[Solved] NUR 640

Assignment Prompt & Instructions

**files (2)**

– ## NUR640WeeklyDis1-7.pdf

– ## NUR640WK3DISRESP.pdf

**## NUR640WeeklyDis1-7.pdf**

NUR 640 Weekly Discussion

FYI Remember… I am a Black Haitian American Female live in USA, FL

Submission Instructions:

• Your initial post should be at least 500 words, formatted, and cited in current
APA style with support from at least 2 academic sources.  Your initial post is
worth 8 points.

Week 1: The PMHNP as a Psychotherapist

Psychotherapy is often misunderstood or devalued.

• Discuss your views of the PMHNP as a psychotherapist

• Discuss whether it is feasible to provide psychotherapy at each patient

encounter

Week2: Dream Interpretation

Freud viewed dreams as the “royal road to the unconscious.”

• Discuss a memorable dream from your childhood.  Provide as much detail about
the dream as possible.

• Interpret the dream of two peers using the psychodynamic dream of Freud or
Jung

Week 3: Genogram

A genogram is often used to illustrate the behaviors of a family unit across generations.
The genogram can be used to reduce resistance to harmful family patterns.

• Recall a family with a member who has a history of drug or alcohol dependence.

• Describe how the genogram can be used to address the denial of family unit

addiction to individual family members.

Week 4: Automatic Thoughts

Patients are often asked to write their record their negative thoughts as homework for
Cognitive Behavioral Therapy (CBT) session.

• Explain how difficult this task might be for depressed patients?

• Identify your culture and ethnicity. Describe how negative thoughts are

perceived in your culture.

• Discuss ways you could increase the likelihood that a depressed patient

completes the Automatic Thoughts Download Automatic Thoughts
assignment.

Week 5: The Culture of Family Violence

Identify your culture and how it address family violence.

• In your opinion, what is the best way for a family therapist to bring up the issues
of abuse and violence in a family when those are not the problems that family
members have identified?

Week 6: Grief

A 75-year-old widower walks into your practice to request therapy services.  He has
grieved the loss of his wife for the last 28 months; they were married 50 years.

• Explain the significance of interpersonal deficit as it relates to interpersonal
therapy

• Describe how you would ask “very good” questions to facilitate the patient’s
ability to see their own experiences.

Week 7: The Therapist’s Personality

According to Carl Rogers, unconditional positive regard involves basic acceptance and
support of a person, regardless of what the person says or does.  The therapist gives
space for the client to express whatever immediate feeling is going on—confusion,
resentment, fear, anger, courage, love, or pride.

• Discuss the role of the therapist’s personality in person-centered psychotherapy.

[https://stu.instructure.com/courses/49953/files/4509652?wrap=1](https://stu.instructure.com/courses/49953/files/4509652?wrap=1)

[https://stu.instructure.com/courses/49953/files/4509652/download?download_frd=1](https://stu.instructure.com/courses/49953/files/4509652/download?download_frd=1)

• Are there particular people who have been or would be especially difficult for
you to unconditionally positively regard?

**## NUR640WK3DISRESP.pdf**

Geslande Dessalines

Discussion 3

Geslande Dessalines, BSN, RN

Saint Thomas University

Psychiatric Management II

Dr. Dorothy Crisostomo, DNP, FNP-C, PMHNP-BC, ARNP

1/26/2026

Using Genograms to Address Denial in Families Affected by Addiction

Genograms are valuable clinical tools used to visually map family relationships, behaviors,
and patterns across generations. In counseling and psychotherapy, genograms go beyond a
traditional family tree by including emotional relationships, patterns of interaction, and recurring
issues such as mental illness, trauma, and substance use disorders (Corey, 2023). One of the most
powerful applications of a genogram is its ability to reduce resistance and denial by helping
families see patterns that they may otherwise minimize or normalize. In my own experience, my
ex-husband/my child’s father has a history of both drug and alcohol dependence. While the
addiction significantly impacted our relationship and family functioning, denial was a major
barrier to acknowledging the problem—not only for him, but also within the broader family
system. This is where a genogram can be especially effective as a therapeutic intervention.
Addiction often exists within a family system that unconsciously supports or enables it.
According to Wheeler (2020), families affected by substance use frequently develop maladaptive
coping strategies, such as minimization, rationalization, and secrecy, which serve to maintain
emotional equilibrium but ultimately reinforce the addiction. When addiction is framed as “just
stress,” “bad luck,” or “something everyone goes through,” denial becomes a shared family
defense rather than an individual issue.

