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Week 9 Discussion

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Assessment for and Challenges Related to Pervasive Mental Illness and Health Concerns
In the 1950s, a radical shift in counseling occurred. Numerous key figures in the fields of family counseling and therapy proposed the view that pervasive mental health problems were not individual problems, as was previously thought, but originated with and were perpetuated by family dynamics. The shift from working with individuals with pervasive or severe mental illness or health concern via individual psychotherapy to working with the identified “patient” and their families in the 1950s provided the context for the birth and growth of family counseling/therapy. Since that time, mental health professionals working with families with a member experiencing pervasive mental illness or a health concern have moved away from the controversial stance above, to acknowledge that both genes and biology influence behavior and that relationships can maintain or exacerbate symptomology as well as assist in alleviating it via various coping mechanisms.
Tertiary intervention is the formal term for working with clients experiencing pervasive mental illness or health concerns, but it may also be referred to as remedial or rehabilitative counseling. When you encounter a couple or family for which tertiary intervention may be appropriate, your assessment focus should shift. First, you should be cognizant of any symptoms or cues that may substantiate your concerns, and if validated, you will need to assess whether couple and family counseling is indeed the best form of counseling service to provide. It may be that one or more persons would benefit from individual services, whether in conjunction with or as a precursor to any couple or family counseling.
With these thoughts in mind:
Post by Day 4 a brief description of three symptoms/cues observed in a family/couple session that may require assessment and intervention beyond the scope of a family/couple session and explain why. Then, explain how you, as a counselor, might take the next steps with the individual who requires additional assessment and intervention. Finally, explain any challenges of continuing couple/family counseling once an individual requires concurrent treatment.
Be sure to support your postings and responses with specific references to the Learning Resources.
Learning Resources
Required Resources
Please note: These films are not available through Walden Library. Contact your instructor if you are unable to obtain a copy independently.
Please select, obtain, and view one of the following two movies to use with this week’s Application Assignment:

  • Movie: Madden, J. (Director). (2005). Proof [Motion picture]. [With G. Paltrow, A. Hopkins, & H. Davis]. United States: Miramax.
  • Movie: Daniels, L. (Director). (2009). Precious [Motion picture]. [With G. Sidibe, Mo’Nique, & P. Patton]. United States: Lionsgate.


  • Course Text: Gurman, A. S., Lebow, J. L., & Snyder, D.  (2015). Clinical handbook of couple therapy (5th ed.). New York, NY: Guilford Press.
    • Chapter 23, “Couple Therapy and the Treatment of Borderline Personality and Related Disorders”
    • Chapter 25, “Couple Therapy and Medical Issues”
  • Article: Aymer, S. R. (2010). Intimate partner abuse: A case study involving a father and a son. Clinical Case Studies, 9(1), 3–17.Retrieved from the Walden Library databases.
  • Article: Martin, C., Southall, A., Liveley, K., Shea, E., & Whitehead, K. (2009). Multisystemic therapy applied to the assessment and treatment of poorly controlled Type-1 Diabetes: A case study in the U.K. National Health Service. Clinical Case Studies, 8(5), 366–382. Retrieved from the Walden Library databases.
  • Article: Rosenfield, B. M., Ramsay, J. R., & Rostain, A. L. (2008). Extreme makeover: The case of a young adult man with severe ADHD. Clinical Case Studies, 7(6), 471–490. Retrieved from the Walden Library databases.


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