Psychological assessment

Psychological Assessment. Evaluation of the family within the systemic approach. The relational systemic approach allows understanding of the symptom within the meaningful context of the family and identifies a mutual influence of the patient and the interactive context. An evaluation of a family system should allow improvement of knowledge about the points of strength and vulnerability of the patient and his or her family'. 'Evaluation is intervention. The systemic diagnosis is linked to the feedback that derives from meeting the family. The evaluation, the intervention and the diagnosis do not appear to be different and neatly distinguished phases, but they are all embedded within the same framework represented by the meeting with the family. The task of the therapist is not to discriminate the authenticity of the symptoms shown by the patient, as to start focusing on the shared and explicit explanation in order to “deconstruct” the symptom and to widen the maps through which the family interpret reality. The ideal unit of evaluation includes all the family members who are part of the problem. The evaluation should take into account two levels of investigation: the history of the symptomatic behaviour and the history of the nuclear and origin family. The therapist has to draw attention to the communicative style, the ways in which the family face their problems and developmental tasks, the distribution of roles and functions. It is necessary to verify whether or not opinions about the symptom are shared by the family, the circulation of unrecognized messages and emotions has to be regarded as the foundation of the symptom. The therapist has to take into account a synchronic level of interactive and communicative models and a diachronic level of individual and collective histories, and the phase of the life cycle that the family is going through. The relational complexity increases further with the investigation into the extended family, the multigenerational context can rep¬resent the diagnostic tool and the symptom becomes the product of the intergenerational history. Once the phase of evaluation has been ter¬minated, it is useful to build a new definition of what has emerged, for and with the family. The relational context also includes the therapist’s position'. 'The specific case of adolescence. Adolescence represents a basic moment for the growth of the system, the family, who has to transform the previous organization of role, functions and relationships, and adopt a more functional one, a process of co-evolution concerning both the boy or girl and the family. The adolescent feels the necessity to become independent from the parents, but at the same time he or she needs to count on them. The adolescent’s ‘symptomatic’ attitudes may be seen as the proposal of an autonomous identity, or that the bond with the parents has not been broken by this difference, the adolescent’s expectation is that the bond should be enriched and transformed by the difference itself, without undergoing traumatic and irreversible disruptions. The problems of adolescence may be related to the integration of different levels of reality, in which individual, familiar and social aspects have to be connected and contemporaneously taken into consideration. For this reason, family therapy may be a likely solution in adolescence. An integrated individual and familiar approach is the most suitable indication for adolescent disorders, both in diagnostic and in therapeutic terms.