A genogram can help address this denial by externalizing the problem. Instead of focusing
solely on the identified individual with substance dependence, the genogram allows the clinician
to collaboratively explore patterns across generations. For example, when mapping a family
history, it may become apparent that multiple relatives struggled with alcohol misuse,
prescription drug dependence, or related issues such as domestic violence, depression, or legal
problems. Seeing these patterns visually can be eye-opening and less threatening than direct
confrontation (Corey, 2023). In the case of my ex-husband, a genogram could highlight how
substance use was not an isolated issue but part of a broader intergenerational pattern. This visual
representation helps shift the conversation from blame to understanding. Instead of “you are the

problem,” the message becomes “this is a pattern that has affected this family over time.”
Research supports this approach, noting that genograms promote insight and reduce
defensiveness by placing behaviors within a systemic and historical context (McGoldrick et al.,
2021). Genograms are also effective in addressing denial among other family members, such as
parents or siblings, who may unintentionally enable addictive behaviors. When family members
see how addiction intersects with roles like caretaker, rescuer, or scapegoat, they may begin to
recognize their own participation in maintaining the cycle. This awareness can foster
accountability without shame, which is critical for therapeutic engagement (Wheeler, 2020).

From an addiction-specific perspective, recent literature emphasizes the importance of
family-based conceptualizations of substance use disorders. A 2022 review in Journal of Family
Therapy found that visual tools like genograms enhance motivation for change by helping
families recognize recurring relational patterns linked to addiction, such as emotional cutoff,
unresolved trauma, and ineffective boundaries (Carr, 2022). These insights can then be used to
set healthier boundaries and support recovery rather than enable continued use.

In summary, genograms are powerful tools for addressing denial in families affected by
addiction because they make invisible patterns visible. By mapping substance use within a
multigenerational framework, genograms reduce resistance, promote insight, and encourage
shared responsibility for change. Rather than assigning blame, they foster understanding,
empathy, and motivation—key ingredients for healing in families impacted by substance
dependence.

Alejandro Llanes

Module 3 Discussion

A genogram is a tool that therapy practitioners use to create a family tree that documents
biological and non-biological data, such as emotional relations among family members, how
family members relate to one another, and intergenerational behavior patterns (Arias, 2017). In a
substance-addicted family system characterized by denial, genograms can be enlightening. The
genogram can reveal that the pattern of substance abuse runs in a family even if it is not
discussed, providing a more accurate picture of the addiction than by viewing it as a single issue.

In families with a history of substance use disorder, denial can be a common defensive
action to protect family members from dealing with the painful proposition of knowing a person
addicted to drugs or alcohol. Family members often minimize symptoms, rationalize their loved
one's behavior, or focus on the drug and/or alcohol use as the result of other problems, such as
work or relationship issues (Arias, 2017). Family-wide minimization may reinforce the family's
maladaptive behaviors as all family members unintentionally conspire to continue the status quo,
avoiding conflict, loss, or shame. This is the importance of the genogram. It makes the invisible
visible and helps people understand their behaviors based on the history of their families.

The genogram is created collaboratively with the family. The clinician invites the family
into constructing the genogram with three or more generations. By having family members name
people and years and patterns of relationships, the clinician can discover the presence of family
members with substance use disorders, enabling patterns, and cycles of denial (Arias, 2017). The
multiple patterns of addiction across generations are revealed to family members within this
narrative to show that addiction is a family issue and not a personal problem. Familiarizing
oneself with the patterns may allow one to hold a mirror to this behavior without the blame and
confrontation that often accompanies accusation.

Second, genograms help to address denial about behaviors and reactions to substance use.
This can be seen when family systems unconsciously recreate the roles of the family dynamics
such as the "hero", "scapegoat" or "enabler" to maintain the illusion of denial about the severity
of addiction (Arias, 2017). Identifying the roles and behaviors in a genogram allows the
members to see how their actions have contributed to the system that supports substance use.
This process may allow the denial that may have been used by the family members as a coping
mechanism to be broken, and how these roles supported the continued use of substances. Thus,
the genogram can be seen as a tool for perception rather than blame.

