MARCH 7, 2016
Exclusive story and photos!
Up close and personal
the Harpers with
LOVE WINS OVER JUDGEMENT
Bullying in LGBT families
introduction to Bullying pg. 3 Meet the Harpers
pg. 4-5
Story of the HarpeRs pg. 6-7 Challenges & Strengths pg. 8 Erikson’s Developmental stages pg. 9 The Harper Family Genogram pg. 10 Harper’s Ecomap pg. 11 Bioecological Systems theory pg. 12 - 14 Family Health Interventions pg. 15 - 17 References
pg. 18 - 19
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If you have not personally experienced bullying for yourself, chances are you already know or have seen someone who has.
So... What is bullying exactly?
“Stand UP. speak out. stop bullying. TOGETHER.�
Bullying is an intentional aggressive and repetitive Chignecto-Central Regional School Board 2015 behavior that involves an imbalance of power. Verbally saying hateful things or physically hurting another person, are only a few of the many forms of bullying. It can happen anywhere and to anyone, but some minority groups such as the LGBT communities are at an increased risk (stopbullying, n.d.). Meet the Harper Family and see how bullying has affected their lives!
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CHARLIE HARPER A 37 year old Canadian from Vancouver who appears very comfortable with his identity, although most who meet him don't know that he is gay. As a professional comedian, Charlie uses sarcasm to mask feelings of inadequacy that resulted from the strained relationship with his emotionally distant father and his overbearing mother. This, however, has caused Charlie to want to be the best possible parent to his son. Charlie comes from a Jewish family, and identifies with modern liberal Judaism where homosexuality is affirmed. He enjoys road biking, and pottery, and running the home.
ALAN HARPER A 34 year old American from Palo Alto, California has known from a very young age that he was different. His mother, Evelyn, raised him by herself, and gave him every opportunity she could. Alan is a flamboyant gay man who is typically the life of the party wherever he goes, but also a shrewd business man whose amateur interest in investment banking has made him successful in his company. Alan’s childhood home was a non-religious one, but he is glad to support Charlie in his cradle traditions, and has agreed that their son may be raised in it as well. Alan is a bit of a workaholic, but also enjoys playing tennis and spending time with his family.
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JAKE HARPER Jake is a brilliant 12 year old who is quick witted and well versed in the politics of his parents' relationship. Jake was conceived through in vitro fertilization (IVF) by use of an anonymous donor egg and sperm from Charlie. As a young child, Jake never seemed to question the obviously progressive family of which he was a part. But now as a 7th grader, he recently surprised his parents by asking about his mother whom he would never know. Jake began his 7th grade year at his familiar junior high school, Palo Alto, and had several peers that also lived in same-sex parent households. Jake enjoys mixed martial arts, riding bikes, and playing soccer. Overall, Jake loves his fathers and is enjoying his childhood.
The Story of the Harpers When Alan was offered a raise to move to his company's new branch in a small town in Nebraska, the Harper's decided to take the opportunity. For Jake, the move required that he say good-bye to his friends, as well as his grandmother and honorary uncles. This was an emotional time for the family, but is was also an opportunity for them to unite even closer as a nuclear family. Settling in Boys Town, Nebraska was definitely what Alan and Charlie expected. It was very small and by the looks they received, not many progressive families frequented the region. Alan's work environment proved to be safe enough, although it was difficult to know what people really thought of him, due to his position as the new the branch manager. Charlie continued his career as a comedian booking weekly comedy shows at a nice little venue in town, drawing a good crowd each time. Jake had been placed mid-semester into a junior high school two blocks from there house, which was in a nice middle class neighborhood. Only 13 7th graders inhabited the campus, and none of them seemed to be interested in the new kid. After the first three weeks, however, Jake's peers began warming up to him, and before long Jake had become friends with several of them. 6
When good things go bad... It wasn't until Jake's class Mother's Day party that things became problematic. Since Charlie was usually available during the day, he thought it would be appropriate to attend the event as Jake's mother figure. The event seemed to go well, and only a few children stared. Several weeks later, Alan and Charlie were notified that Jake had gotten into a fight at school. Charlie rushed over to find Jake in the school nurse's office holding a rag over his nose, while several tears ran his dusty face. The school nurse, Mrs. Alaprichjovic, explained how Jake’s involvement in a verbal altercation with some other students, came to blows. Unfortunately, Jake had been outnumbered and was easily dominated by his opponents. Jake explained, "They kept saying I’ m gay just like my dads, and would not stop." This incident was new to the Hapers. Back in California their non-traditional family unit was accepted and supported, especially at the synagogue they attended regularly. Since relocating, Charlie, Alan, and Jake have attended several synagogues in nearby Omaha, but have yet to decide which one will be best for their family. Until now they felt no rush. A feeling of loneliness rushed through the Harper family as realization set in; they were missing a huge part of their support system. Jake was spiraling into a depression and acting out when it was time to go school. Other times stayed in his room not wanting to talk. Seeing their son so lonely and hurt, affected their happiness, Alan’s performance at work, and Charlie’s ability to find humor for his comedy act. 7
Challenges and Strengths As a family unit, the Harpers’ usually sustain great strength through the cohesiveness of their community. Both Charlie and Alan were living in west Los Angeles several years before Jake was born. Those years involved numerous visits to the synagogue where most of their resources developed from solid friendships and connections. Daily visits from Jake’s “uncles” (who were really Alan and Charlie’s four best friends) were always a treat; not to mention Jake’s beloved grandmother, Evelyn, who lived with them as well.
