harm behaviors is also
critical. Finally, identifying protective factors, such as supportive relatives, school counselors,
mentors, or extracurricular activities, can guide intervention planning.

Primary Goal of Group Treatment

Based on U.S. group therapy best practices, the primary goal of treatment would be to
improve family functioning and reduce the negative impact of parental substance use on the
adolescent. Group therapy can help families develop healthier communication patterns, improve
emotional regulation, and increase awareness of the impact of alcohol misuse on family

[https://stu.instructure.com/courses/50346/users/33214](https://stu.instructure.com/courses/50346/users/33214)

relationships. Psychoeducational family groups and support groups have been shown to improve
coping skills among adolescents affected by parental substance use (SAMHSA, 2023).
Ultimately, the goal is to strengthen resilience, promote healthy family interactions, and reduce
psychological stress for the adolescent.

Harm Reduction Strategies

Harm reduction strategies focus on minimizing the negative consequences of substance
use rather than requiring immediate abstinence. For Tom’s family, several strategies may be
beneficial. First, encouraging parents to monitor and reduce alcohol consumption, particularly
during times when conflict is likely to occur, can decrease family tension. Second, implementing
conflict-management strategies, such as avoiding arguments while drinking and setting family
communication guidelines, may reduce emotional harm to Tom.

Connecting the parents with alcohol education programs or counseling services can
increase their awareness of how their behavior affects their child. Finally, teaching Tom coping
strategies such as stress management, emotional expression, and seeking support from trusted
adults can reduce the psychological impact of family conflict.

Local Support Groups

Because I am located in Miramar, Miami, Florida, the following support groups in the area
would be appropriate referrals:

1. Al-Anon Family Groups – Fort Lauderdale Area
Al-Anon provides peer support for individuals affected by someone else’s drinking. Teen-
focused groups such as Alateen can help adolescents share experiences, develop coping skills,
and reduce feelings of isolation.

2. Alcoholics Anonymous (AA) – Broward County Intergroup
AA meetings provide structured peer support for individuals struggling with alcohol use.
Referring Tom’s parents to AA may help them address problematic drinking behaviors and
reduce alcohol-related conflict within the home.

3. NAMI Broward County Family Support Groups
The National Alliance on Mental Illness (NAMI) offers family education and support groups that
help families manage mental health stressors and improve communication. These programs can
support both Tom and his parents by promoting healthier family dynamics.

The rationale for selecting these organizations is that they are evidence-based, widely
accessible, free or low-cost, and provide both family-focused and substance-use-specific support.
Access to community support networks can significantly improve outcomes for adolescents
living in households affected by substance use.

Tom’s declining academic performance may be closely related to the stress associated with
parental conflict and possible alcohol misuse. A thorough assessment, family-centered group
therapy, and harm reduction strategies can help address the underlying issues affecting his
attention and emotional well-being. Connecting the family with community support groups may
further strengthen coping skills and promote healthier family relationships.

Arlette Del Pino Vento

Discussion 1
NUR 650 Psychiatric Management IV

Dr. PetitHomme PMHNP-BC
03/15/2026

The process of assessing adolescents who show reduced school achievement and problems with
focusing needs to include both possible neurodevelopmental conditions and environmental
stressor effects. Tom's family situation includes parental alcohol-related fights which he
describes as a common occurrence that leads to family stress which impacts his school
performance and focus. The group leader needs to gather essential information about Tom's
complete family situation and his current emotional state and the alcohol consumption habits
present in his home. The clinician should investigate how frequently parents engage in conflicts
which escalate into dangerous confrontations and analyze how Tom behaves or reacts during
these situations. The alcohol consumption patterns at home need to be established through an
assessment which includes the drinking frequency of both parents and their drinking behavior
during conflicts and any situations where Tom has experienced danger due to their actions. The
clinician needs to evaluate anxiety symptoms along with depression and sleep problems and
concentration difficulties because adolescents who experience ongoing familial disputes will
develop emotional health issues. The process of identifying Tom's academic decline needs to
establish its starting point while tracking teacher observations of his attention issues to evaluate
whether school stress drives his academic challenges or whether assessment for attention-deficit/
hyperactivity disorder is needed. The clinician needs to identify specific protective factors which
include supportive peers and trusted adults and extracurricular activities as stress management
resources for Tom to handle his stress.
The primary goal of group treatment in this situation would be to address the family
dynamics that are contributing to Tom's distress while the group establishes better ways for
family members to communicate and decreases the harmful effects of alcohol use on their family
relationships. Family-focused group therapy approaches in the United States often aim to help
family members recognize how their interactions affect one another and to develop more
constructive ways of managing conflict. In this case, the goal would not only be to support Tom
emotionally but also to help the parents recognize how their alcohol use and arguments may be

