Teri and Miles: a family life cycle case conceptualization

1 Teri and Miles and a Comprehensive Family Life Cycle Case Conceptualization Introduction The Josephs, a multi-generational family, have a strong though strained in ways dynamic among themselves. Every Sunday, the family gathers together for a meal, overseen by Mama Joe. The family members consist of Mama Joe as the head of the household, Teri, Maxine, and Bird (her three daughters), and the girls’ respective husbands (Miles, Kenny and Lem), and their children. Mama Joe has a brother, Uncle Pete, who lives in the home but never leaves his room and never joins the family for dinner. Additionally, the girls have a cousin, Faith, who rarely comes around—but when she does, it spells trouble for Teri and Miles, who instantly connects with Faith over a shared love of the arts. While tensions and grudges do exist among the family members, the weekly dinner and Mama Joe’s guidance provides a foundation and routine by which the family has established a solid support system. This paper will provide a comprehensive family life cycle (FLC) case conceptualization in which an assessment of the family and its presenting dynamics is provided, a discussion of how these dynamic factors might play out in the course of therapy, an elaboration on how therapy may be conducted with these factors in mind, how FLC contributes to an understanding of individual identity and development, and other points as well. FLC’s Contribution FLC contributes to an understanding of individual identity and development by locating the client’s idea of self within the context of the family life cycle (Dupont, 2017). Friends, community, culture and society all play a part in how a client develops a sense of self: for Teri and Miles this is no less true than for anyone else in the Joseph family or in any other family for that matter. Vertical and horizontal factors help to explain that identity and its development (Helps, 2014). Horizontal factors include developmental life cycle transitions, historical events (such as economics and politics), unpredictable events (such as illnesses, deaths, accidents and natural disasters). Vertical factors include poverty, racism, sexism, classism, violence, religious beliefs, genetics, and family emotional patterns. As these two vertical and horizontal lines of variables intersect, the individual emerges, surrounded by a familial and socio-cultural context (Roberts, Voli & Johnson, 2015). For Teri, the horizontal factors that contribute to the development of her identity include her career as a lawyer, the fact that she is has been economically successful in her life (more so than her younger sisters), the death of Mama Joe, and the cheating of her husband with Faith. Vertical factors include the family’s emotional life—the routine disputes and grudges that surfaces—as well as spirituality: the Reverend Williams is always invited for dinner at the family meals, so there is some connection with the family to a non-denominational religious group, presumably Christian. For Miles, the horizontal factors that contribute to the development of his identity include his career as a lawyer but also his love for R&B and his desire to quit his job and become a musician (this is major transitional factor and a source of tension in his marriage, as Teri does not support this dream/ambition of Miles). The introduction of Faith into his life fuels the tension, as Faith is not only sympathetic to Miles’ dreams but also very supportive. Faith represents the major vertical factor contributing to Miles’ development as a person. Using the FLC framework, all of these details emerge and help to present the issues faced by Teri and her husband Miles in better focus. The rationale for using the FLC framework with respect to providing counseling for Teri and Miles is that this particular framework is well-suited to helping couples and individuals identify and address issues within their families—issues that both serve as challenges and potential solutions or areas for growth for the client (Settles, 2016). Narrative therapy and solution focused therapy both are useful within this context for treating Teri and Miles and helping them to address their issues. The idea behind narrative therapy is that it promotes the concept of the individual being his or her own self, pursuing the goals that are important for them, and clarifying what these are and why they matter within the context of the larger life story that the individual is constructing. The idea behind solution focused therapy is that through a collaborative effort, solutions to issues can be identified and implemented over the course of observation and a series of question-and-answer sessions. The Major Tasks of the Members of the Joseph Family The family life cycle stages include: unattached young adult, newly married couple, family with young children, family with adolescents, launching family, and family in later years. Each of these stages is represented in the Joseph Family. Rollins and Feldman (1970) state that “stages of the family life cycle are more highly correlated with the family economic behavior than either age of head of household or