Couples and Family Therapy

Introduction

Little C, a pre-adolescent boy, has been brought in by his parents for therapy regarding his behaviors. The scenario in this case calls for family-based treatment. On this front, I will be the co-therapist. Towards this end, this text seeks to come up with not only the case conceptualization, but also recommendations regarding the most appropriate treatment interventions.

Part 1: Clinical History of the Family

Genogram

Presenting Issues (Little C)

Little C is brought in by his parents for deviant behavior. According to his parents, Little C is rebellious and does not obey them. He also often has an irritable and angry mood and is described as being vindictive. He often talks back to his parents and often loses his temper and is rude towards his sister. He also displays clear signs of distress. He often keeps to himself and appears not appear to have normal social life – save for his interaction with some drug dealing boys in the neighborhood.

Inter-generational dynamics

Little C’s grandparents appear to be living in a world of their own and are not keen on establishing meaningful interactions with not only their children, but also their grandchildren. For instance, Lisette’s mother and father are largely focused on their own life and wellbeing, and have left their two daughters to fend for themselves and run their affairs as well as families. One would have expected them to provide meaningful counsel and emotional support to Lissette (and Alexis). Chino’s mother is chaotic and does not help matters. She appears to have had an unstable relationship with Chino’s father and has unfounded fears about current circumstances. As a matter of fact, she actively encourages Chino to abandon Lisette and appears to be unhappy that she (Lisette) comes from a different ethnicity. Lack of the familial support in this case effectively results in instability in the young family.

Little C’s Stage of Development

Little C is in his pre-adolescent years. It would be prudent to note that to a large extent, pre-adolescence is largely associated with changes that could be rather frightening, confusing, as well as diverse. This takes place as a consequence of the growth that a person experiences (i.e. on the cognitive, behavioral, as well as emotional fronts) during the transition from childhood to adolescence. A person at this stage also begins to have a more realistic perspective of life. As consequence, in the present scenario, Little C could be seeking to discover himself and deal with the new challenges of this stage of development. As a matter of fact, frequent mood swings happen to be rather common in this development stage. In most cases, there is the evening out of inconsistent behaviors as time passes by and as the child gets to learn how to handle and address reality. Understanding from parents, guardians, or caregivers is crucial at this stage. Failure to have the said understanding could result in psychological disorders and worsen the situation. In Little C’s case, the said understanding has not been extended. With growing independence, the child appears confused over what role he ought to play in a chaotic family settings. He is increasingly alienated.

Intra-psychic (or intra-individual) factors

In basic terms, inter-psychic factors are inclusive of an individual’s various internal psychological processes. In the present scenario, there is evidence of egodystonic (or negative) processes, i.e. specifically with regard to Lisette’s distress following Chino’s arrest and her concern over her role in this familial setup in the absence of chino. Another example of an egodystonic process is conflict of morals. On this front, it should be noted that both Lisette and Chino are under a lot of pressure to deviate from the ideals that they hold of love and fidelity to one another. For instance, when Chino’s friends visit him in prison, they lie that his wife had sex with another man. Chino’s mother also appears hell-bent on convincing her son to settle with Magdalena. On the other hand, Lisette’s sister Alexis actively cheers on Lisette to sleeping with another man. These, and many other factors, result in the worsening relations between the two love birds (Lisette and Chino) – which results into fights that create an even more chaotic household. However, there is also an example of egosyntonic (positive) processes. For instance, Lisette develops a higher social standing following her getting of the PA job. This is positive in the sense that it effectively lessens the couple’s financial burden.

Family’s life cycle

As members of a family, individuals often pass through diverse intellectual as well as emotional stage from the moment they are born, all the way to their old age. In the present scenario, the relevant family cycle stages are parenting/child rearing and child launching. Some of the key concepts associated with child rearing are inclusive of, but they are not limited to, being aware and responsive to the needs of children at the various developmental stages and being aware of the roles/responsibilities of parenthood. In the present scenario, we see failure on both fronts. When it comes to being aware and responsive to the needs of children at the various developmental stages, Chino and Lisette specifically appear clueless about how to handle and guide Little C through his present developmental stage. On the other hand, with regard to the roles/responsibilities of parenthood, Chino and Lisette appear overwhelmed by the children’s demands and needs. Many are times when they act out their frustration over the infringement of their privacy, inability to control the behavior of their children, etc.