affecting their child. Improving communication, increasing emotional awareness, and
encouraging accountability related to drinking behaviors are all important aspects of treatment.
Research suggests that family-based interventions can significantly improve outcomes for
adolescents experiencing stress related to parental substance use or family conflict because they
address the relational environment rather than focusing solely on the individual adolescent
(Hogue et al., 2021).
Because immediate abstinence from alcohol may not always be realistic, harm reduction
strategies may be a practical starting point for this family. The goal of harm reduction is to
decrease the harmful effects of substance use while supporting users in their progressive
development of better habits. The parents require training about alcohol's ability to escalate
conflicts and cause emotional instability when parents argue with children present. The
recommendation to parents is that they should refrain from drinking alcohol whenever their
family members are present or when disputes arise because this will decrease the severity of
arguments that Tom sees. Parents should be encouraged to become conscious of their drinking
habits because this awareness will help them decide whether to cut back on alcohol or undergo
alcohol screening. The availability of resources which help people develop healthier methods to
cope with stress will decrease their tendency to use alcohol as their main stress relief method.
Harm reduction approaches are widely supported in substance use treatment because they
prioritize safety and incremental improvements rather than requiring immediate complete
abstinence (Collins et al., 2021).
This case is being considered in Miami, Florida, where several support groups are available
that could promote positive health outcomes for Tom and his family.Al-Anon Family Groups
functions as an essential support system for people who need help because their loved ones suffer
from alcohol addiction. Al-Anon meetings enable adolescents and their family members to learn
about addiction while also teaching them how to establish proper boundaries and handle
situations with their family member who consumes alcohol. Alcoholics Anonymous serves as
another essential resource because it provides a broad support network that helps people dealing
with alcohol addiction. If Tom's parents join the meetings then they will learn to identify his
drinking issues while starting their path to recovery. SMART Recovery provides a third choice
which enables people to use cognitive behavioral and motivational strategies for controlling their
addiction problems. The program attracts people who want to use structured methods based on
scientific evidence instead of following the standard twelve-step program. These three agencies
were selected because they offer different types of support that address both the family’s
emotional needs and the parents’ potential substance use concerns. By connecting the family
with community resources that encourage healthier coping, improved communication, and
support for recovery, the overall goal is to reduce the stress in Tom’s home environment and help
restore his ability to focus on school and personal development.

**## NUR650Diss1-7.pdf**

NUR650 Discussions

Submission Instructions:

Your initial post should be at least 500 words, formatted and cited in the current APA style

Provide support for your work from at least 2 academic sources less than 5 years old.

Wk1 Tom’s Parents are Fighting

After studying Module 1: Lecture Materials & Resources, discuss the following:

Tom is a 16-year-old who comes to you to evaluate his lack of attention because his grades are
progressively getting worse. When you ask about stress in his life, he notes that his parents are
always fighting, and this upsets him. He believes that they fight more when they have been
drinking, and he believes that his father is the heavier drinker of the two, but he cannot quantify
either parent's use.

• What information would be most critical for the group leader to collect in the first visit?
• What is the primary goal for group treatment of this patient’s family problem based on

US group therapy best practices?
• Which harm reduction strategies would you recommend?
• Identify your city. Then refer this patient to three support groups near you that promote

positive health outcomes for this patient. What was your rationale for choosing these
three agencies?

W2 Harriet Needs Surgery

After studying Module 2: Lecture Materials & Resources, discuss the following:

Harriet is a 51-year-old married woman with a past history of alcohol and cocaine abuse. She has
been attending AA and NA meetings regularly and does not report urges to drink or use drugs
during the 4 years you have been her psychiatric mental health nurse practitioner. She needs
carpal tunnel surgery and the typical regimen during recovery is oxycodone 15 mg per day.

• What information would be most critical for the group leader to collect in the first visit?
• What is the primary goal for the treatment of this patient’s family problem, based on the

US clinical guidelines?

[https://stu.instructure.com/courses/50346/pages/module-1-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-1-lecture-materials-and-resources)

[https://stu.instructure.com/courses/50346/pages/module-2-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-2-lecture-materials-and-resources)

• Discuss one curative factor the group would observe during the initial, middle and
termination phases in group therapy?

• Identify your city. Then refer this patient to three agencies near you that would support
positive health outcomes for this patient. (These agencies must not have been used in past
discussion posts). What was your rationale for choosing these three agencies?

W3 Motivational Interview with Mary

After studying Module 3: Lecture Materials & Resources, discuss the following:

Mary is 27 years old and has had a history of alcohol dependence for several years. Mary has a
daughter Kylie, aged 3 years, who displays signs of fetal alcohol syndrome. Social work services
have been involved with Mary and Kylie since her birth, culminating in Kylie being looked after
by the local authority as a result of Mary arriving to collect Kylie from the local nursery while
significantly under the influence of alcohol. Mary has demonstrated ambivalence regarding her
ability to control her alcohol use. Mary has referred herself to a local counseling agency as
suggested by the social worker and her PCP.

• Discuss how you might use the principles of motivational interviewing with Mary.
• Provide a detailed overview of how the interview may progress. Include each step of

motivational interviewing in your discussion.
• Describe how a provider would recognize this patient is ready to change. Use principles

of motivational interviewing to support your answer.