Third, genograms can highlight strengths and resources. Although genograms are designed
to focus on family problems, a careful and detailed genogram may illustrate strengths at home,
positive relationships, and coping mechanisms family members previously used (SAMHSA,
2020). This balanced approach reduces defensiveness in families by helping family members
realize both the problems and strengths they may wish to draw on in order to effect change. By
identifying and focusing on positive elements in addition to negative ones, a softer approach to
change may be encouraged.

Finally, because the genogram is not a fixed image, it can be constantly revised throughout
the course of treatment to reflect new information and new family relationships. This focus on
continuing adaptation and longitudinal transformation means that genograms can be both an
assessment tool, and a dynamic document that supports the active therapeutic process and helps
family members move from a place of denial to a place of engagement with change (SAMHSA,
2020). In summary, genograms help families to shift their perception from individual behavior to
systemic patterns, to conceptualize and discuss individual behavior in systemic terms, and to
create an acceptance that can ease a family's recovery and new patterns of interaction that can be
helpful to the family.

•

**## NUR640WK3DISRESP.pdf**

Geslande Dessalines

Discussion 3

Geslande Dessalines, BSN, RN

Saint Thomas University

Psychiatric Management II

Dr. Dorothy Crisostomo, DNP, FNP-C, PMHNP-BC, ARNP

1/26/2026

Using Genograms to Address Denial in Families Affected by Addiction

Genograms are valuable clinical tools used to visually map family relationships, behaviors,
and patterns across generations. In counseling and psychotherapy, genograms go beyond a
traditional family tree by including emotional relationships, patterns of interaction, and recurring
issues such as mental illness, trauma, and substance use disorders (Corey, 2023). One of the most
powerful applications of a genogram is its ability to reduce resistance and denial by helping
families see patterns that they may otherwise minimize or normalize. In my own experience, my
ex-husband/my child’s father has a history of both drug and alcohol dependence. While the
addiction significantly impacted our relationship and family functioning, denial was a major
barrier to acknowledging the problem—not only for him, but also within the broader family
system. This is where a genogram can be especially effective as a therapeutic intervention.
Addiction often exists within a family system that unconsciously supports or enables it.
According to Wheeler (2020), families affected by substance use frequently develop maladaptive
coping strategies, such as minimization, rationalization, and secrecy, which serve to maintain
emotional equilibrium but ultimately reinforce the addiction. When addiction is framed as “just
stress,” “bad luck,” or “something everyone goes through,” denial becomes a shared family
defense rather than an individual issue.

A genogram can help address this denial by externalizing the problem. Instead of focusing
solely on the identified individual with substance dependence, the genogram allows the clinician
to collaboratively explore patterns across generations. For example, when mapping a family
history, it may become apparent that multiple relatives struggled with alcohol misuse,
prescription drug dependence, or related issues such as domestic violence, depression, or legal
problems. Seeing these patterns visually can be eye-opening and less threatening than direct
confrontation (Corey, 2023). In the case of my ex-husband, a genogram could highlight how
substance use was not an isolated issue but part of a broader intergenerational pattern. This visual
representation helps shift the conversation from blame to understanding. Instead of “you are the

problem,” the message becomes “this is a pattern that has affected this family over time.”
Research supports this approach, noting that genograms promote insight and reduce
defensiveness by placing behaviors within a systemic and historical context (McGoldrick et al.,
2021). Genograms are also effective in addressing denial among other family members, such as
parents or siblings, who may unintentionally enable addictive behaviors. When family members
see how addiction intersects with roles like caretaker, rescuer, or scapegoat, they may begin to
recognize their own participation in maintaining the cycle. This awareness can foster
accountability without shame, which is critical for therapeutic engagement (Wheeler, 2020).

From an addiction-specific perspective, recent literature emphasizes the importance of
family-based conceptualizations of substance use disorders. A 2022 review in Journal of Family
Therapy found that visual tools like genograms enhance motivation for change by helping
families recognize recurring relational patterns linked to addiction, such as emotional cutoff,
unresolved trauma, and ineffective boundaries (Carr, 2022). These insights can then be used to
set healthier boundaries and support recovery rather than enable continued use.

In summary, genograms are powerful tools for addressing denial in families affected by
addiction because they make invisible patterns visible. By mapping substance use within a
multigenerational framework, genograms reduce resistance, promote insight, and encourage
shared responsibility for change. Rather than assigning blame, they foster understanding,
empathy, and motivation—key ingredients for healing in families impacted by substance
dependence.