Although it didn’t happen every evening, the Harpers always tried to have dinner together so that they could maintain healthy communication with each other. In general, Jake felt as though he could talk to his fathers and grandmother about anything. The challenges that the Harpers faced in California were few. However, in recent years, Jake began to infrequently act out in anger. Alan and Charlie, not knowing if it should be addressed directly, chose to leave it alone, and hoped it was just a phase.
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Erikson’s Developmental Stages Jake: 12 years old (Industry vs Inferiority) Before the Mother’s Day party, Jake was achieving a sense of self-confidence through learning and performing successfully in school. Jake was also involved in extracurricular activities such as martial arts, soccer, and biking which gave him satisfaction and pleasure in interacting with other peers and being involved in the community. After the fight, Jake is unable to find emotional stability and create positive interpersonal relationships with his peers at his new school (Townsend, 2015).
Alan: 34 years old (Generativity vs Stagnation or Self-Absorption) Alan has achieved professional growth by becoming the new branch manager for his company. With his inquisitiveness in investment banking, he has secured a great career and is pursuing his life goals. He is actively involved in his work environment but doubts what his new coworkers think of him. Alan will need to establish stronger relationships with his new coworkers in order to be accepted by them and viewed as a positive contributor to the company (Townsend, 2015).
Charlie: 37 years old (Generativity vs Stagnation or Self-Absorption) Since moving to Boys Town, Charlie has continually adjusted, resulting in, successfully reestablishing his career in his new environment. Charlie has had great outcomes with his weekly comedy shows, but has more leisure when spending time with Jake while Alan is working copious of hours. Charlie also continues to worship his religion by always visiting the local synagogue with Jake. Charlie is flourishing normally while trying to be a good role model for his son (Townsend, 2015). 9
Martin Harper
m 1963
Janet Harper
Evelyn Cryer
Unknown Grandfather
Egg Donor Surrogate Mother
Charlie Harper
Alan Harper
m 2008
KEY Male Female Homosexual Relationship Secret Affair
Jake Harper
10 Kaakinen, Duff-Gedaly, Hanson, & Coelho, 2015
Harper’s Ecomap Alan’s mother, now far from the family
The town synagogue where the Harpers worship
Charlie’s Comedy Club
Friends in California that have been left behind
Alan’s new job
Jake’s classmates and the classmates’ parents
Jake’s new school
Relationship Key: (straight line) Strong (dashes) Weak (railroad thing) Tense (arrows) Direction of energy flow
Mrs. Alaprichjovic, the school nurse Kaakinen et al., 2015 11
Bioecological System Theory Bronfenbrenner’s Bioecological Systems Theory states, “The development of humans is shaped by a combination of genetic makeup and environmental influences” (Kaakinen et al., 2015, p. 82). Over the years, many theorists have debated if human development is influenced by their environment (nature) or from genetics (nurture). Bronfenbrenner was not convinced it had to be “either or” when developing his theory, so instead he forged ahead with a “both and” mindframe, embracing both theories in hopes of understanding how and why humans develop in a variety of ways. These ideas evolved into a theory comprised of five systems, each with a different level of engagement. The Microsystem describes day-to-day places and interactions with family members, peers in school, and neighborhood friends. The next level is the Mesosystem, which focuses on larger relationships with the family, such as school, religion, and other family interactions. The Exosystem is a category of larger external environments that indirectly influence individuals and their families. For example, the state of a parent’s job such as stress level, salary and travel can affect a child’s development in different ways. Broad cultural values and belief systems fall under the Macrosystem that can include a variety of ideologies ranging from ethnicity, societal values, to a national democratic government. Lastly the Chronosystem in the Bioecological Systems Theory focuses on how changes occur over time either on an individual or environmental level, can affect the other four systems in development. An example of a change might be an unexpected war or death of a parent in which the individual or family has no control over (Kaakinen et al., 2015). 12
Chronosystem
Macrosystem
“...what happens outside of the family unit is as important as what happens inside…” (Kaakinen et al., 2015, p. 85) 13
Microsystems:
These systems immediate to the individual in which they maintain a direct contact with daily. (Kaakenin et al., 2015)
The Harper family home, their synagogue, Charlie’s comedy venue, Alan’s bank, Jake’s school, and the city in which they live: Boys Town . Leaving the comfort of their big city microsystems, and Jake’s grandmother are major events for the Harpers.
