Family Intervention Essay

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Paul -- You can see why this was reworked. I did not do it in the regular format because of our relationship, and I didn't worry about double spacing, and all that jazz. You know there is more here than you need.

So, based on an interview and reading several texts, this is a combination of theory and practice, with an emphasis on questioning and other theoretical constructs. Right now, we do not have complete information, as you know, so we need to discover some of that in order to proceed.

Here's what I need from you:

Look over this and let me know if you need more for it.

Send me an outline detailing exactly what you need to complete the class, format, length, theoretical issues, etc. And EXCATLY when you need it.

Give me the order #s you see on your system so I can cross-correlate.

I will try to put your project to the top of the list and get ya handled. Let me know about this so if we need to adjust we can do so immediately!

Kelvin

Introduction- The Bolder family was experiencing a great upset within their marriage. Recently the Bolder's son had found some pornographic images on the computer that the father had been viewing. His wife found this to be the straw that broke the camel's back so to speak. In order to save their marriage the Bolder's agreed to enter into therapy were they would be able to talk about what had happen and address the issue appropriately. Initially, we do not have adequate information to understand a complete picture of the Bolder family: Are there cultural or religious issues that cause Mr. Boulder's use of pornography to be problematic, or is it that the son found it -- how old is the son? The phrase, "broke the camel's back" implies that there are already seething issues, and this issue is more of a locus of conflict than the individuated problem. The model used in our group was the post-modern narrative in which all of the family; including the wife's parents (who she was estranged from) were involved in solving this family dilemma. For my clinical model I will be using the Transgenerational model to help the bolder family.

Theoretical Background - Everyone in the world suffers pain and difficulty in their family relationships from time to time. Whether due to unexpected loss, chronic illness or simply the transition from one stage of family life to another, the pain and confusion families experience is not wanted and great efforts are made by families to relieve themselves of this suffering. Sometimes they are not able to do this alone. Too, within the structure and long-term ev9olution of life's relationships, individuals go through different issues that may, or may not be important to one of the family member, but extremely important to others. Essentially, there are five modes of Family therapy, outlined briefly on the chart below:

Theory[footnoteRef:1] [1: See: Bowen, M. (1994). Family Therapy in Clinical Practice. New York: Jason Aronson; Madanes, C. (1991). Strategic Family Therapy, New York: Jossey Bass; Datillo, F., ed. (1998). Case Studies in Couple and Family Therapy, New York: Guilford Press; Goldenberg and Goldenberg, (2008). Family Therapy: An Overview. Belmont, CA: Thompson Higher Education.]

Focus

Concepts

Issues

Bowen;

Trans-generational

Patterns that develop within the family structure to defuse conflict. Key generator of anxiety is a perception of too much closeness or too great distance within family dynamics.

Seven interlocking concepts make up the theory; namely scale of differentiation; nuclear family emotional system, family projection processes, multi-generational transmission processes, sibling position profiles, emotional cut-off and triangles. The main goal of this therapy is to reduce chronic anxiety by (1) facilitating awareness of how the emotional systems function; and (2) increasing levels of differentiation so that the focus is on making changes for oneself rather than on trying to change others.

External stress is major contributor if families lack the capacity to think through relationship dilemmas, but instead overreact.

Minuchin;

Structural

Brief (less than 10 sessions); create a NOW transformative change and less interested in insights, feelings, beliefs, etc. from the past.

This view holds that a family needs clear boundaries and no coalitions to be healthy. The therapist must restructure the family, change right now, in the therapy session. Usually minor problems respond better to this view.

The family has the necessary resources to deal with positive change; the therapist is simply a guide; but family is essentially healthy.

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Hayley and MRI;

Strategic.

Communication is real issue within family groups; patterns become dysfunctional because of cyclic issues unresolved.

Disrupt the cycles that maintain the symptoms and introduce more positive conditions and ways to communicate; 1st order change is removal of symptom; 2nd order is where family interaction changes.

Families often remain confused, particularly as children age; different roles for parents engender different forms of communication. There is consistent change and struggle, even in normal families.

Milan;

Systematic

The family is a self-regulating system that controls itself according to trial -- and error rules formed over time; most rules involve communication issues.

Questioning in therapy builds upon each question to form a more circular view of the family dynamics.

Emphasis placed on exploring differences, similarities, emotional responses, and how to judge beliefs over time.

DeShazer;

Solution Oriented

Focuses on solutions over problems; problem is a focus of behavior, but if something isn't broken, don't worry about it/

Therapist is guide but more non-interventionist. People have the capacity to find their own solutions to issues.

Positivist view -- find something that works and reinforce it; if it doesn't work, discard it.

Key Questions for the Therapist regarding the Bolder Family:

Demographic Make-up of the family

Situational dynamics; why was finding pornography a seminal issue

Note: what is finding pornography a symptom of? Why is it a problem?

Explore intimacy issues with Mom and Dad?

What is typical communication style?

How are wife's issues with her father tied in with current situation?

How are husband's issues tied in with wife's past abuse?

Should the extended family be invited to the therapy session; or are there two separate issues: Issue #1 with Mrs. Bolder and her father, and Issue #2, the inner-communication issues within the Bolder family.

Or, can Mrs. Bolder actively connect with her issues with her family without resolving her previous issues? One might say she is projecting some of her previous insecurities on her husband.

Are Mrs. Bolder's parents willing to participate in therapy sessions and will they be honest and productive about past issues. This needs exploring prior to a session so that it doesn't harm the situation.

In family systems therapy, there are eight forces shaping family functioning; listed below are some of the issues surrounding this paradigm as it relates to the Bolders, particularly from Mr. Bolder's point-of-view:

Issue (Goldberg, 2008, 179)

Mr. Bolder POV

Family Dynamic for the Bolders

Differentiation of self

Mr. Bolder wonders why his family seems estranged from him; he is using pornography for sexual release because his wife has been sexually distant from him for a while; he was not sure if this was just part of the cycle of the relationship, or if there were deeper problems.

Mrs. Bolder is obviously finding it hard to communicate with her family on issues she finds important; We are not clear if she is feeling abandoned, but if through therapy we can get each family member to express how they see themselves, and how they see interactions with other family members, we will understand more of the conflict.

Triangles

Mr. Bolder thought for years that there was a stronger bond between he and his wife, and the triangulation was then husband, wife, and children. While he knew she had some past issues and that they were drifting apart, he thought that was an issue of the evolution of the marriage. He had noticed her lack of interest in intimacy, so rather than pressuring her, he decided to view pornography for his sexual release.

The triangulation for this family is complex; we do not yet understand Mrs. Bolder's issues, or whether Mr. Bolder is contributing to them in ways as well. As for the son finding pornography, this is completely normal in family dynamics, and depending on the age of the son, time for Mr. Bolder to talk with the son. Mrs. Bolder likely feels rejected, it is a Catch-22, she is backing away from intimacy, yet jealous of Mr. Bolder finding a sexual release. What emotional triangles continue to press buttons?

Multi-generational transmission process

To Bowen, connecting current and past generations is natural. We do not know Mr. B's issues about his parents, or his relationship with his in-laws. But it is clear that our process will, at sometime, require Mr. B to help Mrs. B confront the multi-generational issues that are still traumatic. Bowen is not interested in system relief, but instead, in rooting out causes and fixing.....

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