Alejandro Llanes

Module 3 Discussion

A genogram is a tool that therapy practitioners use to create a family tree that documents
biological and non-biological data, such as emotional relations among family members, how
family members relate to one another, and intergenerational behavior patterns (Arias, 2017). In a
substance-addicted family system characterized by denial, genograms can be enlightening. The
genogram can reveal that the pattern of substance abuse runs in a family even if it is not
discussed, providing a more accurate picture of the addiction than by viewing it as a single issue.

In families with a history of substance use disorder, denial can be a common defensive
action to protect family members from dealing with the painful proposition of knowing a person
addicted to drugs or alcohol. Family members often minimize symptoms, rationalize their loved
one's behavior, or focus on the drug and/or alcohol use as the result of other problems, such as
work or relationship issues (Arias, 2017). Family-wide minimization may reinforce the family's
maladaptive behaviors as all family members unintentionally conspire to continue the status quo,
avoiding conflict, loss, or shame. This is the importance of the genogram. It makes the invisible
visible and helps people understand their behaviors based on the history of their families.

The genogram is created collaboratively with the family. The clinician invites the family
into constructing the genogram with three or more generations. By having family members name
people and years and patterns of relationships, the clinician can discover the presence of family
members with substance use disorders, enabling patterns, and cycles of denial (Arias, 2017). The
multiple patterns of addiction across generations are revealed to family members within this
narrative to show that addiction is a family issue and not a personal problem. Familiarizing
oneself with the patterns may allow one to hold a mirror to this behavior without the blame and
confrontation that often accompanies accusation.

Second, genograms help to address denial about behaviors and reactions to substance use.
This can be seen when family systems unconsciously recreate the roles of the family dynamics
such as the "hero", "scapegoat" or "enabler" to maintain the illusion of denial about the severity
of addiction (Arias, 2017). Identifying the roles and behaviors in a genogram allows the
members to see how their actions have contributed to the system that supports substance use.
This process may allow the denial that may have been used by the family members as a coping
mechanism to be broken, and how these roles supported the continued use of substances. Thus,
the genogram can be seen as a tool for perception rather than blame.

Third, genograms can highlight strengths and resources. Although genograms are designed
to focus on family problems, a careful and detailed genogram may illustrate strengths at home,
positive relationships, and coping mechanisms family members previously used (SAMHSA,
2020). This balanced approach reduces defensiveness in families by helping family members
realize both the problems and strengths they may wish to draw on in order to effect change. By
identifying and focusing on positive elements in addition to negative ones, a softer approach to
change may be encouraged.

Finally, because the genogram is not a fixed image, it can be constantly revised throughout
the course of treatment to reflect new information and new family relationships. This focus on
continuing adaptation and longitudinal transformation means that genograms can be both an
assessment tool, and a dynamic document that supports the active therapeutic process and helps
family members move from a place of denial to a place of engagement with change (SAMHSA,
2020). In summary, genograms help families to shift their perception from individual behavior to
systemic patterns, to conceptualize and discuss individual behavior in systemic terms, and to
create an acceptance that can ease a family's recovery and new patterns of interaction that can be
helpful to the family.

•

**## NUR640WeeklyDis1-7.pdf**

NUR 640 Weekly Discussion

FYI Remember… I am a Black Haitian American Female live in USA, FL

Submission Instructions:

• Your initial post should be at least 500 words, formatted, and cited in current
APA style with support from at least 2 academic sources.  Your initial post is
worth 8 points.

Week 1: The PMHNP as a Psychotherapist

Psychotherapy is often misunderstood or devalued.

• Discuss your views of the PMHNP as a psychotherapist

• Discuss whether it is feasible to provide psychotherapy at each patient

encounter

Week2: Dream Interpretation

Freud viewed dreams as the “royal road to the unconscious.”

• Discuss a memorable dream from your childhood.  Provide as much detail about
the dream as possible.

• Interpret the dream of two peers using the psychodynamic dream of Freud or
Jung

Week 3: Genogram

A genogram is often used to illustrate the behaviors of a family unit across generations.
The genogram can be used to reduce resistance to harmful family patterns.

• Recall a family with a member who has a history of drug or alcohol dependence.

• Describe how the genogram can be used to address the denial of family unit

addiction to individual family members.

Week 4: Automatic Thoughts

Patients are often asked to write their record their negative thoughts as homework for
Cognitive Behavioral Therapy (CBT) session.

• Explain how difficult this task might be for depressed patients?

