Family hypothesis:
respond to Lindsay:
Presenting Problem: The client Deidre is a single 16-year-old Latino female living in a nuclear family with 1 brother and 1 sister. The client is attending Tuckahoe High School. The client is showing signs of Anxiety, depression, and ADHD but has potential signs of Autism as well. Based on the client’s behavior, the mom referred the child to counseling services. The client is having anger outbursts, shuts downs, and is having a delay in social skills. The mother also states that Deirdre is sad due to the loss of her friend and tends to dwell on the past as well as gets anxious about the future. The client is experiencing these problems because they believe that they are struggling with social issues and anxiety regarding family matters.
Family hypothesis:
The client Deidre is dealing with a lot of changes and this transition is taking a toll on her mental health. She is dealing with a lot of expectations from her mother. She is also experiencing changes from being a girl transitioning into a woman. This comes with a lot of anxiety as the world is now treating her as if she is an adult when she is just a child still. For example, the body changes, life changes, and societal changes. Therefore, her family must try to strategically keep the family together. “The symptom is a signal that a family has difficulty in getting past a stage in the life cycle” (Dykeman, 2022). This means that she and her mom must adapt to change so it will not jeopardize the family structure. The second construct that I will use is Brief Strategic. What that entail is “focus is on modifying maladaptive “patterns of interaction in the family [that] influence the behavior of each family member” (Dykeman, 2022). With that being said, the child and the family will hopefully structure themselves by having the therapist influence the family. With that, hopefully, Deirdre will become interested in wanting to help the dynamic and will want to prevent any further damage.
Treatment Goal:
The goal for Deirdre’s anxiety and depression would be to try to create a better bond with the family so that way Deirdre can feel more secure with their life conflicts as well. The goal for the family system theory is to get to a point in which the family functions at a level that moves towards better communication. “Haley was interested in understanding the strengths families have and the challenges they face as they move through the life cycle” (Dykeman, 2022). A family goal would be to get everyone to contribute, collaborate, cooperate, and lastly maintain decent communication to work together towards a common goal or reconciliation. The goal for “First-order change is essentially “change without change”—or any change within a system that does not produce a change in the structure of the system” and “First-order change occurs when a family modifies problem behaviors yet maintains its present structure” (Dykeman, 2022). An example of this is if Deidre were to temporarily move in with her friend instead of fixing the problem with her mom being a ‘helicopter mom’. The goal for “second-order change is “change of change”—a type of change whose occurrence alters the fundamental structure of the system” and “refers to transformations in either the structure or the internal order of a system” (Dykeman, 2022). An example of this is having Deirdre or Deirdre’s mom break the hostile family environment by doing something funny or nice.
Interventions:
Intervention 1: The first intervention I will use is the interrupt family dysfunctional patterns intervention. This states “examination of the ways in which family members suffer and feel inadequate or devalued when engaged in incongruent communication patterns” (Dykeman, 2022). What this means is that Deirdre feels as if she can’t talk with her family and feels as if she is not heard by her mom which makes her feel as if she doesn’t have an opinion and that she doesn’t matter. Her mom dismisses her and therefore she gets upset. This intervention helps bring the family together by having the family just talk to one another and hear each other out.
Intervention 2: The second intervention is using The Communication Game “[she] observed that when a person delivers an incongruent or mixed message, there is little skin or eye contact. It is as though the sender is out of touch with the other person.” (Dykeman, 2022). What this strategy entails is getting people involved in a deeper connection. This can help Deirdre and her family because they can relate to each other just by making physical eye contact and simple body language techniques to help re-accumulate them to the basic form of communication which can improve how they listen and react to one another using kindness.
Expected Outcome:
The goal of family theory is “Family counseling can help you look at the patterns of communication and relationship that connect people to one another and to their social and physical environments” (Dykeman, 2022). The outcome I hope to see for my client is _within the family systems theory. What this is discussing is that there are strategies to with this theory that can help families like Deirdre problem solve so that everyone involved is able to have friendly and successful relationship.
Dykeman, C. (2022). Family theory. In D. Capuzzi & M. D. Stauffer (Eds.), Counseling and psychotherapy: Theories and interventions (7th ed., pp. 287-308). American Counseling Association.
respond to tammara:
Presenting Problem:
The client is Jason, a 38-year-old Jewish Caucasian male who has presented with several symptoms. Jason is successful in his law practice and has an active social life. He participates regularly with the Jewish community. He presented initially in counseling as depressed and feeling isolated. He was emotional and worked long hours in order to keep his mind busy. Jason was reluctant to share his personal relationship status. He then presented as nervous and anxious and explained that he was in a secret relationship with a man, Kevin, who he was initially fulfilled by, and now there are trust issues that are tearing them apart and causing Jason a lot of unpleasant side effects, including leg shaking, pale in appearance and sweating.
Hypothesis:
It is hypothesized that transgenerational and strategic systems are contributing to the emotional and physical instabilities of this client. The strategic approach details that this client’s belief systems are what is keeping Jason bound and going to such great lengths to hide his homosexual relationship with Kevin. The structure of his family, even in a dysfunctional manner, has shaped Jason’s thought processed and directly contributes to his ability to live his life on his terms. The transgenerational component indicates that this client has been programed to believe that his lifestyle is unpleasant to not only his but his church family. The beliefs of the past has placed fear into Jason and will not allow him the opportunity to speak his truth.
Treatment Goals:
The goals for Jason to minimize the anxiety, isolation and the uncertain emotions, would be to guide Jason in telling his family about the relationship and lifestyle he has had for the past year. With support and acceptance, Jason can feel less alone and minimize the need to cry, regularly. Supporting Jason in speaking up for himself to his family, will also give him the confidence to speak to his partner and explain how he feels and how those thoughts have manifested in into nightmares and instability in their relationship.
According to Dykeman (2022), First-order change means, “change without change.” For this client this would include the family gathering together and sharing some of the positive things that they see, experience and enjoy about Jason. This is a subtle change that will not change the structure nor the dynamic of the family.
The second change-order is the type of change that alters the system, “change of change” (Dykeman, 2022). This would be Jason actually coming clean to his family and explaining his lifestyle and his relationship. This may change the dynamic of the familial relationship but free up the anxiety and isolation that he has been experiencing.
Interventions/Techniques:
The technique that would be used for his family would be to interrupt pattern of secrecy and unhealthy judgments. This specific intervention is to monitor how the family responds to Jason and sexuality. Identifying the problem based on the responses of the family will give a better understanding of pattern of misjudgment, potential homophobia based on personal beliefs along with religious beliefs.
The second intervention used is, the communication game (Satir). This technique focuses on family communication and how it is affected when there is a lack of touch, eye contact and talking, congruently (Dykeman, 2022). This would be conducted with two family members at a time. Mixed messages promote the dysfunction in a family and this communication game will give the members an opportunity to identify where the dysfunction exists in their communication patterns. This technique will help indicate to Jason’s family how the existing communication is causing him anxiety and creates insecurities because he cannot be himself in the family.
Expected Outcome:
The techniques listed above will give Jason’s family the opportunity to see how their interactions and communication styles, affect the client and his well-being. According to Dykeman (2022), family counseling will help the group identify their communication patterns, and how impact others. Not having to live in secrecy will relieve some of the loneliness, over working and anxiety of trying to prevent his relationship and sexual orientation from being revealed. Regardless of the outcome of the family sessions, Jason will redefine “family” if his family does not acknowledge and understand that he still may not be accepted. This will help him to create the family that he needs to help and support him. Jason will then develop the skills to confront his partner on the back of the newfound confidence.
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