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Family Assessment Visual Report California State University, San Marcos NURS 480


Jack Pearson is a 44-year old man who is married to his wife Rebecca Pearson and is a father to biological twins, Kevin and Kate, and their adoptive son, Randall. He is a Vietnam war veteran and has jumped job to job throughout the years from fixing people’s cars to construction. He currently works at a desk job at a building firm. His dream, however, is to start up his own architectural business called “The Big Three Homes”, inspired by his children. Jack grew up in an difficult home, with an abusive alcoholic father and a mother who wasn’t there for him amidst the abuse. Motivated through his troubled childhood, Jack made a promise to be a better man and father because of it. Jack is known as the family’s “superhero” and is the type of man that people ponder “what can that man not do?” He is hard-working, loyal, extremely reliable, passionately caring, and optimistic. However, with his strong facade, there hides the biggest flaw he holds deep inside: his alcohol addiction.

Alcoholism is a condition that involves uncontrolled drinking and being dependent on alcohol. It is unhealthy alcohol use that poses health and safety risks. Genetic and family history of alcoholism greatly increase the risk of developing this condition, as well as other social and environmental factors (Alcohol Use Disorder, 2018). Jack’s dad was an alcoholic and he grew up watching him turn to alcohol. Under the influence, Jack has put himself in risky situations such as drunk driving, getting into bar fights, replacing his coffee at work with alcohol, and coming home late from the bar, all of which jeopardize his family financially, physically and emotionally.

Rebecca Pearson is a 38-year old mother of biological twins, Kevin and Kate, and an adopted son, Randall. She originally birthed triplets, however the baby, Kyle, died at birth. She is primarily a stay-at-home mother, but recently became a lead singer for a jazz band that performs regularly at pubs. She came from a traditional and strict family, whose own mother was always judgmental of her and what she chose to do in life. Because of this, she became self-critical and a perfectionist. She strives to be the best mother and wife she could be to her kids and husband. She is emotional, sensitive, kind-hearted, protective, and loving.

Kevin Pearson is a 9-year old boy, the twin of

Kate, and the oldest. He can be selfish, whiny, jealous and has a lot of temper tantrums. However, he battles with feeling invisible and feeling left out in his family. He takes them out mostly on his brother Randall, where he is seen as a villain and ends up alienating him further from the family and his parents.

Kate Pearson is a 9-year old girl, the twin of

Kevin. She is a quiet, reserved and insecure girl who struggles early with her weight. She has a weak, distant relationship with her mom due to the pressure of living up to what she is like. She and her dad Jack are very close and is often spoiled by him.

Randall Pearson is a 9-year old boy and is the adopted son of the family. He was found in a fire station and was brought to the hospital where he was then adopted by the Pearsons. He is a well-spoken, intelligent and curious boy. He struggles with his identity early on, being black and raised in a white family. To alleviate this, Rebecca often favoritizes him the most in the family.

According to Duvall’s family stages of development, the Pearson family is in the “families with school-age children” stage. Jack and Rebecca are a few years into their marriage and their newborns are now children. They are in the stages where they must transition in “supporting child in outside interests and needs”, and also “determining disciplinary actions and family rules and roles”. They also are in the stage of “working out authority and socialization roles with school” among their children (Kaakinen, Coehlo, Steele, Tabacco, & Hanson, 2015, p. 80). The Pearson Family are a middle-class traditional nuclear family living in Pittsburgh. They have annual traditions such as hosting a family dinner every Super bowl game. They also gather together every Sunday to watch their favorite football team, the Pittsburgh Steelers. They celebrate all holidays together, and for each holiday they go on a different

trip out of town together.

Jack and Rebecca do not explicitly identify with a religion,

nor do they bestow any religious traditions and beliefs to their children.

The Pearson family are grounded on a strong marriage, in which Jack and Rebecca have

cultivated through effective communication methods. As a couple, they are not afraid to get in each other’s faces if a problem exists. They do not hide their feelings or try to avoid it, but are upfront about it and want to talk about their issues right away. However, they’re both different in their approach. Jack likes to approach conflict calmly, while Rebecca starts with a head of steel. She presses onto him while Jack tries not to blow out in anger. They are both able to hold eye contact and have body language that shows the other that they are listening and are engaged in their conversation. For the most part, their tone of voice is civil and both remain respectful towards one another. Oftentimes their body language reflect their current emotion, but at the end of a conflict, they hold each other to reaffirm that they listened and are willing to do what the other is asking of.

The Pearson children are no different. They are each equally vocal about

their feelings and concerns, and find their own ways to get them across to each other and to their parents. Facial expressions such as eye rolling and pouting are the main nonverbal cues of the Pearson children. They often walk away after expressing their concerns and are fetched by their parents for an individual talk. Jack and Rebecca are effective in getting their points across, as they do not aggressively yell at their children for discipline, but are rather firm and neutral about it. They communicate with gestures through use of touch such as hugs, cupping of their faces, and kisses. Also, Jack is mainly the one to have one-on-one talks with their children, as he is the more calm and sensible one compared to Rebecca.