• Identify your culture and ethnicity. Describe how negative thoughts are

perceived in your culture.

• Discuss ways you could increase the likelihood that a depressed patient

completes the Automatic Thoughts Download Automatic Thoughts
assignment.

Week 5: The Culture of Family Violence

Identify your culture and how it address family violence.

• In your opinion, what is the best way for a family therapist to bring up the issues
of abuse and violence in a family when those are not the problems that family
members have identified?

Week 6: Grief

A 75-year-old widower walks into your practice to request therapy services.  He has
grieved the loss of his wife for the last 28 months; they were married 50 years.

• Explain the significance of interpersonal deficit as it relates to interpersonal
therapy

• Describe how you would ask “very good” questions to facilitate the patient’s
ability to see their own experiences.

Week 7: The Therapist’s Personality

According to Carl Rogers, unconditional positive regard involves basic acceptance and
support of a person, regardless of what the person says or does.  The therapist gives
space for the client to express whatever immediate feeling is going on—confusion,
resentment, fear, anger, courage, love, or pride.

• Discuss the role of the therapist’s personality in person-centered psychotherapy.

[https://stu.instructure.com/courses/49953/files/4509652?wrap=1](https://stu.instructure.com/courses/49953/files/4509652?wrap=1)

[https://stu.instructure.com/courses/49953/files/4509652/download?download_frd=1](https://stu.instructure.com/courses/49953/files/4509652/download?download_frd=1)

• Are there particular people who have been or would be especially difficult for
you to unconditionally positively regard?

**## NUR640WK3DISRESP.pdf**

Geslande Dessalines

Discussion 3

Geslande Dessalines, BSN, RN

Saint Thomas University

Psychiatric Management II

Dr. Dorothy Crisostomo, DNP, FNP-C, PMHNP-BC, ARNP

1/26/2026

Using Genograms to Address Denial in Families Affected by Addiction

Genograms are valuable clinical tools used to visually map family relationships, behaviors,
and patterns across generations. In counseling and psychotherapy, genograms go beyond a
traditional family tree by including emotional relationships, patterns of interaction, and recurring
issues such as mental illness, trauma, and substance use disorders (Corey, 2023). One of the most
powerful applications of a genogram is its ability to reduce resistance and denial by helping
families see patterns that they may otherwise minimize or normalize. In my own experience, my
ex-husband/my child’s father has a history of both drug and alcohol dependence. While the
addiction significantly impacted our relationship and family functioning, denial was a major
barrier to acknowledging the problem—not only for him, but also within the broader family
system. This is where a genogram can be especially effective as a therapeutic intervention.
Addiction often exists within a family system that unconsciously supports or enables it.
According to Wheeler (2020), families affected by substance use frequently develop maladaptive
coping strategies, such as minimization, rationalization, and secrecy, which serve to maintain
emotional equilibrium but ultimately reinforce the addiction. When addiction is framed as “just
stress,” “bad luck,” or “something everyone goes through,” denial becomes a shared family
defense rather than an individual issue.

A genogram can help address this denial by externalizing the problem. Instead of focusing
solely on the identified individual with substance dependence, the genogram allows the clinician
to collaboratively explore patterns across generations. For example, when mapping a family
history, it may become apparent that multiple relatives struggled with alcohol misuse,
prescription drug dependence, or related issues such as domestic violence, depression, or legal
problems. Seeing these patterns visually can be eye-opening and less threatening than direct
confrontation (Corey, 2023). In the case of my ex-husband, a genogram could highlight how
substance use was not an isolated issue but part of a broader intergenerational pattern. This visual
representation helps shift the conversation from blame to understanding. Instead of “you are the

problem,” the message becomes “this is a pattern that has affected this family over time.”
Research supports this approach, noting that genograms promote insight and reduce
defensiveness by placing behaviors within a systemic and historical context (McGoldrick et al.,
2021). Genograms are also effective in addressing denial among other family members, such as
parents or siblings, who may unintentionally enable addictive behaviors. When family members
see how addiction intersects with roles like caretaker, rescuer, or scapegoat, they may begin to
recognize their own participation in maintaining the cycle. This awareness can foster
accountability without shame, which is critical for therapeutic engagement (Wheeler, 2020).

