Genogram Elainna Nazzario

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three years ago, when Nicholas began to abuse alcohol, Teresa revealed she had to take over the role of main decision maker in the family. Before Teresa makes a decision she considers Rebecca’s needs first, then her son’s and then her own. Teresa makes her decisions by how her daughter may negatively react because of her autistic features.

Generational Trends

On Nicholas’ side of the family there are 3 members that have struggled with alcoholism including himself. Teresa’s father suffers with alcoholism and her brother suffers from drug abuse. On Nicholas’ side, his niece Isabella has autism and his daughter Rebecca does too. Nicholas and two of his three siblings have earned bachelor degrees. A commonality between Nicholas and Teresa is that they gain a lot of their support from one of their sisters, while each of them have kept their distance from one of their troubled brothers. Although Teresa has not revealed that her father was verbally or physically abusive toward her, she has revealed that growing up her sister and brother were often disciplined harshly by their father. It is notable that both of her siblings have abusive or hateful relationships with their father, and Teresa reports being indifferent. More exploring in Teresa’s upbringing and exploring of her grandparents and her husband’s grandparents will this writer to get a bigger picture.

Developmental Information

The developmental stage of the family is the preparation stage. All of the family members want to make goals, work on effective communication, and start problem solving. The most significant loss in the family was the death of Angela. A lot of anger and resentment was experienced by Nicholas and his siblings, he reports, “My mother did not want to be here, she did not care enough to want to stay”. Another major event occurred when Nicholas’ Pete revealed his AIDS diagnosis to his family, both his father and brother began to feel guilt and give monetary support. The last major event revealed involved Larry Jr., he started using drugs 4 years ago and it escalated to his arrest. Larry Jr. was arrested for drug crimes and beating his girlfriend and mother of his children severely. Teresa’s brother Larry Jr. has served 2 years behind bars but has since been released. Teresa has worked to keep far away from Larry Jr. and his immediate family. In all of these reactions to loss there are no anticipated changes or transitions in the near future.

The current goals of the family, include open and honest communication between Teresa and her husband Nicholas, the encouragement of Christopher to spend time with his father, and education in alcohol recovery for the family. No goals have been met yet. The spiritual life in the family is suffering because the family has stopped attending church as a unit and instead goes occasionally, or sometimes with one member of the family. The family does want to re-connect with the church but need to practice time management.

General Impressions

Most of the talking was from the mother, Teresa, perhaps because she was has learned to be the main decision maker in her family and the habit continued on into the session. The family has no boundaries with the outside world, Teresa reports her family is an open books, stating, “If you know me, you know me very well, I love to talk”. All of the family members enjoy spending time outside the house. The family is very affectionate to one another, except Nicholas who reportedly was very affectionate but ever since his alcohol addiction began, he has been more distant.

The strengths of this family include their desires to change and openness to new treatment. The weaknesses of the family system include the father’s lack of effective communication skills, mother’s possible co-dependency behavior and son’s lack of effective communication skills. There is a possible triangle effect between Christopher and Teresa, both do not want to spend time with Nicholas if it can be avoided. Another possible triangle effect can be seen between Nancy and her mother Patricia who do not get along with Larry.

Assessment of Family Interaction

Using the AFI, I have assessed the overall function of the family. All members of this struggle with commitment to other family members, communication of thoughts and feelings within family, ways of dealing with frustration, shared moral values, rules of order and general expectations. The big areas of focus for therapy will be effective communication, positive and effective encouragement of one another, establishing a shared value system and setting of general boundaries and expectations. Overall the main areas of concentration are cohesion, expressiveness, conflict, moral-religious emphasis, organization and control. The biggest concern that needs to be addressed is re-establishing safety. The family does not feel safe because both children are fearful that the father may leave and the mother no longer trusts her husband, she expresses feelings of indifference.

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