Sunday, May 20, 2012
Family Systems Approach
Using a Family Systems Approach with Lois, Client Profile 4
Family systems therapy is useful in marital stress as well as with communication problems between family members (Corey, 2009). This approach respects and integrates each member of the family into the intervention, promoting a change in family dynamics during the therapeutic process. Lois will benefit from her husband's involvement in the therapy since he plays a contributing role in her issues (Kazak & Segal-Andrews, 1992; Laureate Education, Inc., 2006). In family systems therapy, each family member begins to change and integrate new patterns of response to each other. This approach supports changes in the family, enhancing their overall functioning (Corey, 2009). Another benefit of this approach is that neither an individual nor the family is blamed for any dysfunction - rather the family learns to communicate more effectively and introduce healthier patterns in their interactions.
It will be important for the therapist to consider any disparity between the family's beliefs and values and those of family systems therapy. Some of the concepts of this approach, such as individualism, self-actualization, self-determination, independence, and self-expression may not coincide with the beliefs and values of the family's Hispanic, Catholic background. Another limitation might be the husband's open involvement in the therapy. If he believes family matters should be kept within the family, or if he is simply resistant to change within the family, the therapist will have difficulty including him in the therapeutic process (Corey, 2009).
Lois is a Latina who may have learned roles specific to her gender, religion, and ethnicity, such as the subservient role she seems to have taken with her husband and throughout her life. From her self-description, she cannot cope with being alone, and she has always focused on caring for and pleasing others (Laureate Education, Inc., 2006). Addressing any cultural component to Lois' role expectations will be an important consideration in therapy (Kazak & Segal-Andrews, 1992). Because Catholicism may perpetuate female roles similar to those of Lois' heritage, her beliefs may exacerbate her inclination to fill subservient roles.
Ethical or Legal Issues to Address
Two issues that must be addressed immediately are Lois' depression and her husband's potential abuse. If Lois is depressed, the therapist will need to fully assess her for suicidal ideation or a definitive plan for hurting herself. Since she has mentioned her previous alcohol abuse, it will important to continually re-assess her to make sure she has is not using alcohol as a coping tool. The second issue is the husband's verbal (and potential physical) abuse of Lois and her mother. Her mother is a member of a vulnerable population and any suspected abuse must be reported (Remley & Herlihy, 2010).
Overall Therapeutic Goal
The therapist will focus on verbal and nonverbal communication within the family and between each of the members to gain a perspective of the negative symptoms of their interactions (Laureate Education, Inc., 2006). As each member gains a greater awareness of how and why they interact, they can begin to change how they relate to each other and how they function as a whole. From this awareness they will learn new ways to interact with each other.
The Therapeutic Process
During the initial sessions, the therapist will invite Lois' husband, and perhaps her mother and her daughter into therapy. It is important for the counselor to gain an accurate perspective of how the family system interacts and how these interactions affect each member. The therapist will make note of cultural expectations and gender perspectives, and provide interventions that help Lois and her family change the context within which they interact with each other (Kazak & Segal-Andrews, 1992). For example, if Lois' husband yell's in her face, she may find her safest reaction is to take a subservient role. If he learns to control his anger, she may learn to take a different role in the family system (Laureate Education, Inc., 2006).
Goals of Therapy
One of the goals of therapy for Lois and her family will be enabling them as a family and as a cohesive group of individuals, to change the dynamics of their family system so it has less stress on each of its members (Corey, 2009). The therapist may choose to work from one or more of several lenses. For example, a behavioral lens might help each member act and react differently in their interactions, or a teleological lens, may help the members of the family understand how their reactions serve as communicative mechanisms that are self- or family- protective. The overall goal is enabling the family to change in ways they believe will be beneficial for them (Corey, 2009).
Specific Strategies and Techniques
Techniques used will be specific to systemic viewpoints in family therapy. For example, using Haley and Madane's strategic family therapy, the therapist will help the family members reframe or re-interpret their behavior as a reflection of unhappiness or need rather than anger. Amplifying, as well as pretending and enactments might also be used to help develop an awareness of how the family members interact with one another (Corey, 2009).
Corey, G. (2009). Theory and practice of counseling and psychotherapy (8th ed.). Belmont, CA: Thompson Brooks/Cole.
Kazak, A. E., & Segal-Andrews, A. M. (1992). Women and families: Individual and family systems issues related to theory, therapy, and research. Journal of Family Psychology, 5(3-4), 360-378. doi: 10.1037/0893-3200.5.3-4.360
Laureate Education, Inc. (Producer). (2006). Case study: a CBT/behavioral therapy perspective In Counseling and Psychotherapy theories [Streaming Video]. Baltimore: Author.
Remley, T. P., Jr., & Herlihy, B. (2010). Ethical, legal, and professional issues in counseling (3rd ed.). Upper Saddle River, NJ: Merrill/Pearson Education.
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