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Original Question

Brenda (age 35) and Tom (age 36) Smith have an appointment with you for an evaluation of their son, Joshua, who is 5 years old. They bring all of their children to the appointment, including Timmy (3 months), Joshua (5), Sally (7), Mary (11), and Jane (15). Joshua was recently diagnosed with leukemia and his progression is guarded. He has been withdrawn and irritable is crying a lot, and has not been interested in playing or doing the things he used to enjoy before his diagnosis. Since the diagnosis, his siblings have been fighting more at home and refusing to do their chores, and the two oldest are refusing to go to school. Answer the following questions from your perspective as their psychiatric nurse practitioner. Based on Joshua’s presentation, what relevant questions and information would you ask regarding Joshua’s development (starting with prenatal) to complete a psychiatric evaluation? Select one of the Jones’ children (except Joshua) and identify the normal developmental milestones you would expect based on their current age. Using Bowen Family Systems Theory, how might you best approach the first interview with this family? What, if any, any cultural considerations should you apply when working with the Jones family?

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