From an addiction-specific perspective, recent literature emphasizes the importance of
family-based conceptualizations of substance use disorders. A 2022 review in Journal of Family
Therapy found that visual tools like genograms enhance motivation for change by helping
families recognize recurring relational patterns linked to addiction, such as emotional cutoff,
unresolved trauma, and ineffective boundaries (Carr, 2022). These insights can then be used to
set healthier boundaries and support recovery rather than enable continued use.

In summary, genograms are powerful tools for addressing denial in families affected by
addiction because they make invisible patterns visible. By mapping substance use within a
multigenerational framework, genograms reduce resistance, promote insight, and encourage
shared responsibility for change. Rather than assigning blame, they foster understanding,
empathy, and motivation—key ingredients for healing in families impacted by substance
dependence.

Alejandro Llanes

Module 3 Discussion

A genogram is a tool that therapy practitioners use to create a family tree that documents
biological and non-biological data, such as emotional relations among family members, how
family members relate to one another, and intergenerational behavior patterns (Arias, 2017). In a
substance-addicted family system characterized by denial, genograms can be enlightening. The
genogram can reveal that the pattern of substance abuse runs in a family even if it is not
discussed, providing a more accurate picture of the addiction than by viewing it as a single issue.

In families with a history of substance use disorder, denial can be a common defensive
action to protect family members from dealing with the painful proposition of knowing a person
addicted to drugs or alcohol. Family members often minimize symptoms, rationalize their loved
one's behavior, or focus on the drug and/or alcohol use as the result of other problems, such as
work or relationship issues (Arias, 2017). Family-wide minimization may reinforce the family's
maladaptive behaviors as all family members unintentionally conspire to continue the status quo,
avoiding conflict, loss, or shame. This is the importance of the genogram. It makes the invisible
visible and helps people understand their behaviors based on the history of their families.

The genogram is created collaboratively with the family. The clinician invites the family
into constructing the genogram with three or more generations. By having family members name
people and years and patterns of relationships, the clinician can discover the presence of family
members with substance use disorders, enabling patterns, and cycles of denial (Arias, 2017). The
multiple patterns of addiction across generations are revealed to family members within this
narrative to show that addiction is a family issue and not a personal problem. Familiarizing
oneself with the patterns may allow one to hold a mirror to this behavior without the blame and
confrontation that often accompanies accusation.

Second, genograms help to address denial about behaviors and reactions to substance use.
This can be seen when family systems unconsciously recreate the roles of the family dynamics
such as the "hero", "scapegoat" or "enabler" to maintain the illusion of denial about the severity
of addiction (Arias, 2017). Identifying the roles and behaviors in a genogram allows the
members to see how their actions have contributed to the system that supports substance use.
This process may allow the denial that may have been used by the family members as a coping
mechanism to be broken, and how these roles supported the continued use of substances. Thus,
the genogram can be seen as a tool for perception rather than blame.

Third, genograms can highlight strengths and resources. Although genograms are designed
to focus on family problems, a careful and detailed genogram may illustrate strengths at home,
positive relationships, and coping mechanisms family members previously used (SAMHSA,
2020). This balanced approach reduces defensiveness in families by helping family members
realize both the problems and strengths they may wish to draw on in order to effect change. By
identifying and focusing on positive elements in addition to negative ones, a softer approach to
change may be encouraged.

Finally, because the genogram is not a fixed image, it can be constantly revised throughout
the course of treatment to reflect new information and new family relationships. This focus on
continuing adaptation and longitudinal transformation means that genograms can be both an
assessment tool, and a dynamic document that supports the active therapeutic process and helps
family members move from a place of denial to a place of engagement with change (SAMHSA,
2020). In summary, genograms help families to shift their perception from individual behavior to
systemic patterns, to conceptualize and discuss individual behavior in systemic terms, and to
create an acceptance that can ease a family's recovery and new patterns of interaction that can be
helpful to the family.

•

**## NUR640WeeklyDis1-7.pdf**

NUR 640 Weekly Discussion

FYI Remember… I am a Black Haitian American Female live in USA, FL

Submission Instructions:

• Your initial post should be at least 500 words, formatted, and cited in current
APA style with support from at least 2 academic sources.  Your initial post is
worth 8 points.

Week 1: The PMHNP as a Psychotherapist

Psychotherapy is often misunderstood or devalued.

• Discuss your views of the PMHNP as a psychotherapist

• Discuss whether it is feasible to provide psychotherapy at each patient

encounter

Week2: Dream Interpretation

Freud viewed dreams as the “royal road to the unconscious.”