length of time a couple had been married” (p. 20), and this applies considerably well to the relationship of Teri and Miles, as financial factors are always a consideration for Teri (which is part of the reason she does not support Miles’ adventure in music as opposed to maintaining his nice, stable career in law). Teri is seen as a bread-winner and is a financial rock for her younger sibling who is constantly asking for a loan and never repaying it. However, the definition of marital success is not shared between Teri and Miles, as they appear to be in two different family life cycle stages and moving in opposite directions, moreover. Rollins and Feldman (1970) define marital success according to eight different criteria: 1) permanence, 2) social expectations, 3) personality development, 4), companionship, 5) happiness, 6) satisfaction, 7) adjustments, and 8) integration. From this perspective, it could be said that Teri and Miles are experiencing trouble in all criteria. Their tasks should be to move toward one another for each item, but that movement is not taking place. Teri is too career-oriented while Miles is too focused on his own personality development. The major task of Mama Joe was to keep the family centered and supported, but her death has left a gap in this department and no one but young Ahmad has attempted to fill it. By bringing the family together again for soul food Sundays, Ahmad performs a significant role, but the reality is that with Mama gone, each family member has to step up and contribute to whole left by her absence. Each family is experiencing changes as well and transitioning into a new life cycle stage. Lem and Bird are expecting their first child; Teri and Miles are divorcing, but he is still coming for Sunday dinner so their relationship is not completely over; and even Faith is playing a larger role in being part of the family. Kenny and Maxine represent the stable, loving couple raising children to uphold the values instilled in them by Mama Joe. Their major task is simply to hang on to what they have but also Maxine and Teri have to bury the hatchet and put away the grudges they bear one another. For each family member their tasks within their developmental family life cycle phase are the following: Lem and Bird must differentiate themselves in relation to their family, as must Faith. They must also adjust as a couple system to make space for the child they are set to have. Kenny and Maxine must shift the parent-child relationship to permit Ahmad to have more independent activities and relationships, especially as he has demonstrated great maturity in trying to keep the family together. Teri and Miles must be willing to allow one another to explore new interests and a accept a multitude of exits from and entries into their family system. Healthy Transitions As Ballard (2012) notes, “transitioning successfully from one stage of development to the next in the family life cycle requires the accomplishment of certain developmental tasks. Couples and families who fail to accomplish these tasks often become “stuck” and unable to move forward” (p. 141). Teri is particularly stuck in and needs to become unstuck so that she can move forward—in terms of her relationship with her sister and in terms of her relationship with her husband. She needs to understand that life is a cycle of stages and that each stage has its requirements, tasks, and attitudes that are needed before an individual can move forward. Her husband wants to pursue a new interest and she needs to be supportive of his decision so that they can both make a healthy transition together. Higgins, Duxbury and Lee (1994) state that “one of the consequences of the inability to balance work and family demands is the increasing level of work-family conflict experienced by employed parents” (p. 144). This is particularly true in the case of Teri and Miles. The two have careers and both experience overload and interference, which results from exerting too much time and energy on work and not enough on one another and the building and strengthening of the family. Their relationships serves as a microcosm of the rest of the Joseph family in that the dynamic is breaking down because change is not being embraced and growth is not occurring. Work and family have to be balanced. As Teri places too much emphasis on work, Miles is going in the opposite direction to the other extreme: he wants to abandon work altogether and focus on music, which to him is becoming like a new family. He is replacing his family with Teri with his family in music. The fact that he is still coming to Sunday dinner even after their separation, however, indicates that the dynamic has not completely been destroyed. They are stalling but a healthy dynamic can be restored so long as each is still willing to work it out. Vertical and Horizontal Stress Newby (1996) notes that “the degree of anxiety engendered by the stress on the vertical and the horizontal axes at the points where they converge is the key determinant of how well the family will manage its transitions through life. Although all normative change is to some degree stressful, it has been observed that when the horizontal (developmental) stress intersects with a vertical (transgenerational) stress, there is a quantum leap m anxiety within the family system” (p. 789). For the Joseph family the developmental stress and transgenerational stress flow points are intersecting at the immediate family, causing a breakdown in bonds. Teri Teri’s vertical stress consists of an emotional climate that is stifling. She is “always letting everybody know she paid for everything” and she knows it: she has a chip on her shoulder about poverty and she is proud of herself for working hard enough to grant others the ability to have what they want. However, her lack of humility in being able to provide rubs her family members the wrong way—especially Maxine who takes umbrage at her digs and comments. Teri is too consumed with her own achievements to recognize that others have not set for themselves the same goals that she has set for herself. Obtaining a career was her goal—but not the goal of her sisters. As for her husband, he also has a different dream. As her nephew realizes, for a family to be strong, every individual has to be giving and be willing to do what is needed at the right time in each situation. Big Mama Joe for instance knows what to do to defuse a situation and de-escalate tense environments—but with her gone, the individuals of the Joseph family have to learn how to do this. Teri has to learn how to be more involved in the lives of her sisters and in the life of her husband instead of being self-involved and too caught up in her own work so that she can lord it over others, showing how she makes all the money and supports them. This is not the way to win their affection or their love and she has to realize that when it comes to her husband and his needs. Teri’s horizontal stress consists of her husband’s decision to quit his job to pursue music. This causes strain for her because now she is even more sensitive of her role as bread winner and must deal with what this means at a whole new level. As Hanline (1991) shows, transitions are only possible if there are supports in place. Big Mama Joe acted as the support for the family members as they developed, but now that she is gone, and now that Teri has become “stuck” in her family life cycle stage, there is a need to address the big stress issue in her life which is the fear of losing one’s work. Miles Miles’ vertical stress consists of negotiating the politics around him in order to find his place in society. He has worked hard but now he feels he is being called in a new direction and his wife is not understanding of his needs. Communication is limited between them because he does not know how to explain to her his appreciation of art and music. She is distant and he does not know how to reach her. His horizontal stress consists of developing and taking the transition to the next family life cycle and doing it without his wife. This is troubling because they have come so far together and yet they have not moved beyond the stage where they to settle into the new phase. In order to transition appropriately, he needs support but looks for it in the wrong place—i.e., with Faith, which is a betrayal of his bond with Teri. Miles needs to understand that even if his wife is distant from where he is, seeking to replace her is not an appropriate option for the family. Interventions and Implications Narrative therapy and solution focused therapy can be applied in any culture, especially in a multicultural society, as they do not project any type of specific aim or frame of reference but rather allow the client to put forward the narrative or the goals so that the counseling can proceed organically. The positive aspect of these systematic interventions is that they promote organic solutions that come from the client rather than from the counselor and thus are not impacted by ethnic or cultural miscues. Narrative Therapy Interventions Telling one’s story. This intervention allows the client to find his or her voice and both Teri and Miles could benefit from it by telling their story in their own words. This would be a way for them to provide meaning and communicate it so that it can be heard aloud for what might be the first time. Teri and Miles could explore their own experiences and discover how alterations make the story new. Externalization technique. This intervention allows the client to see the problems he or she is having as external to themselves instead of as actually being part of the person. In other words, they can see that they are not attached to their problems and in this sense they can free themselves from them. The implication here is that if one is not attached to one’s problems it is easier to change one’s behavior for the better. For Teri and Miles, this intervention would help them to identify the issues they are having and subsequently identify other behaviors that they could engage in instead of the behaviors they are doing that are leading to conflict. Deconstruction technique. This intervention allows the counselor to break down the problems so that they become easier to understand and process. Sometimes clients have difficulty processing an issue because it seems so big and complex. By