W4 Richard is Motivated

After studying Module 4: Lecture Materials & Resources, discuss the following:

Richard is a 62-year-old single man who says that his substance dependence and his bipolar
disorder both emerged in his late teens. He says that he started to drink to “feel better” when his
episodes of depression made it hard for him to interact with his peers. He also states that alcohol
and cocaine are a natural part of his manic episodes. He also notes that coming off the cocaine
and binge drinking contribute to low mood, but he has not responded well to referrals to AA and
past inpatient stays have led to only temporary abstinence. Yet, Richard is now trying to forge a
closer relationship with his adult children, and he says he is especially motivated to get a better
handle on both his bipolar disorder and his substance use. He has been more compliant with his
mood stabilizing and antidepressant medication, and his psychiatric provider would like his dual
diagnoses addressed with psychotherapy.

• What diagnostic information would be most critical to collect in the first visit?

[https://stu.instructure.com/courses/50346/pages/module-3-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-3-lecture-materials-and-resources)

[https://stu.instructure.com/courses/50346/pages/module-4-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-4-lecture-materials-and-resources)

• Which diagnostic measures are recommended by the US clinical guidelines for the
treatment of this patient’s family problem?

• Which evidence based harm reduction strategies would you recommend to treat this
patient?

• Identify your city. Then refer this patient to three agencies near you that would support
positive health outcomes for this patient. (These agencies must not have been used in
past discussion posts). What was your rationale for choosing these three agencies?

W5 Pretty Serious Partying

After studying Module 5: Lecture Materials & Resources, discuss the following:

Jackie is a 31-year-old pregnant patient (2nd child, two different fathers) single mother of a 6-
year-old who is coming for prenatal care since she suspects she is pregnant. She is no longer with
the father of Robby, her firstborn. She indicates "pretty serious partying" with the likely father of
the baby. By pretty serious partying she means 10-12 drinks per occasion, one to two times per
week, plus intermittent methamphetamine use.

• Which clinical information would be most critical for you to collect in the first visit?
• What are the greatest risk factors for substance use disorder for this patient?
• Which harm reduction strategies would you recommend?
• Identify your city. Then refer this patient to three agencies near you that would support

positive health outcomes for this patient. (These agencies must not have been used in
past discussion posts). What was your rationale for choosing these three agencies?

W6 Toneika

After studying Module 6: Lecture Materials & Resources, discuss the following:

Tomeika is a three-year-old girl. She was recently diagnosed with autism spectrum disorder
(ASD).
Tomeika is able to make many vocalizations and is able to say one recognizable word. Tomeika
will say “juice”, which she pronounces as “oos.” Throughout the day, Tomeika cries and falls to
the floor to gain access to food, obtain a favorite toy, or when she wants to be picked up. Her
parents, Mr. and Mrs. Williams, would like for Tomeika to communicate her desires with words,
but do not know how to help her. Tomeika recently began attending an early childhood special
education classroom for learners with ASD in the County Public School System for six hours a
day, four days a week. On Wednesdays, Tomeika and her peers do not go to school. Instead, on
this day, Tomeika’s interventionist, Mrs. Dell, has parent conferences in her students’ homes.

[https://stu.instructure.com/courses/50346/pages/module-5-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-5-lecture-materials-and-resources)

[https://stu.instructure.com/courses/50346/pages/module-6-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-6-lecture-materials-and-resources)

During the conferences, Mrs. Dell discusses educational programming, learner progress, areas of
concern, and also provides training to parents.

• Which diagnostic information would be most critical for you to collect in the first visit?
• What is the primary goal for the treatment of this patient’s family problem based on

current US clinical practice guidelines?
• Which complementary and alternative medication treatments would you recommend?
• Identify your city. Then refer this patient to three agencies near you that would support

positive health outcomes for this patient. (These agencies must not have been used in
past discussion posts). What was your rationale for choosing these three agencies?

W7 Hip Fracture

After studying Module 7: Lecture Materials & Resources, discuss the following:

The patient is a 71-year-old widowed man who is seen regularly in the clinic for health
maintenance and follow-up of his chronic insomnia and anxiety. He has regular prescriptions for
triazolam (Halcion) and clonazepam (Klonopin) for these problems. Recently he has been
reporting frequent episodes of losing his balance and falling, and eight weeks ago was
hospitalized for a hip fracture sustained during one of these falls resulting in hip surgery. On this
visit, he also complains of becoming increasingly confused.

• What information would be most critical for you to collect in the first visit?
• What is the primary goal for the treatment of this patient?
• Identify potential obstacles for change. Which educational approach would the PMHNP

provide to overcome these obstacles?
• How would you teach the patient about the Beers list and Halcion?
• Discuss a medication in detail that could be safely substituted to treat insomnia in

geriatric patients.

