Family Therapy Case Vignette Essay: Ethical, Cultural & Structural Approaches
Family therapy is an essential approach to a family that exhibits psychosocial problems and other dynamic events. Most families undergo diverse behavioral complications that require various therapeutic approaches to restore ordinary and peaceful behavioral acts. Formulating the most appropriate therapy for a family depends on the underlying ethical and cultural factors that should be considered. Ethics are essential when developing a therapy procedure for any family within a particular environment. Integrity in therapy, respect for human rights and dignity, and effective communication between the scientific community and the general public are all important aspects of ethical considerations. These guidelines guarantee study subjects’ safety, informed consent, and voluntariness. You will strike a balance between prioritizing your therapy’s impact and adhering to the highest ethical standards in your work (Franca et al., 2019). Cultural considerations are essential in developing a concrete therapy process (Kalb et al., 2019). Culture impacts how people view the world and life from diverse points. It influences how people conceptualize the meaning of life, behavior, and other events in life. The paper will provide a concrete analysis of family therapy as an underlying challenge.
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How to Formulate Therapy for Robert’s Family?
The underlying ethical and cultural factors play a crucial role in the therapy formulation for the designated family. Robert’s family exhibits a dynamic range of psychosocial and behavioral issues. Diverse events within the family play a crucial role in children’s and parents’ underlying behavioral problems. The critical consideration in the formulation of the therapy for the stipulated family is the underlying cause of events that precede dynamic behavioral transformation operations. The family requires a strict approach to the underlying issues which lead to the current behavioral practices. The designated family will be subjected to structural therapy to solve the underlying problems (Calabro et al., 2021). The selected approach will be essential and beneficial to both the parents and the children as it is goal oriented. The designated therapy will be formulated on five unique principles: a focused interaction approach, matrix of identity, family structure, well-functioning family, and the position of a family therapist.
Interaction Focused Approach
This phase of family therapy is based on establishing a criterion that induces an in-depth understanding of behavioral patterns. In the case study, Robert exhibits strange behavior attributed to his old life when his father left him at 11. The disappearance of his father is the root cause of the behavior that he exhibits. The interaction approach aims to identify the source of strange behavior and works towards eliminating the underlying conduct. Interactions within the family play a crucial role in determining the essential basis of the problem. The two children, Robert Jn and Madeline, also exhibit diverse negative behaviors towards their parents. The behavioral transformation among the designated children is attributed to the parent’s behavior and the interaction within the family.
Matrix of Identity
The matrix of identity is based on the interactions among the family members at a personal level. The case study depicts the minimal interactions between Robert and his wife, as stipulated by his absence from the children’s perception. The nature of the underlying individuals will play a crucial role in the aspect of a dynamic solution. Here is a strategic approach to how the designated individual should interact with the children. Robert should be advised to interact more with the children and the family members. It will result in the aspect of increasing the bonding activity. As a result, the behavioral transformation will be initiated as the rate of interaction increases.
The father’s absence from the family is one of the significant sources of the underlying problems. The therapist will advise Robert to be available for the family to eliminate the behavior exhibited by the children, especially Madeline. The underlying nature of the stipulated act will involve all the cultural considerations that will be able to mend the behavior. The designated father should provide both physically and mentally for both children and the wife. The personal interactions between the father and the wife should also exhibit high-level respect, which is crucial for better relations within the family.
Family Structure
The family structure within the designated case study comprises a father, mother, and children. The stipulated family structure’s core behavioral patterns are based on dynamic interests and social interactions. Social interactions within the family are minimal, which could significantly contribute to the stray behavioral activities that have been induced. The assessment of the underlying problem within the family reveals a wide range of dynamic psychosocial implications (Gardiner et al., 2020). A lack of respect has dominated the nature of family relations. In a typical family setting, children learn diverse behaviors from their parents in a social interaction manner. It has been portrayed by the underlying child Robert Jr who smirks when his mother is talking.
Well-Functioning Family Approach
The therapist will deduce the aspect of solution-based recommendations and practices that the designated family should adopt. In this phase, the therapist will analyze the underlying problems within the family. It looks at how the daily response to underlying needs develops crucial solutions for the designated issues. There are various communication issues within the family that the established family lacks an answer to tackling in a predetermined time. The therapist will provide the family with crucial tasks to develop solutions for the short-term problems they face within their environment.
When families cannot adjust to change, they often try the exact solutions repeatedly without success.
When families cannot embrace change within the environment, they attempt a repetitive mode of solutions. In most cases, this act does not result in any beneficial transformation for the family. The same scenario has been observed within the designated family. The act of implementing the exact solution to the underlying problem has been depicted through the aspect of ignorance. The family’s son has been portraying a similar behavioral action as the father when interacting with the mother. The child obtains the behavior from the father and behaves similarly to Christine. The aspect of similar solutions to the existing problem with minimal success within the family has been depicted through the act of Robert being unavailable.
Robert believes that being unavailable to the family, especially the children, will solve the underlying problems within the family. However, this accelerates the existing situation as Madeline becomes inactive, lazy, and fat and blames it on her father’s absence. Robert adopted the same solution from his father, who left the family when he was the age of 11 years. It is a form of unavailability that he hopes will solve the family problem in the current status. These joint activities only accelerate the underlying issues within the family. Alternatively, Christine being a child from an abusive family and lonely life neglects the children within the society. It is an approach from her family in ancient times, and she believes the same will be essential to inducing a successful solution to the existing problem.