I am also of the opinion that there are apparent failures on the part of Chino’s and Lisette’s parents on the child launching front. The parents in both instances do not make any effort to lend emotional support and counsel, or guide the young couple on the ideals of a stable marriage life. As a consequence, Lisette and Chino are largely left to their own designs over how to bring up their young family.

Family’s structure

In the present scenario, failure to approach parenting from a united front leaves Little C with no substantive guide in his life. This is more so the case given that both of his parents appear to be working at cross-purposes. The failure of grandparents to provide meaningful emotional support to the young couple does not help matters. As a matter of fact, their negative influence (Chino’s mother) and lack of involvement (Lissette’s mother and father) contribute to the dysfunction in Chino/Lisette’s marriage.

Cognitions

Family cognitions could in this case be in relation to the values, beliefs, as well as assumptions of key players in the present scenario. For instance, Chino’s mother appears to be convinced that it is Chino’s responsibility to discipline and mold the behavior of his children. She believes that Chino has failed in this role. In so doing, she essentially reinforces his aggression against Little C. Lisette also appears to be inclined towards the need to get even and be vindictive instead of seeking meaningful solutions when she encounters challenges. For instance, she is motivated to cheat by Chino’s extramarital affair with Magdalena. Her parenting responsibilities also appear to be influenced by her own parent’s approach to parenting. For instance, in her pursuit of the ‘miss independent’ image, she appears motivated by her own parent’s little concerns over her wellbeing and that of their grandchildren. This perspective results in her pushing away of Little C – such as when she finds him outside her apartment and refuses to take him in. Here, she remarks to Alexis that she has resolved to deny all persons the opportunity to take her for granted.

Communication, problem solving and conflict resolution

It is clear that in this case, that there is an inherent inability on the part of the families involved to resolve conflicts, address the various challenges encountered, and engage in meaningful formats. For instance, from the onset, Chino and Lisette fail to come to a common agreement over how to go about acquiring the stereo. As a matter of fact, Lisette does not attempt to stop Chino from committing the crime of theft despite Chino making it clear that he intends to acquire the stereo using extrajudicial means. This attitude towards crime appears to have been picked by Little C who is later on accused of stealing a toy car from a merchant in the hood. Further, the inability of the young couple to solve conflict is apparent in multiple scenarios. For instance, after Lisette finds out that Chino has been unfaithful to her, she plots to hit back at him instead of addressing the issue from a more sober perspective. This sends the family’s fortunes on a downward spiral – effectively resulting in the further alienation of the two parents from their children. Little C ends up witnessing quite a number of ugly confrontations between his parents. The instability in the family setting results in lack of meaningful guidance and supervision, resulting in Little C’s drifting off to drug dealing habits.

Race/ethnicity and socioeconomics

There are certain ethnic stereotypes that have been peddled around in this case. For instance, Chino’s mother is not happy with Lisette’s ethnicity and projects it in negative light in the presence of her grandchildren – a course of action which could result in the development of negative attitudes towards their mother. At some point, she even uses the derogatory term ‘nappy head’ in reference to Lisette’s ethnicity. It would be prudent to note that the term has been deployed in normal-world settings in an attempt to present persons of African-American descent as undesirable or inferior. On the socioeconomic front, the financial challenges that the young family is facing at first, and the lack of meaningful adult supervision for the children, also contributes to Little C’s drug dealing exploits. Further, Chino’s arrest could be directly linked to the financial scenario at the familial level, coupled with the demands of his wife. Lisette’s resolve to make something out of herself following her strained relationship with Chino makes things even worse in as far as her parental responsibilities are concerned. The needs of Little C are further ignored and neglected.

Gender-role dynamics

Some of the attributes ascribed to the male gender relate to specific behaviors and roles. For instance, in this case, various characters appear to have their own perspective about masculine roles. These perspectives are projected on to the children, specific Little C. At the onset, Chino and Lisette appear to be convinced that it is the role of a man to provide. It is for this reason that Chino is uncomfortable with Lisette’s move to look for a job when he is in jail. At some point, Chino also makes it clear to Little C that to be deemed a man, he should first learn to fend for himself and quit depending on him (Chino). To a large extent, we could speculate that this hugely contributes towards Little C’s embrace of drug dealing. Further, there is the overall expectation projected at both the familial and societal level that a man should not display any emotion. It is for this reason that Little C is laughed at by his drug dealing peers after being whipped by his father in public.