[https://stu.instructure.com/courses/50346/pages/module-7-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-7-lecture-materials-and-resources)

**## NUR650W1respose.pdf**

Dailys Prado Bravo

St. Thomas University

NUR 650

Dr PetitHomme

March 2026

Adolescents who present with declining academic performance and lack of attention
require a comprehensive psychosocial evaluation. In Tom’s case, his report of parental conflict
and suspected alcohol misuse suggests that family stressors may be contributing to his
symptoms. Family substance use and interpersonal conflict are well-documented risk factors for
emotional distress, impaired concentration, and academic difficulties in adolescents (Substance
Abuse and Mental Health Services Administration [SAMHSA], 2023).

Critical Information to Collect During the First Visit

During the initial visit, the group leader should prioritize gathering several categories of
information. First, a comprehensive psychosocial assessment is essential. This should include
Tom’s academic history, attention and concentration symptoms, mood, sleep patterns, and any
history of anxiety or depression. Screening for attention-deficit/hyperactivity disorder (ADHD)
and trauma-related symptoms may also be necessary.

The clinician should assess family functioning and parental alcohol use. Important
information includes the frequency and intensity of parental conflicts, whether alcohol is
involved in arguments, the quantity and frequency of each parent’s alcohol consumption, and
whether Tom has experienced emotional or physical harm related to these conflicts. Adolescents
exposed to parental alcohol misuse are at higher risk for psychological distress and behavioral
problems (Windle et al., 2021).

Safety and coping mechanisms must be evaluated. The clinician should assess whether
Tom feels safe at home, whether domestic violence is present, and what coping strategies he
currently uses to deal with stress. Screening for suicidal ideation or self-harm behaviors is also
critical. Finally, identifying protective factors, such as supportive relatives, school counselors,
mentors, or extracurricular activities, can guide intervention planning.

Primary Goal of Group Treatment

Based on U.S. group therapy best practices, the primary goal of treatment would be to
improve family functioning and reduce the negative impact of parental substance use on the
adolescent. Group therapy can help families develop healthier communication patterns, improve
emotional regulation, and increase awareness of the impact of alcohol misuse on family

[https://stu.instructure.com/courses/50346/users/33214](https://stu.instructure.com/courses/50346/users/33214)

relationships. Psychoeducational family groups and support groups have been shown to improve
coping skills among adolescents affected by parental substance use (SAMHSA, 2023).
Ultimately, the goal is to strengthen resilience, promote healthy family interactions, and reduce
psychological stress for the adolescent.

Harm Reduction Strategies

Harm reduction strategies focus on minimizing the negative consequences of substance
use rather than requiring immediate abstinence. For Tom’s family, several strategies may be
beneficial. First, encouraging parents to monitor and reduce alcohol consumption, particularly
during times when conflict is likely to occur, can decrease family tension. Second, implementing
conflict-management strategies, such as avoiding arguments while drinking and setting family
communication guidelines, may reduce emotional harm to Tom.

Connecting the parents with alcohol education programs or counseling services can
increase their awareness of how their behavior affects their child. Finally, teaching Tom coping
strategies such as stress management, emotional expression, and seeking support from trusted
adults can reduce the psychological impact of family conflict.

Local Support Groups

Because I am located in Miramar, Miami, Florida, the following support groups in the area
would be appropriate referrals:

1. Al-Anon Family Groups – Fort Lauderdale Area
Al-Anon provides peer support for individuals affected by someone else’s drinking. Teen-
focused groups such as Alateen can help adolescents share experiences, develop coping skills,
and reduce feelings of isolation.

2. Alcoholics Anonymous (AA) – Broward County Intergroup
AA meetings provide structured peer support for individuals struggling with alcohol use.
Referring Tom’s parents to AA may help them address problematic drinking behaviors and
reduce alcohol-related conflict within the home.

3. NAMI Broward County Family Support Groups
The National Alliance on Mental Illness (NAMI) offers family education and support groups that
help families manage mental health stressors and improve communication. These programs can
support both Tom and his parents by promoting healthier family dynamics.

The rationale for selecting these organizations is that they are evidence-based, widely
accessible, free or low-cost, and provide both family-focused and substance-use-specific support.
Access to community support networks can significantly improve outcomes for adolescents
living in households affected by substance use.

Tom’s declining academic performance may be closely related to the stress associated with
parental conflict and possible alcohol misuse. A thorough assessment, family-centered group
therapy, and harm reduction strategies can help address the underlying issues affecting his
attention and emotional well-being. Connecting the family with community support groups may
further strengthen coping skills and promote healthier family relationships.