Bowen’s Family Systems Therapy
The family requires an elaborate plan to treat the underlying behavioral mode and respect. Bowen’s family systems therapy utilizes many factors to eliminate the underlying problem. The theoretical constructs that the designated family use towards constructing an elaborate plan. Some of the core factors include; differentiation of self and emotional triangle. Based on differentiation of self, the designated family members should be subjected to a practice that enables them to separate thoughts from feelings. Robert and Christine must be on the verge of bringing the family close and together. It will allow them to cope with the variables in their lives and their family altogether (Thompson et al., 2019). Highly differentiated people may be more able to keep their identities distinct while feeling connected to the community.
Due to a lack of emotional boundaries within the family, an individual with a low level of separation may feel intense fusion or experience what the group is feeling. Those with a well-developed sense of self are more likely to find fulfillment in their achievements, while those with a less robust sense of identity look for approval from others. The second phase of Bowen’s theory is the emotional triangle, which represents the human network on the underlying relationships within the family. Anxiety can cause a dyad to become unstable after it has existed for some time. However, a three-person method may offer additional tools for controlling and minimizing group anxiety. Many triangles form their laws and live with two sections in peace and one in conflict, which can be a source of tension despite the triangle’s promise for enhanced stability. Young people frequently find themselves caught in a love triangle involving their parents (Erdem & Safi, 2018). According to Bowen, the intergenerational transmission process illustrates how people look for mates with comparable levels of distinctiveness, which can result in the transmission of specific traits and conditions from one generation to the next.
Structural Family Therapy
Salvador Minuchin developed structural family therapy to assess the family unit in real-time by observing its members’ interactions and patterns of behavior during treatment. Therapists use techniques like role-playing in session to investigate parental and sibling subsystems, among others, in families. The act of role-playing within the stipulated family plays a crucial role in modifying children’s behavior within the family. Robert and Christine can role play in a scenario critical for introducing a typical behavioral pattern and diverse responsibilities. It will induce holding every family member accountable for their roles and responsibilities to maintain the environment. As stipulated by the theory, family relationships within the designated family are essential for a functional family. Christine and Robert will role play to create stable relationships that are crucial for the aspect of a better part of the family. The diverse nature of the relationships within the family requires respect that can be channeled to the children.
Conclusion
Family therapy can improve troubled relationships between members. Its goals are to solve conflicts, improve communication, and create a better-functioning home environment. Robert’s family exhibits various behavioral and psychological issues. Structural therapy is the most appropriate approach to solving the family’s issues. It is formulated on five approaches, including a focused interaction approach, matrix of identity, family structure, well-functioning family, and the position of a family therapist. However, the family needs to work towards unity and improved relationships among members to ensure the approach’s effectiveness.
References
Calabrò, P., Gragnano, F., Niccoli, G., Marcucci, R., Zimarino, M., Spaccarotella, C., … & Working Group of Interventional Cardiology and the Working Group of Thrombosis of the Italian Society of Cardiology. (2021). Antithrombotic therapy in patients undergoing transcatheter interventions for structural heart disease. Circulation, 144(16), 1323-1343. https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.121.054305
Erdem, G., & Safi, O. A. (2018). The cultural lens approach to Bowen family systems theory: Contributions of family change theory. Journal of Family Theory & Review, 10(2), 469-483. https://www.gizemerdemphd.com/uploads/1/2/0/9/120924515/_2018_the_cultural_lens_approach_to_bowen_family_systems_theory.pdf
França, K., Kumar, A., Castillo, D., Jeffery, M., Hyczy da Costa Neto, M., Damevska, K., … & Lotti, T. (2019). Trichotillomania (hair pulling disorder): clinical characteristics, psychosocial aspects, treatment approaches, and ethical considerations. Dermatologic therapy, 32(4), e12622. https://onlinelibrary.wiley.com/doi/abs/10.1111/dth.12622
Kalb, R., Feinstein, A., Rohrig, A., Sankary, L., & Willis, A. (2019). Depression and suicidality in multiple sclerosis: red flags, management strategies, and ethical considerations. Current neurology and neuroscience reports, 19(10), 1-8. https://link.springer.com/article/10.1007/s11910-019-0992-1
Thompson, H. M., Wojciak, A. S., & Cooley, M. E. (2019). A family-based approach to the child welfare system: integration of Bowen family theory concepts. Journal of Family Social Work, 22(3), 231-252. https://www.tandfonline.com/doi/abs/10.1080/10522158.2019.1584776
Here is the case study:
Robert and Christine, a Latino couple in their early 30’s, were referred by Robert’s managed care insurance for family therapy. The couple’s 2 children, 10-year-old Robert Jr. and 8-year-old Madeline are present for the intake session. Christine complains that their son Robert Jr., “has no respect for me and calls me awful names, just like his father”. Robert smirks while Christine talks. He tells you that Christine is, “just like her mother, lazy and fat”. Christina shoots back with,” at least my dad was around when I was a child”. Robert’s reply is, “look what that got you.”
During the psychosocial assessment, you learn that Robert’s father left him when he was 11-years-old and that he was the caretaker of his younger siblings while his mother worked 2 jobs. Christine was raised by both parents, in a very strict, abusive home. Her father was an alcoholic. He sexually abused Christine and her sister. Her mother told both her and her sister to not speak to anyone about the abuse. You notice Madeline hiding in the corner with fear in her eyes during the session. Robert Jr. sits with his arms crossed, smirking like his father.
1. Utilizing the information in the reading assignments, in consideration of ethical and cultural factors, discuss how you would formulate therapy for this family?
2. When families are unable to adjust to change, they often try the same solutions over and over again without success. What do you see in this family that illustrate this process?
3. Discuss your treatment of this family with regard to each of the following:
– Bowen’s Family Systems Therapy
– Structural Family Therapy