Couple dynamics

There are a number of factors on the familial front that have influenced Little C’s conduct. To begin with, his parent’s inability to embrace the various challenges associated with the parenting/child rearing role result in his needs being neglected. In various scenarios, the two parents appear overwhelmed by the three children’s needs and demands. Further, both Chino and Lisette appear ill-equipped to help Little C navigate through the stage of development he is in at present. Next, the inability of the said couple to address disagreements in a constructive format effectively results in ugly confrontations and outbursts – some of which take place in Little C’s presence. Little C’s exposure to scenes of this nature could effectively result in anxiety and distress. The two parents have also failed to establish a clear structure and rules governing the collective and individual conduct of members of the family. For instance, in addition to engaging in sex and related behavior at the most inappropriate times, Chino and Lisette are also engaged in inappropriate conduct (i.e. stealing on the part of Chino and extramarital affairs on the part of both). As a consequence, this unbecoming conduct of the couple leaves Little C with no moral beacon.

Stressors

The key stressors that ought to be highlighted on this front are inclusive of, but they are not limited to; parental responsibility, extramarital affairs and financial strain, etc. There are also a number of other stressors that could be identified as pileup stressors. Two such stressors are work responsibilities and relationship conflict.

When it comes to parental responsibility, both Chino and Lisette appear overwhelmed by the various parental roles and the demands of bringing up young children. On the other hand, extramarital affairs bring significant distress on the part of both partners. When Lisette finds out that Chino has been having an affair with Magdalena, she hits back by having sex with her boss. This deeply hurts Chino and makes a bad situation even worse. In as far as financial strain is concerned, Chino’s income as a bicycle messenger happens to be meagre. For this reason, they live in an unstable crime-prone neighborhood and the family has little savings to live on after Chino is locked up for stealing a stereo.

Work responsibilities in this case could be considered a stressor due to the fact that both roles (i.e. in the case of Chino as a security guard and Lisette as a PA) appear demanding. Chino has to work at night and is kept from his family during hours where meaningful interactions would ordinarily take place. This could be deemed a pile up stressor owing to the fact that it is triggered by financial challenges that the family encounters and results in additional stress for the family. Relationship conflict emanates from the inability of Chino and Lisette to resolve their differences in an amicable manner.

Larger system factors

One larger system factor that could be having an impact on the family is the inability of the government to provide meaningful opportunities for persons in this particular neighborhood. It is for this reason that both Chino and Lisette fail to find gainful employment at the onset. To a large extent, it appears to be a rather tough neighborhood. This is all too clear following the instantaneous breakings that take place after the blackout. This could have a negative influence on the likes of Little C, i.e. in as far as deviant behavior is concerned.

The society also appears to have failed in its role to nurture the younger generation. Parental guidance appears to have taken a backseat in the neighborhood. This is more so the case given the prevailing drugs challenge and the fact that the said drugs are being dealt by youngsters who happen to be in their adolescence. This could have motivated Little C to engage in drug dealing.

Coping patterns

With regard to Little C’s parents, some of the coping patterns could be inclusive of; adjusting of expectations, denial, cigarette smoking and ingestion of alcohol, and engagement in extramarital affairs. When it comes to Little C, he appears to be engaging in what could be conceptualized as emotion-focused and behavioral coping patters. These are inclusive of lashing out, disobedience, avoidance of social interactions, and affiliation with drug-dealing gangs.

Strengths, resources and/or sources of social support

Sources of support on the part of both Chino and Lisette could be inclusive of meaningful friends, coworkers, family members, as well as social support workers. It would also be prudent to note that both could provide crucial support to each other. In the case of Little C, support could either be formal or natural. In my opinion, both kinds of support would be instrumental in this realm. While formal support could be inclusive of community organizations and mental health specialists (such as ourselves), natural support largely zeroes in on family.

In some instances, familial support could be misunderstood by clinicians. In this case, the family might not be considered an instrumental part and parcel of healing and recovery for persons presenting with mental health conditions. Instead, clinicians may opt to largely focus on individual therapy as opposed to family therapy. This point of view could be held as a consequence of failure by clinicians to fully appreciate the relevance of improved communication and collective situation handling/conflict resolution at the familial level.