Arlette Del Pino Vento

Discussion 1
NUR 650 Psychiatric Management IV

Dr. PetitHomme PMHNP-BC
03/15/2026

The process of assessing adolescents who show reduced school achievement and problems with
focusing needs to include both possible neurodevelopmental conditions and environmental
stressor effects. Tom's family situation includes parental alcohol-related fights which he
describes as a common occurrence that leads to family stress which impacts his school
performance and focus. The group leader needs to gather essential information about Tom's
complete family situation and his current emotional state and the alcohol consumption habits
present in his home. The clinician should investigate how frequently parents engage in conflicts
which escalate into dangerous confrontations and analyze how Tom behaves or reacts during
these situations. The alcohol consumption patterns at home need to be established through an
assessment which includes the drinking frequency of both parents and their drinking behavior
during conflicts and any situations where Tom has experienced danger due to their actions. The
clinician needs to evaluate anxiety symptoms along with depression and sleep problems and
concentration difficulties because adolescents who experience ongoing familial disputes will
develop emotional health issues. The process of identifying Tom's academic decline needs to
establish its starting point while tracking teacher observations of his attention issues to evaluate
whether school stress drives his academic challenges or whether assessment for attention-deficit/
hyperactivity disorder is needed. The clinician needs to identify specific protective factors which
include supportive peers and trusted adults and extracurricular activities as stress management
resources for Tom to handle his stress.
The primary goal of group treatment in this situation would be to address the family
dynamics that are contributing to Tom's distress while the group establishes better ways for
family members to communicate and decreases the harmful effects of alcohol use on their family
relationships. Family-focused group therapy approaches in the United States often aim to help
family members recognize how their interactions affect one another and to develop more
constructive ways of managing conflict. In this case, the goal would not only be to support Tom
emotionally but also to help the parents recognize how their alcohol use and arguments may be

affecting their child. Improving communication, increasing emotional awareness, and
encouraging accountability related to drinking behaviors are all important aspects of treatment.
Research suggests that family-based interventions can significantly improve outcomes for
adolescents experiencing stress related to parental substance use or family conflict because they
address the relational environment rather than focusing solely on the individual adolescent
(Hogue et al., 2021).
Because immediate abstinence from alcohol may not always be realistic, harm reduction
strategies may be a practical starting point for this family. The goal of harm reduction is to
decrease the harmful effects of substance use while supporting users in their progressive
development of better habits. The parents require training about alcohol's ability to escalate
conflicts and cause emotional instability when parents argue with children present. The
recommendation to parents is that they should refrain from drinking alcohol whenever their
family members are present or when disputes arise because this will decrease the severity of
arguments that Tom sees. Parents should be encouraged to become conscious of their drinking
habits because this awareness will help them decide whether to cut back on alcohol or undergo
alcohol screening. The availability of resources which help people develop healthier methods to
cope with stress will decrease their tendency to use alcohol as their main stress relief method.
Harm reduction approaches are widely supported in substance use treatment because they
prioritize safety and incremental improvements rather than requiring immediate complete
abstinence (Collins et al., 2021).
This case is being considered in Miami, Florida, where several support groups are available
that could promote positive health outcomes for Tom and his family.Al-Anon Family Groups
functions as an essential support system for people who need help because their loved ones suffer
from alcohol addiction. Al-Anon meetings enable adolescents and their family members to learn
about addiction while also teaching them how to establish proper boundaries and handle
situations with their family member who consumes alcohol. Alcoholics Anonymous serves as
another essential resource because it provides a broad support network that helps people dealing
with alcohol addiction. If Tom's parents join the meetings then they will learn to identify his
drinking issues while starting their path to recovery. SMART Recovery provides a third choice
which enables people to use cognitive behavioral and motivational strategies for controlling their
addiction problems. The program attracts people who want to use structured methods based on
scientific evidence instead of following the standard twelve-step program. These three agencies
were selected because they offer different types of support that address both the family’s
emotional needs and the parents’ potential substance use concerns. By connecting the family
with community resources that encourage healthier coping, improved communication, and
support for recovery, the overall goal is to reduce the stress in Tom’s home environment and help
restore his ability to focus on school and personal development.

**## NUR650Diss1-7.pdf**

NUR650 Discussions

Submission Instructions:

Your initial post should be at least 500 words, formatted and cited in the current APA style

Provide support for your work from at least 2 academic sources less than 5 years old.

Wk1 Tom’s Parents are Fighting

After studying Module 1: Lecture Materials & Resources, discuss the following:

Tom is a 16-year-old who comes to you to evaluate his lack of attention because his grades are
progressively getting worse. When you ask about stress in his life, he notes that his parents are
always fighting, and this upsets him. He believes that they fight more when they have been
drinking, and he believes that his father is the heavier drinker of the two, but he cannot quantify
either parent's use.

• What information would be most critical for the group leader to collect in the first visit?
• What is the primary goal for group treatment of this patient’s family problem based on

US group therapy best practices?
• Which harm reduction strategies would you recommend?
• Identify your city. Then refer this patient to three support groups near you that promote

positive health outcomes for this patient. What was your rationale for choosing these
three agencies?

W2 Harriet Needs Surgery

After studying Module 2: Lecture Materials & Resources, discuss the following:

Harriet is a 51-year-old married woman with a past history of alcohol and cocaine abuse. She has
been attending AA and NA meetings regularly and does not report urges to drink or use drugs
during the 4 years you have been her psychiatric mental health nurse practitioner. She needs
carpal tunnel surgery and the typical regimen during recovery is oxycodone 15 mg per day.

• What information would be most critical for the group leader to collect in the first visit?
• What is the primary goal for the treatment of this patient’s family problem, based on the

US clinical guidelines?

