Encanto Treatment Plan Assignment

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City University of Seattle *

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FALL 2018

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Psychology

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Jan 9, 2024

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Case Conceptualization, Diagnosis, and Treatment Plan Counselor: Brian Lee Client: Luisa Madrigal from Encanto Biopsychosocial factors Luisa from the Disney film, Encanto, is a member of the Madrigal family, and one of two sisters to the protagonist, Maribel. Endowed with the gift of super strength from the Madrigal candle, her strength allows her to do seemingly all physical endeavors the town needs fulfilled. She is a granddaughter to Abuela, the first inheritor of the Madrigal candle. Although she expresses supernatural strength, she has meek and shy personality traits. She does not seem to have any medical issues, or any illnesses/diseases caused by her genetics. Her sleep has been impacted due to intrusive thoughts. She feels social pressure to always be strong, which impacts her sleeping. She does not complain about any tasks she is asked to perform. But she feels pressures to perform and take on all difficult tasks, even if at the expense of her own mental health. She admits feeling pressure to always “carry [the load].” Social/Cultural Influences Luisa lives with her two sisters, Maribel, and Isabela, her mother, father, her Abuela, as well as many extended family members in a small town. The cultural factors that seem to be most contributing to her current experience are her role as a daughter/granddaughter in the family in regards to the her superstrength ability gifted to her by the Madrigal miracle candle. This family tradition gives each generation/descendant of the Madrigal family. Her gift of strength puts her in a position to essentially be the labor force of the family and the town. These cultural factors impact the client’s mental health by feeling the need to always present herself as strong

physically as well as mentally. She feels immense anxiety and pressure from her role in the family/town to always be “on point” due to the fact that the family and townspeople regularly rely on her for every and any task. This pressure is the main contributor to the presenting symptoms in Luisa. The strengths that seem most relevant to her current development are her ability to persevere and be available for her family even though she is going through a silent struggle. In order to place Luisa’s symptoms in context, it is important to note that there is a family history of anxiety, depression, intergenerational trauma. Furthermore, Luisa and her family have been experiencing significant stress in terms of losing their Madrigal miracle candle, and their house crumbling, which are likely contributing to her difficulties. Symptoms and client Luisa has expressed feeling overwhelmed by fulfilling familial expectations. She feels immense pressure to be able to take on family burdens, and to never make mistakes. She also shows physiological symptoms. She shows quick shallow breathing. She exhibits eye twitching. She discloses a lack of sleep. Proposed diagnosis I propose a diagnosis of Generalized Anxiety Disorder code F41.1.. Although it is unknown how long the symptoms listed above have persisted, it can be assumed that it has lasted long enough for other family members such as Maribel to express concern, and for Luisa to finally show levels of transparency as well. Luisa is easily irritable, shows restlessness, muscle tension in the expression of eye twitching, sleep disturbance as disclosed by other family members. Although her performance in her family is dynamic and for the town has not drastically diminished, this is likely due to familial and cultural pressures to save

face, as expressed in her song Surface Pressure. She has shown great distress in her loss of magic, feeling inadequate and useless for the family and town. One additional diagnosis for Luisa could be muscle dysmorphic disorder. She is constantly working, albeit the fact her gift gives her nigh-invincibility and seemingly limitless strength. She expresses little rest throughout the film and is shown consistently doing physical labor and/or exercise. Although not an official mental disorder in it of itself by the DSM-5, it is a comorbid specifier that may be exacerbating the main disorder in her Generalized Anxiety Disorder. Two suggestions for treatment planning The treatment that would be best for Luisa would be a dual approach including a therapeutic approach - Cognitive Behavioral Therapy (CBT) would be recommended - alongside anxiolytic medication as needed. A strong focus of her treatment plan should be around addressing her constant need to prove her worth to her family. While integrating CBT in her treatment, two goals can be extrapolated to help Luisa. One goal can be to directly address her long-standing anxiety in always needing to work and take the pressure of the family onto herself. The treatment of Luisa can help her to first reestablish healthy boundaries with her work and relationship with her gift. A weekly intervention of assessing her progress is strongly recommended to be able to accurately measure and track her progress. A secondary treatment plan can include family therapy including her and her family. The utilization of family therapy, particularly in her dynamic with her direct family and Abuela can help redefine family dynamics and relationships to better distribute family responsibilities and expectations. This directly addresses Luisa’s increased anxiety

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