Family Therapy Course

Family Therapy Course

Please put the question or section name above each paragraph

Examine the following clinical vignettes:

Your client is a 30-year-old female of Jewish descent who attends therapy on her own. She is self-referred. During the first session, she explains that she is coming to therapy to decide how she should move in regards to her marital relationship. She explains that she was married for 5 years and has a 3-year-old daughter. Her husband was very affectionate before the marriage, but became very absent since they got married and had a child. He is often at work, comes home late, and spends most of his time at home watching TV. They have not had a sexual relationship since their daughter was born. When she mentioned the topic of divorce, the husband informed her that if she divorced him, her family would find her dead body the next day in the lake by their house.

Please answer the below questions:

1) In terms of your assessment strategy, what questions will you ask, and what will you try to elucidate with your assessment strategy?

2) Were you able to detect a domestic violence incident? If yes, what would be your response as a therapist?

3) What will be important for you to consider related to the client’s unique social locations (e.g., gender, sexual orientation, disability status) in order to provide culturally-competent and effective treatment services?

4) What interventions will you apply in working with the client? (See below Structural Family System to use as intervention)

Length: 3- 4 pages, use at least 3 articles to cite.

Structural Family Systems (Minuchin):

General Concepts:

– Symptoms are the result of dysfunctional role assignments

and overly rigid or overly diffuse boundaries

– The focus is change in the family structure, not the

presenting problem

– Dysfunctional families lack alternatives resulting from

inflexible family structure

– Action-oriented, not insight-oriented

– Healthy subsystems are free of interference from other

subsystems

– Attention paid to cultural considerations and family

metaphors

– Focuses on family life cycle adjustments

Role of the Therapist:

– Stage director; observer; educator

– Active in making interventions to uncover & modify

underlying structure of family

Timeframe: Here and now

Duration: Short term

Unit of Treatment: Whole Family

How Change Occurs:

– Through Restructuring and Realigning the Hierarchy

Termination Criteria:

– Presenting problem is resolved

– Family system restructured to allow problem-solving

– Family has skills to resolve future conflicts

Early Stage Goals:

– Form therapeutic subsystem (Joining)

– Assess boundaries, alliances, coalitions

– Symptom reduction

– Relabel the presenting problem and reframe the family’s

view of it

– Remove the IP label

– Set goals

Early Stage Interventions:

– Joining, accommodating, mimesis

– Confirmation and empathy

– Reframe Problem as family problem

– Enactments: e.g. draw picture of family – shows power

distribution

– Tracking

– Family Mapping: look for alliances and splits

Middle Stage Goals:

– Change underlying family structure and patterns that

maintain symptoms

– Strengthen boundaries between subsystems

– Restructure: boundaries, hierarchy, alignments

– Create a cohesive executive subsystem

– Educate about development issues

Middle Stage Interventions:

– Re-enactment

– Manipulate intensity – e.g. repetition of themes, blocking

or encouraging interactions, modulating voice

– Boundary making – e.g. changing the placement of people

in the room

– Paradoxical interventions – if clients aren’t compliant – do

more of what doesn’t

– Unbalance the system – e.g. support “one down” person

– Teach conflict resolution skills (communication skills,

parenting skills)

– Psychoeducation – regarding family patterns and

developmental issues

– Shaping competence – by highlighting strengths and

progress

Late Stage Goals:

– Consolidate Gains

Late Stage Interventions:

– Highlight therapeutic progress

– Mark structural alterations

– Emphasize strengths

– Discontinue sessions digressively

 

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