Case Study: A Runaway Daughter and Her Mother

The family system is founded on the notions that for change to occur in the life of an individual, the therapist must understand and work with the family as a whole. In working with the family, the therapist can understand how the individual in counseling functions within his family system and how the client’s behaviors connect to other people in the family. This theory also holds the perception that symptoms are a set of family habits and patterns passed down by generation and not a result of a psychological problem or an inability to change (Corey, 2017). Furthermore, the family system theory holds the idea that when a change occurs everyone in the unit is affected by the change.

1. The following paper discusses a case scenario of Adrian, Judy, and Pam. The family is presenting to therapy in regards to their concern about their adult daughter (Pam) not listening to her parents (Adrian and Judy) requests. From the beginning of the session, it is apparent each member has a different view of what their role is in the family. Roles are vital in ensuring healthy family functioning and should be clearly defined so that each member understands what they are to accomplish (Tobin, 2016a). It is revealed later into the session that Judy and Adrian were not able to conceive children, so they adopted both Pam and their deceased son, Victor. Victor committed suicide ten years ago.

The basic concepts of this type of therapy are boundaries, subsystems, complementary and alignments which are easily applied and grasped. The most important aspect the therapist must keep in perspective is that every family is made up of structure and that these structures are seen only when the members of the family interact. If the therapist does not consider the entire structure of the family and intervene in only one of the many subsystems are most likely not to attain a lasting change.

Family is something that plays a tremendous role in our life. Even though the structure of families has changed over the years, it is important to acknowledge that there many families out there whether they are traditional families, nuclear family, stepfamilies or others which tend to have different types of problems in their families. Therefore, many families attempt to go to family therapy in order for them to obtain help in solving the different types of issues they might have at home. As stated in the book Family Therapy by Michael P. Nichols (2013), “The power of family therapy derives from bringing parents and children together to transform their interaction… What keeps people stuck in their inability to see their own participation in the problems that plague them. With eyes fixed firmly on what recalcitrant others are doing, it’s hard for most people to see the patterns that bind them together. The family therapist’s job is to give them a wake-up call” (2013).

The problem that brought Debbie, Fiona, and Frank to counseling was Debbie’s pregnancy. Fiona would like Debbie to live as normal of life as possible and terminate the pregnancy so she can finish school and be a teenager. On the other hand, Frank is excited about Debbie’s pregnancy and is pushing her to keep the child. Due to the ongoing argument between Frank and Fiona, Debbie has not been able to voice her opinion about her pregnancy. According to structural family therapy, the family is a whole and in order for symptoms to be relieved, change within the family’s structure must occur (Gladding, 2015). Therefore, the underlying presenting problem is the insertion of Frank into the family and his power

Although Twyla and Roberta both struggled with mother issues, they develop different reactions yet similar solutions to their troubles. During her stay at the youth shelter,

Whitaker’s (1978) conceptualization of the dynamic was evident when he told the family “It’s really the family that has the anxiety about everybody’s getting together, and the family he’s acting for” (p. 9). Recognizing the importance of Don’s participation in the therapeutic process, the family agreed to a second session with all members present.

One goal for the therapist is to determine what the structure is, and then decide whether it is problematic for the family or not. According to Minuchin (1974), “Family structure is the invisible set of functional demands that organizes the ways in which family members interact” (Minuchin p. 51). Additionally, Gladding (2007) suggested:

Initially, I would proceed with the Bowenian family therapy assessment tool, genograms. I anticipate there might be slight hesitation from Ken, the father who was described to initially present to therapy as, “extreme hostility t being forced into therapy.” It might be a useful tactic to remind the family as a whole that, due to them family unit feeling, “out of sorts” to work together in session and create a family genogram, we might be able to detect some generational patterns. It would be my hope, as a therapist, to work collaboratively with the entire family asking for feedback from everyone. Working collaboratively with the entire family, it is my attempt and hope to engage both Anne and Timothy, who were described as being “extremely quiet and not involved in the conversation”.

From a structural therapy perspective, it would be important to work on re/defining and restructuring the family so that it can operate in a more functional and healthy way. Clarifying and defining the boundaries between Nancy and her children, particularly Sarah, will be critical in trying to erode the enmeshment that is currently occurring. These treatment goals might be more difficult to achieve with Melanie and Amy considering they are currently living with their great grandmother; however, effort on the social workers part should still be made.

The family stated that the only member that requires more attention than others is the teenage son. The son states he does well in school and does not get in trouble a lot at home. The son has numerous friends in the neighborhood that he plays with. The mother has the roles of wife and mother, she does not work out of the home. The father has roles of husband, father, and soldier.

The family is made up of five people: Claudia, the IP; Carolyn, mother; Laura, the sister; Don, the brother; and David, the father. The family is coming into therapy because there have been mounting concerns about Claudia and her behavior—acting out, staying out late, some fairly typical teenage stuff. For the purpose of this paper, I will be starting at the beginning where the family is first coming into therapy. I will first school that I will apply is Structural Family Therapy and the second school is Bowen Family Therapy.

After a thorough review of the textbook and the course material, the specific family system approach that I choose to explore is the Bowenian Approach for this literature review. This specific family system approach is also known as the Bowen Family System Theory as well (D.V. Papero, 2006). The Bowen Family System Theory was established by Murray Bowen, a theorist and psychiatrist who specialized in treating children who were deranged and had schizophrenia (Rockwell, 2010). In the 1950s, Bowen wanted to explore a new venture so he decided that he wanted all of the family members of each child to be involved in an therapeutic process at the same time (Rockwell, 2010).

Approaches to Family Therapy: Minuchin, Haley, Bowen, & Whitaker Treating families in therapy can be a complex undertaking for a therapist, as they are dealing not only with a group of individuals but also with an overall system. Throughout history several key theorists have attempted to demystify the challenges families face and construct approaches to treatment. However, there have been key similarities and differences among the theoretical orientations along the way. While some have simply broadened or expanded from existing theories, others have stood in stark

This family is seeking therapy assistance due to the following reasons: grief and loss encountered during Kate’s cancerous condition and after her death, the lawsuit Anna placed onto her parents, Jesse’s delinquent behavior, and the parents’ deteriorating relationship. The family is concerned with the alliances that have been building within the family and in regards to their negative communication skills. The Fitzgerald family feels that the family is becoming dysfunctional and distant. Having a positive attachment amongst each other at all times assists with minimizing issues, and it is much easier to find solutions to any problems or challenges when positive relationships emerge (Cassidy and Shaver, 2008, p. 200). This is why the Fitzgerald family is seeking help now.