When considering the Pearson family’s dynamic, they undeniably have strengths and weaknesses as a whole. As strengths, they are a strong close-knit family who are constantly around each other and support each other. They are effective communicators when problems arise. They trust each other and value each other’s opinion. They listen and respect one another’s thoughts. They are able to distinguish their roles in the family. Some challenges is that the parents play “favorites” with their children, and can spoil them unfairly, which gives room for jealousy and fights. There is a disconnect between Jack and Rebecca in knowing how to treat them all the same and being inclusive so that they all feel loved.

alcoholism Strengths: ●

Rebecca’s realization Jack isn’t “Superhero” after all and pushes for the appropriate help he needs to tend to her husband’s well-being and health Jack learning he, too, can falter and realizing he cannot do this alone and joins an Alcohol Anonymous support group for the sake of his safety and family security The children’s strong love and appreciation for their parents prevents them to be angry with their dad, but full of empathy and the need to help and be there for him

Challenges: ● ● ●

Jack’s overwhelming pride takes over and he eventually quits the AA support group Jack is often drunk at work which causes him to be careless with his work that could cost him his job Rebecca grows weary and tired of Jack’s inconsistency in getting help and quitting alcohol. This sparks more arguments, and eventually more risky behavior from Jack Kate, who is the most close to Jack, finds herself responsible and for Jack. She feels the need to take care of him. Parent-child relationship switches

Application of family nursing theory:

The Family Systems Theory is a framework that views the family as a whole system. It sees the individual family members as participants of a larger family system. It describes that a change in one member of the family, such as Jack and his alcoholism, affects all members of the family, like his wife Rebecca and his three kids Kevin, Kate and Randall. This system assesses the “impact” of the illness/condition on the entire family as a whole. This system believes a family is “interconnected”, thus the probability of an individual family member being affected by such condition is much higher. This fits for the Pearson family because they are extremely close and are interconnected in many ways. Additionally, it looks at how each family member is specifically affected and how those individual impact changes the whole family dynamic and function. The family systems theory would be the best framework as its main goal is to “maintain or restore the stability of the family”, in which is currently unstable in the presence of Jack’s alcoholism (Kaakinen et al., 2015, p. 76).

The Pearsons are a nuclear family, consisting of Jack, the dad, Rebecca, the mother, and Kevin, Kate and Randall as the three kids. Jack is the patriarch of the family and holds a pivotal spot and specific role in each of the family members lives. His alcoholism drastically affects his mental functioning and his ability to perform his dad and husband duties. Such affect can lead to the other family members worrying how will life be like if he possibly gets in a car crash from drunk driving or gets fired from his job from being drunk while working. Also, he has had several nights where he comes home extremely late, causing him to miss out on the duties he’s responsible for that Rebecca had to pick up and do instead. Being absent at home causes the children to wonder if he’s still around or if their parents are going to separate. Additionally, he forgets important events that involve his children because he was out drunk or is currently drunk. Ultimately, he is the breadwinner of the family and everything that happens to the family is a direct result of his efforts and doing. Without him, it will cause the whole family system to be in a huge imbalance.

Jack uses alcohol as his coping strategy in times of stress and he turns to it to feel better about himself. He especially drinks when he’s burnt out from carrying the load of his family financially, physically and emotionally or when he’s frustrated with how his job is going. Jack’s behavior under the influence has also caused his wife Rebecca to be angry and frustrated with him. She denies he’s an alcoholic and doesn’t realize the magnitude of his condition. Additionally, his children mistaken his behavior and absence from home and at school events as if he and their mom are getting a divorce or are fighting. Jack strongly prides himself and it prevents him from showing his family that he is weak or suffering, so he bottles it up and turns to alcohol to suppress it further. He vanishes late at night to drink at bars and escapes the hard reality he faces through drinking so he can try and stay strong for his family even if he is personally struggling.




Intervention: Assess the family’s coping strategies in times of stress through a “Stress coping Style checklist” (Park & Choi, 2017), particularly in the moments Jack is under the influence or absent due to him being out drinking and determine the appropriate strategies to exercise as a response Rationale: Identifying the family’s coping strategies can help “positively influence the client’s treatment outcomes” in areas such as “codependency, emotional stability, interpersonal relationships and problem solving” (Park & Choi, 2017). This can further help the family in knowing which strategies to keep and build on, and which to discontinue as it may not be healthy when dealing with Jack’s alcoholism overall. Outcome: The family will become a strong, reliable source of support for Jack by sharing their different and healthy ways of coping with stress and enable Jack to perform such strategies with them as a family when he has the urge to drink. Intervention: Educate Jack’s family about alcohol use disorder such as the cause, the behavior normally seen, and the effects it has on an individual both mentally and physically when under the influence of alcohol. Rationale: Family members’ attitudes heavily influence the client’s choice of admitting their alcohol problem and seeking help. Such attitude can be based off the family’s lack of knowledge, misunderstanding and underestimation of the problematic behavior that comes with alcohol use (Park & Choi, 2017). Educating the family can help recognize the problematic behavior and help the client (Jack) avoid alcohol completely and take the necessary steps in recovering or care for him when he is under the influence to prevent further problems that can compromise him and his family’s safety. Outcome: The Pearson family will be well-educated and informed about alcohol use disorder to understand Jack and will dismiss any misinterpretations they had of Jack’s behavior and be able to effectively intervene when dealing with his alcoholism. Intervention: Encourage Jack to be more open and vocal about his personal struggles and allow the family to take care of him emotionally, mentally and physically for once, instead of him assuming that responsibility 24/7 Rationale: Communicating and being open about their alcoholism can help alleviate any buried “anxiety, powerlessness and depression” in the client (Park & Choi, 2017) Outcome: Jack will verbalize that he is more open about his struggles to his family and communicates when he is in need of support and comfort

Alcohol use disorder. (2018, January 31). Retrieved from Kaakinen, J. R., Coehlo, D. P., Steele, R., Tabacco, A., & Hanson, S. H. (2015). Family health care nursing: theory, practice, and research. Philadelphia: F.A. Davis Company. Park, G., & Choi, Y. (2017). Family Stress and Coping From Hospitalization of Clients With Severe Alcohol Use Disorder in Korea. Journal of Addictions Nursing, 28(1), 4-10. doi:10.1097/jan.0000000000000154

N480 Family Nursing Visual Report: Pearson Family  
N480 Family Nursing Visual Report: Pearson Family