Mesosystems:
Although the Harpers are new in town, they have already begun to establish connections within These systems that actively their microsystems. Charlie and Alan are interact with the major parts of appreciated in their vocational settings, and Jake the individual's microsystem. is making friends. Their religious setting seems (Kaakenin et al., 2015) solid. But these connections are new, and possibly still fragile.
Exosystem:
This system does not actively involve the individual, but still affects them. (Kaakenin et al., 2015)
Macrosystem:
This system involves the culture, ideology, or belief attitudes of the environment that influence the individual (Kaakenin et al., 2015)
Chronosystem:
This system covers the dimension of time in relation to a person’s development. (Kaakenin et al., 2015)
Alan’s company opening their new branch in Nebraska, grandma Evelyn’s decision to remain in California, the neighborhood school being located conveniently nearby, U.S. legislation on same-sex marriage and mandatory LGBTQ curricula. Broadly, the mid-western U.S. culture is one that tends toward conservative views on family structure. Despite recent legislation that legitimizes same-sex marriage, the belief systems in their new region have an influence on institutional environments, such as Jake’s school. The Harper family’s present challenge is the culmination of time related contexts which influence the above systems. The effects of Jake’s recognizing the absence of his mother combined with a critical developmental period within his family and the taunts of school bullies have resulted in a crisis of identity and self-worth. 14
Harper Family Intervention #1 Diagnosis:
Relocation Stress Syndrome r/t lack of adequate support
system and moving from one location to another, a.m.b alienation, anger, depression, decline in family communication, and decreased ability to perform at work (Ackley & Ladwig, 2015).
Intervention:
Visit the Harper family in their home to build rapport and
to discuss their concerns.
Rationale:
Evidence-based home visiting models address psychological, social,
physiological, economical, family, and other factors that influence family health and development (Supplee, 2012).
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Harper Family Intervention #2 Diagnosis:
Relocation Stress Syndrome r/t lack
of adequate support system and moving from one location to another, a.m.b alienation, anger, depression, decline in family communication, decreased ability to perform at work (Ackley & Ladwig, 2015).
Intervention:
According to the Harper's concerns from the first home visit, research the area and provide options to decrease stress levels and increase community involvement and support. Schedule another home visit to provide information and together synergize a family plan.
Rationale:
Quality family planning is monitored by the CDC and must follow “trustworthy� clinical practice guidelines. This involves using evidence based recommendations for clients (Tregear, Gavin, & Williams, 2015).
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Harper Family Nursing Diagnosis #3 Diagnosis:
Relocation Stress Syndrome r/t lack of adequate support
system and moving from one location to another, a.m.b alienation, anger, depression, decline in family communication, decreased ability to perform at work (Ackley & Ladwig, 2015).
Intervention:
Follow up with the family by phone 2 day after home visit and set up an appointment for 1 week to evaluate the interventions in their family plan. Continue to follow-up with family periodically.
Rationale:
Follow-up is an important part when applying the bioecological theory. It allows for changes in the family plan or further discussions involving new concerns (Kaakinen, 2015).