[https://stu.instructure.com/courses/50346/pages/module-1-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-1-lecture-materials-and-resources)

[https://stu.instructure.com/courses/50346/pages/module-2-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-2-lecture-materials-and-resources)

• Discuss one curative factor the group would observe during the initial, middle and
termination phases in group therapy?

• Identify your city. Then refer this patient to three agencies near you that would support
positive health outcomes for this patient. (These agencies must not have been used in past
discussion posts). What was your rationale for choosing these three agencies?

W3 Motivational Interview with Mary

After studying Module 3: Lecture Materials & Resources, discuss the following:

Mary is 27 years old and has had a history of alcohol dependence for several years. Mary has a
daughter Kylie, aged 3 years, who displays signs of fetal alcohol syndrome. Social work services
have been involved with Mary and Kylie since her birth, culminating in Kylie being looked after
by the local authority as a result of Mary arriving to collect Kylie from the local nursery while
significantly under the influence of alcohol. Mary has demonstrated ambivalence regarding her
ability to control her alcohol use. Mary has referred herself to a local counseling agency as
suggested by the social worker and her PCP.

• Discuss how you might use the principles of motivational interviewing with Mary.
• Provide a detailed overview of how the interview may progress. Include each step of

motivational interviewing in your discussion.
• Describe how a provider would recognize this patient is ready to change. Use principles

of motivational interviewing to support your answer.

W4 Richard is Motivated

After studying Module 4: Lecture Materials & Resources, discuss the following:

Richard is a 62-year-old single man who says that his substance dependence and his bipolar
disorder both emerged in his late teens. He says that he started to drink to “feel better” when his
episodes of depression made it hard for him to interact with his peers. He also states that alcohol
and cocaine are a natural part of his manic episodes. He also notes that coming off the cocaine
and binge drinking contribute to low mood, but he has not responded well to referrals to AA and
past inpatient stays have led to only temporary abstinence. Yet, Richard is now trying to forge a
closer relationship with his adult children, and he says he is especially motivated to get a better
handle on both his bipolar disorder and his substance use. He has been more compliant with his
mood stabilizing and antidepressant medication, and his psychiatric provider would like his dual
diagnoses addressed with psychotherapy.

• What diagnostic information would be most critical to collect in the first visit?

[https://stu.instructure.com/courses/50346/pages/module-3-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-3-lecture-materials-and-resources)

[https://stu.instructure.com/courses/50346/pages/module-4-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-4-lecture-materials-and-resources)

• Which diagnostic measures are recommended by the US clinical guidelines for the
treatment of this patient’s family problem?

• Which evidence based harm reduction strategies would you recommend to treat this
patient?

• Identify your city. Then refer this patient to three agencies near you that would support
positive health outcomes for this patient. (These agencies must not have been used in
past discussion posts). What was your rationale for choosing these three agencies?

W5 Pretty Serious Partying

After studying Module 5: Lecture Materials & Resources, discuss the following:

Jackie is a 31-year-old pregnant patient (2nd child, two different fathers) single mother of a 6-
year-old who is coming for prenatal care since she suspects she is pregnant. She is no longer with
the father of Robby, her firstborn. She indicates "pretty serious partying" with the likely father of
the baby. By pretty serious partying she means 10-12 drinks per occasion, one to two times per
week, plus intermittent methamphetamine use.

• Which clinical information would be most critical for you to collect in the first visit?
• What are the greatest risk factors for substance use disorder for this patient?
• Which harm reduction strategies would you recommend?
• Identify your city. Then refer this patient to three agencies near you that would support

positive health outcomes for this patient. (These agencies must not have been used in
past discussion posts). What was your rationale for choosing these three agencies?

W6 Toneika

After studying Module 6: Lecture Materials & Resources, discuss the following:

Tomeika is a three-year-old girl. She was recently diagnosed with autism spectrum disorder
(ASD).
Tomeika is able to make many vocalizations and is able to say one recognizable word. Tomeika
will say “juice”, which she pronounces as “oos.” Throughout the day, Tomeika cries and falls to
the floor to gain access to food, obtain a favorite toy, or when she wants to be picked up. Her
parents, Mr. and Mrs. Williams, would like for Tomeika to communicate her desires with words,
but do not know how to help her. Tomeika recently began attending an early childhood special
education classroom for learners with ASD in the County Public School System for six hours a
day, four days a week. On Wednesdays, Tomeika and her peers do not go to school. Instead, on
this day, Tomeika’s interventionist, Mrs. Dell, has parent conferences in her students’ homes.

[https://stu.instructure.com/courses/50346/pages/module-5-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-5-lecture-materials-and-resources)

[https://stu.instructure.com/courses/50346/pages/module-6-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-6-lecture-materials-and-resources)

During the conferences, Mrs. Dell discusses educational programming, learner progress, areas of
concern, and also provides training to parents.