• Discuss a memorable dream from your childhood.  Provide as much detail about
the dream as possible.

• Interpret the dream of two peers using the psychodynamic dream of Freud or
Jung

Week 3: Genogram

A genogram is often used to illustrate the behaviors of a family unit across generations.
The genogram can be used to reduce resistance to harmful family patterns.

• Recall a family with a member who has a history of drug or alcohol dependence.

• Describe how the genogram can be used to address the denial of family unit

addiction to individual family members.

Week 4: Automatic Thoughts

Patients are often asked to write their record their negative thoughts as homework for
Cognitive Behavioral Therapy (CBT) session.

• Explain how difficult this task might be for depressed patients?

• Identify your culture and ethnicity. Describe how negative thoughts are

perceived in your culture.

• Discuss ways you could increase the likelihood that a depressed patient

completes the Automatic Thoughts Download Automatic Thoughts
assignment.

Week 5: The Culture of Family Violence

Identify your culture and how it address family violence.

• In your opinion, what is the best way for a family therapist to bring up the issues
of abuse and violence in a family when those are not the problems that family
members have identified?

Week 6: Grief

A 75-year-old widower walks into your practice to request therapy services.  He has
grieved the loss of his wife for the last 28 months; they were married 50 years.

• Explain the significance of interpersonal deficit as it relates to interpersonal
therapy

• Describe how you would ask “very good” questions to facilitate the patient’s
ability to see their own experiences.

Week 7: The Therapist’s Personality

According to Carl Rogers, unconditional positive regard involves basic acceptance and
support of a person, regardless of what the person says or does.  The therapist gives
space for the client to express whatever immediate feeling is going on—confusion,
resentment, fear, anger, courage, love, or pride.

• Discuss the role of the therapist’s personality in person-centered psychotherapy.

[https://stu.instructure.com/courses/49953/files/4509652?wrap=1](https://stu.instructure.com/courses/49953/files/4509652?wrap=1)

[https://stu.instructure.com/courses/49953/files/4509652/download?download_frd=1](https://stu.instructure.com/courses/49953/files/4509652/download?download_frd=1)

• Are there particular people who have been or would be especially difficult for
you to unconditionally positively regard?

**## NUR640WK3DISRESP.pdf**

Geslande Dessalines

Discussion 3

Geslande Dessalines, BSN, RN

Saint Thomas University

Psychiatric Management II

Dr. Dorothy Crisostomo, DNP, FNP-C, PMHNP-BC, ARNP

1/26/2026

Using Genograms to Address Denial in Families Affected by Addiction

Genograms are valuable clinical tools used to visually map family relationships, behaviors,
and patterns across generations. In counseling and psychotherapy, genograms go beyond a
traditional family tree by including emotional relationships, patterns of interaction, and recurring
issues such as mental illness, trauma, and substance use disorders (Corey, 2023). One of the most
powerful applications of a genogram is its ability to reduce resistance and denial by helping
families see patterns that they may otherwise minimize or normalize. In my own experience, my
ex-husband/my child’s father has a history of both drug and alcohol dependence. While the
addiction significantly impacted our relationship and family functioning, denial was a major
barrier to acknowledging the problem—not only for him, but also within the broader family
system. This is where a genogram can be especially effective as a therapeutic intervention.
Addiction often exists within a family system that unconsciously supports or enables it.
According to Wheeler (2020), families affected by substance use frequently develop maladaptive
coping strategies, such as minimization, rationalization, and secrecy, which serve to maintain
emotional equilibrium but ultimately reinforce the addiction. When addiction is framed as “just
stress,” “bad luck,” or “something everyone goes through,” denial becomes a shared family
defense rather than an individual issue.

A genogram can help address this denial by externalizing the problem. Instead of focusing
solely on the identified individual with substance dependence, the genogram allows the clinician
to collaboratively explore patterns across generations. For example, when mapping a family
history, it may become apparent that multiple relatives struggled with alcohol misuse,
prescription drug dependence, or related issues such as domestic violence, depression, or legal
problems. Seeing these patterns visually can be eye-opening and less threatening than direct
confrontation (Corey, 2023). In the case of my ex-husband, a genogram could highlight how
substance use was not an isolated issue but part of a broader intergenerational pattern. This visual
representation helps shift the conversation from blame to understanding. Instead of “you are the

problem,” the message becomes “this is a pattern that has affected this family over time.”
Research supports this approach, noting that genograms promote insight and reduce
defensiveness by placing behaviors within a systemic and historical context (McGoldrick et al.,
2021). Genograms are also effective in addressing denial among other family members, such as
parents or siblings, who may unintentionally enable addictive behaviors. When family members
see how addiction intersects with roles like caretaker, rescuer, or scapegoat, they may begin to
recognize their own participation in maintaining the cycle. This awareness can foster
accountability without shame, which is critical for therapeutic engagement (Wheeler, 2020).