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References Ackley, B. J. & Ladwig, G. B. (2014). Nursing diagnosis handbook: An evidence-based guide to planning care (10th ed). Maryland Heights, MO: Elsevier Saunders. Chignecto-Central Regional School Board. (2015, September 17). Stand Up. Speak Out. Stop Bullying. Together. Retrieved from: http://www.ccrsb.ca/content/stand-speak-out-stop-bullying-together-0 Countess, J. (2011, October 1). The Phantom Of The Opera" Celebrates 25th Anniversary As Broadway Cast Attends Live Simulcast Of Tribute Concert From The Royal Albert Hall In London At New York City's Ziegfeld Theater [Online image]. Retrieved from Zimbo: http://www.zimbio. com/pictures/1hAWEZ8I3wd/Phantom+Opera+Celebrates+25th+Anniversary/7g2nny0csJh/David+Cryer Daily Mail Report. (2012, November 12). Stressful pregnancy 'could make children easier prey for bullies'. Retrieved from Daily Mail: http://www.dailymail.co.uk/health/article-2233486/Stressful-pregnancy-make-children-prey-bullies.html Fanpop, Inc. (2016). Two and a Half Men [Online images]. Retrieved from Fan Pop: http://www.fanpop.com/clubs/two-and-a-half-men/images Hart, W. (n.d.). Conchata Ferrell [Online image]. Retrieved from TV Guide: http://www.tvguide.com/celebrities/conchata-ferrell/145346/ Hinckley, D. (2015, February 15). CBS' successful sitcom 'Two and a Half Men' bids farewell after 12 seasons [Online image]. Retrieved from NY Daily News: http://www.nydailynews.com/entertainment/tv/men-goodbye-12-seasons-article-1.2111709 Kaakinen, J., Duff-Gedaly, V., Hanson, S., & Coelho, D. (2015). Family health Care nursing: Theory, practice, and research (5th ed.). Philadelphia, PA: F.A. Davis Company. Nebraska Tourism Commission. (n.d.). Boys Town [Online image]. Retrieved from Visit Nebraska: http://visitnebraska.com/see_and_dos/boys-town
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SBT News. (2010). Actor Jake renews contract wins and a good increase in salary [Online image]. Retrieved from SBT News: http://sbtdiretodaredacao.blogspot.com/2010/10/o-ator-jake-renova-contrato-e-ganha-um.html Share TV. (n.d.). Holland Taylor [Online image]. Retrieved from Share TV: http://sharetv.com/person/holland_taylor Stopbullying.gov. (n.d.). Bullying Definition. In What is bullying? Retrieved from a U.S. Department of Health and Human Services website: http://www.stopbullying.gov/what-is-bullying/definition/ Supplee, L. (2012). Evidence based home visiting to enhance child health and development and to support families. Retrieved from an American Psychological Association website: http://www.apa.org/pi/families/resources/newsletter/2012/07/home-visiting.aspx Townsend, M. (2014). Psychiatric Mental Health Nursing (8th ed.). Philadelphia, PA: F. A. Davis Company. Tregear, S., Gavin, L., & Williams, J. (2015). Systematic review evidence methodology: Providing quality family planning services. American Journal of Preventive Medicine, 49 (2), S23-S30. doi:10.1016/j.amepre.2015.03.033 Trilad Media. (2009). Alan Harper PSD [online image]. Retrieved from Official PSDS: http://www.officialpsds.com/Alan-Harper-PSD32805.html Tunis - The Great Synagogue of Tunis (Beit Mordechai Synagogue) [Online image]. (n.d.). Retrieved from The Divine Name : http://www.divine-name.info/worldwide/tunesia/tunis.htm Watchlex.com. (2016). Charlie Sheen wears a Rolex Explorer II Watch [Online image]. Retrieved from Watchlex: http://watchlex.com/celebs/charlie-sheen/rolex-explorer-ii/4474?id=2 Young, L. (n.d.). Same-sex marriage legalized in US [Online image]. Retrieved from Boston Globe: https://www.bostonglobe.com/news/bigpicture/2015/06/26/same-sex-marriage-legalized/uvHHJinitjqatwRp0Et5DJ/story.html
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CSUSM NURS 480: Visual Report Written, Edited, and Designed By: April Busch, Althea Florentino, Richell Menke, Joe Pinner, Vicky Tran