• Which diagnostic information would be most critical for you to collect in the first visit?
• What is the primary goal for the treatment of this patient’s family problem based on

current US clinical practice guidelines?
• Which complementary and alternative medication treatments would you recommend?
• Identify your city. Then refer this patient to three agencies near you that would support

positive health outcomes for this patient. (These agencies must not have been used in
past discussion posts). What was your rationale for choosing these three agencies?

W7 Hip Fracture

After studying Module 7: Lecture Materials & Resources, discuss the following:

The patient is a 71-year-old widowed man who is seen regularly in the clinic for health
maintenance and follow-up of his chronic insomnia and anxiety. He has regular prescriptions for
triazolam (Halcion) and clonazepam (Klonopin) for these problems. Recently he has been
reporting frequent episodes of losing his balance and falling, and eight weeks ago was
hospitalized for a hip fracture sustained during one of these falls resulting in hip surgery. On this
visit, he also complains of becoming increasingly confused.

• What information would be most critical for you to collect in the first visit?
• What is the primary goal for the treatment of this patient?
• Identify potential obstacles for change. Which educational approach would the PMHNP

provide to overcome these obstacles?
• How would you teach the patient about the Beers list and Halcion?
• Discuss a medication in detail that could be safely substituted to treat insomnia in

geriatric patients.

[https://stu.instructure.com/courses/50346/pages/module-7-lecture-materials-and-resources](https://stu.instructure.com/courses/50346/pages/module-7-lecture-materials-and-resources)

**## NUR650W1respose.pdf**

Dailys Prado Bravo

St. Thomas University

NUR 650

Dr PetitHomme

March 2026

Adolescents who present with declining academic performance and lack of attention
require a comprehensive psychosocial evaluation. In Tom’s case, his report of parental conflict
and suspected alcohol misuse suggests that family stressors may be contributing to his
symptoms. Family substance use and interpersonal conflict are well-documented risk factors for
emotional distress, impaired concentration, and academic difficulties in adolescents (Substance
Abuse and Mental Health Services Administration [SAMHSA], 2023).

Critical Information to Collect During the First Visit

During the initial visit, the group leader should prioritize gathering several categories of
information. First, a comprehensive psychosocial assessment is essential. This should include
Tom’s academic history, attention and concentration symptoms, mood, sleep patterns, and any
history of anxiety or depression. Screening for attention-deficit/hyperactivity disorder (ADHD)
and trauma-related symptoms may also be necessary.

The clinician should assess family functioning and parental alcohol use. Important
information includes the frequency and intensity of parental conflicts, whether alcohol is
involved in arguments, the quantity and frequency of each parent’s alcohol consumption, and
whether Tom has experienced emotional or physical harm related to these conflicts. Adolescents
exposed to parental alcohol misuse are at higher risk for psychological distress and behavioral
problems (Windle et al., 2021).

Safety and coping mechanisms must be evaluated. The clinician should assess whether
Tom feels safe at home, whether domestic violence is present, and what coping strategies he
currently uses to deal with stress. Screening for suicidal ideation or self-harm behaviors is also
critical. Finally, identifying protective factors, such as supportive relatives, school counselors,
mentors, or extracurricular activities, can guide intervention planning.

Primary Goal of Group Treatment

Based on U.S. group therapy best practices, the primary goal of treatment would be to
improve family functioning and reduce the negative impact of parental substance use on the
adolescent. Group therapy can help families develop healthier communication patterns, improve
emotional regulation, and increase awareness of the impact of alcohol misuse on family

[https://stu.instructure.com/courses/50346/users/33214](https://stu.instructure.com/courses/50346/users/33214)

relationships. Psychoeducational family groups and support groups have been shown to improve
coping skills among adolescents affected by parental substance use (SAMHSA, 2023).
Ultimately, the goal is to strengthen resilience, promote healthy family interactions, and reduce
psychological stress for the adolescent.

Harm Reduction Strategies

Harm reduction strategies focus on minimizing the negative consequences of substance
use rather than requiring immediate abstinence. For Tom’s family, several strategies may be
beneficial. First, encouraging parents to monitor and reduce alcohol consumption, particularly
during times when conflict is likely to occur, can decrease family tension. Second, implementing
conflict-management strategies, such as avoiding arguments while drinking and setting family
communication guidelines, may reduce emotional harm to Tom.

Connecting the parents with alcohol education programs or counseling services can
increase their awareness of how their behavior affects their child. Finally, teaching Tom coping
strategies such as stress management, emotional expression, and seeking support from trusted
adults can reduce the psychological impact of family conflict.

Local Support Groups

Because I am located in Miramar, Miami, Florida, the following support groups in the area
would be appropriate referrals:

1. Al-Anon Family Groups – Fort Lauderdale Area
Al-Anon provides peer support for individuals affected by someone else’s drinking. Teen-
focused groups such as Alateen can help adolescents share experiences, develop coping skills,
and reduce feelings of isolation.

2. Alcoholics Anonymous (AA) – Broward County Intergroup
AA meetings provide structured peer support for individuals struggling with alcohol use.
Referring Tom’s parents to AA may help them address problematic drinking behaviors and
reduce alcohol-related conflict within the home.