From an addiction-specific perspective, recent literature emphasizes the importance of
family-based conceptualizations of substance use disorders. A 2022 review in Journal of Family
Therapy found that visual tools like genograms enhance motivation for change by helping
families recognize recurring relational patterns linked to addiction, such as emotional cutoff,
unresolved trauma, and ineffective boundaries (Carr, 2022). These insights can then be used to
set healthier boundaries and support recovery rather than enable continued use.

In summary, genograms are powerful tools for addressing denial in families affected by
addiction because they make invisible patterns visible. By mapping substance use within a
multigenerational framework, genograms reduce resistance, promote insight, and encourage
shared responsibility for change. Rather than assigning blame, they foster understanding,
empathy, and motivation—key ingredients for healing in families impacted by substance
dependence.

Alejandro Llanes

Module 3 Discussion

A genogram is a tool that therapy practitioners use to create a family tree that documents
biological and non-biological data, such as emotional relations among family members, how
family members relate to one another, and intergenerational behavior patterns (Arias, 2017). In a
substance-addicted family system characterized by denial, genograms can be enlightening. The
genogram can reveal that the pattern of substance abuse runs in a family even if it is not
discussed, providing a more accurate picture of the addiction than by viewing it as a single issue.

In families with a history of substance use disorder, denial can be a common defensive
action to protect family members from dealing with the painful proposition of knowing a person
addicted to drugs or alcohol. Family members often minimize symptoms, rationalize their loved
one's behavior, or focus on the drug and/or alcohol use as the result of other problems, such as
work or relationship issues (Arias, 2017). Family-wide minimization may reinforce the family's
maladaptive behaviors as all family members unintentionally conspire to continue the status quo,
avoiding conflict, loss, or shame. This is the importance of the genogram. It makes the invisible
visible and helps people understand their behaviors based on the history of their families.

The genogram is created collaboratively with the family. The clinician invites the family
into constructing the genogram with three or more generations. By having family members name
people and years and patterns of relationships, the clinician can discover the presence of family
members with substance use disorders, enabling patterns, and cycles of denial (Arias, 2017). The
multiple patterns of addiction across generations are revealed to family members within this
narrative to show that addiction is a family issue and not a personal problem. Familiarizing
oneself with the patterns may allow one to hold a mirror to this behavior without the blame and
confrontation that often accompanies accusation.

Second, genograms help to address denial about behaviors and reactions to substance use.
This can be seen when family systems unconsciously recreate the roles of the family dynamics
such as the "hero", "scapegoat" or "enabler" to maintain the illusion of denial about the severity
of addiction (Arias, 2017). Identifying the roles and behaviors in a genogram allows the
members to see how their actions have contributed to the system that supports substance use.
This process may allow the denial that may have been used by the family members as a coping
mechanism to be broken, and how these roles supported the continued use of substances. Thus,
the genogram can be seen as a tool for perception rather than blame.

Third, genograms can highlight strengths and resources. Although genograms are designed
to focus on family problems, a careful and detailed genogram may illustrate strengths at home,
positive relationships, and coping mechanisms family members previously used (SAMHSA,
2020). This balanced approach reduces defensiveness in families by helping family members
realize both the problems and strengths they may wish to draw on in order to effect change. By
identifying and focusing on positive elements in addition to negative ones, a softer approach to
change may be encouraged.

Finally, because the genogram is not a fixed image, it can be constantly revised throughout
the course of treatment to reflect new information and new family relationships. This focus on
continuing adaptation and longitudinal transformation means that genograms can be both an
assessment tool, and a dynamic document that supports the active therapeutic process and helps
family members move from a place of denial to a place of engagement with change (SAMHSA,
2020). In summary, genograms help families to shift their perception from individual behavior to
systemic patterns, to conceptualize and discuss individual behavior in systemic terms, and to
create an acceptance that can ease a family's recovery and new patterns of interaction that can be
helpful to the family.

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