3. NAMI Broward County Family Support Groups
The National Alliance on Mental Illness (NAMI) offers family education and support groups that
help families manage mental health stressors and improve communication. These programs can
support both Tom and his parents by promoting healthier family dynamics.

The rationale for selecting these organizations is that they are evidence-based, widely
accessible, free or low-cost, and provide both family-focused and substance-use-specific support.
Access to community support networks can significantly improve outcomes for adolescents
living in households affected by substance use.

Tom’s declining academic performance may be closely related to the stress associated with
parental conflict and possible alcohol misuse. A thorough assessment, family-centered group
therapy, and harm reduction strategies can help address the underlying issues affecting his
attention and emotional well-being. Connecting the family with community support groups may
further strengthen coping skills and promote healthier family relationships.

Arlette Del Pino Vento

Discussion 1
NUR 650 Psychiatric Management IV

Dr. PetitHomme PMHNP-BC
03/15/2026

The process of assessing adolescents who show reduced school achievement and problems with
focusing needs to include both possible neurodevelopmental conditions and environmental
stressor effects. Tom's family situation includes parental alcohol-related fights which he
describes as a common occurrence that leads to family stress which impacts his school
performance and focus. The group leader needs to gather essential information about Tom's
complete family situation and his current emotional state and the alcohol consumption habits
present in his home. The clinician should investigate how frequently parents engage in conflicts
which escalate into dangerous confrontations and analyze how Tom behaves or reacts during
these situations. The alcohol consumption patterns at home need to be established through an
assessment which includes the drinking frequency of both parents and their drinking behavior
during conflicts and any situations where Tom has experienced danger due to their actions. The
clinician needs to evaluate anxiety symptoms along with depression and sleep problems and
concentration difficulties because adolescents who experience ongoing familial disputes will
develop emotional health issues. The process of identifying Tom's academic decline needs to
establish its starting point while tracking teacher observations of his attention issues to evaluate
whether school stress drives his academic challenges or whether assessment for attention-deficit/
hyperactivity disorder is needed. The clinician needs to identify specific protective factors which
include supportive peers and trusted adults and extracurricular activities as stress management
resources for Tom to handle his stress.
The primary goal of group treatment in this situation would be to address the family
dynamics that are contributing to Tom's distress while the group establishes better ways for
family members to communicate and decreases the harmful effects of alcohol use on their family
relationships. Family-focused group therapy approaches in the United States often aim to help
family members recognize how their interactions affect one another and to develop more
constructive ways of managing conflict. In this case, the goal would not only be to support Tom
emotionally but also to help the parents recognize how their alcohol use and arguments may be

affecting their child. Improving communication, increasing emotional awareness, and
encouraging accountability related to drinking behaviors are all important aspects of treatment.
Research suggests that family-based interventions can significantly improve outcomes for
adolescents experiencing stress related to parental substance use or family conflict because they
address the relational environment rather than focusing solely on the individual adolescent
(Hogue et al., 2021).
Because immediate abstinence from alcohol may not always be realistic, harm reduction
strategies may be a practical starting point for this family. The goal of harm reduction is to
decrease the harmful effects of substance use while supporting users in their progressive
development of better habits. The parents require training about alcohol's ability to escalate
conflicts and cause emotional instability when parents argue with children present. The
recommendation to parents is that they should refrain from drinking alcohol whenever their
family members are present or when disputes arise because this will decrease the severity of
arguments that Tom sees. Parents should be encouraged to become conscious of their drinking
habits because this awareness will help them decide whether to cut back on alcohol or undergo
alcohol screening. The availability of resources which help people develop healthier methods to
cope with stress will decrease their tendency to use alcohol as their main stress relief method.
Harm reduction approaches are widely supported in substance use treatment because they
prioritize safety and incremental improvements rather than requiring immediate complete
abstinence (Collins et al., 2021).
This case is being considered in Miami, Florida, where several support groups are available
that could promote positive health outcomes for Tom and his family.Al-Anon Family Groups
functions as an essential support system for people who need help because their loved ones suffer
from alcohol addiction. Al-Anon meetings enable adolescents and their family members to learn
about addiction while also teaching them how to establish proper boundaries and handle
situations with their family member who consumes alcohol. Alcoholics Anonymous serves as
another essential resource because it provides a broad support network that helps people dealing
with alcohol addiction. If Tom's parents join the meetings then they will learn to identify his
drinking issues while starting their path to recovery. SMART Recovery provides a third choice
which enables people to use cognitive behavioral and motivational strategies for controlling their
addiction problems. The program attracts people who want to use structured methods based on
scientific evidence instead of following the standard twelve-step program. These three agencies
were selected because they offer different types of support that address both the family’s
emotional needs and the parents’ potential substance use concerns. By connecting the family
with community resources that encourage healthier coping, improved communication, and
support for recovery, the overall goal is to reduce the stress in Tom’s home environment and help
restore his ability to focus on school and personal development.