deconstructing it, the client can better cope with it. For Teri and Miles, this intervention would allow them to sift through the dynamic that is causing them problems, and better understand why it is happening and what they can do to change that. Solution Focused Therapy Interventions Goal setting. As Burg and Mayhall (2002) note, “in solution focused advising the advisor does not provide the goal but can facilitate a semi-structured conversation that leads the student toward a goal” (p. 80). For goal setting to work, the client must set the goal and while the counselor may have an idea of what goal should be set, the client must discover this on his or her own. The counselor can guide the discussion so that the client reaches this goal. For Teri and Miles, the goals should be for Teri to be more supportive of her husband’s needs and for Miles to demonstrate more gratitude for his wife’s sacrifices for the family. Scaling. Scaling or rating something on a scale of 1 to 10 helps the client to identify where problem areas are: for instance, the client might be asked to rate his or her confidence in communicating with the partner. For Teri and Miles, scaling could be a useful intervention in terms of how it allows them to see where issues exist without them actually having to think about the issues concretely. They can simply identify what things are hardest for them by scaling, which can lead to greater awareness of themselves and one another and that in turn to modified behavior. The miracle question. This intervention allows the counselor to pose a scenario in which the client wakes up and finds that all the problems and issues that existed the day before were suddenly solved. The question is, “How would you know and how would you communicate this knowledge to your spouse without saying so directly?” This intervention allows the client to forget the problems and consider a behavior that would be positive as though the problems did not exist. For Teri and Miles it would allow them to stop dwelling on their personal issues with one another and adopt a more thankful and caring approach to each other. 3 Short-Term Goals Three short-term goals for Teri and Miles are: 1) to share a conversation every day with one another in which the other person is the primary focus of the conversation for at least 15 minutes; 2) to hold each other accountable for keeping focused on these goals; and 3) to offering encouraging words to the other person at the end of their conversation. 3 Long-Term Goals Three long-term goals for Teri and Miles are: 1) to reconcile and profess again their marriage vows; 2) to bring even more children into the Joseph family; 3) to follow their dreams and to be supportive of one another no matter where those dreams may take them. Treatment Plan The treatment plan for Teri and Miles will begin by introducing the two types of therapy: narrative therapy and solution focused therapy. The plan will be for each to tell his and her story in their own words, without interruption, judgment or comment from anyone else. These sessions can take place one-on-one or together as a unit, or in both ways as the case might be. It will be determined by Teri and Miles. Following the introduction of the two therapies, the interventions will be applied in the following sequence: 1) First, the two will engage in the “telling one’s story” intervention. Each will have an opportunity to tell their own story and describe their own life narrative, where it has come, where it is now, and where they see it going. 2) Second, the two will engage in scaling as way of identifying problem areas. 3) Third, the two will participate in deconstruction so that their problems can be broken down and made to be seen in simpler terms that can easily be comprehended. 4) Fourth, the two will externalize their problems so that they can see that they are not their problems and their problems are not them. 5) Fifth, the two will respond to the “miracle” question so that they can see how their lives might be differently approached were they not so focused on their problems but rather on each other and communicating a positive feeling and appreciation. 6) Sixth, the two will set goals for themselves based on the ideas that have permeated over the past sessions. Their achievement of these goals will be measured over the remaining sessions to see how well they are working towards them. Each intervention will last one session and each session will last 1 hour. If the two choose to do their sessions jointly, each will have 1 hour for themselves and the sessions will go for two hours. The counseling plan should be completed within two months time allowing for follow-up sessions to discuss how behavioral solutions that have been implemented are helping or not helping and what subsequent action needs to be taken to improve the situation. Ethnic, Family, and Cultural Considerations That May Influence Counseling Since Teri and Miles are African Americans, ethnic considerations should be made when providing counseling. Sensitivity to ethnicity and to background cultures is important when counseling clients and it is also helpful to allow them to draw attention to their culture and ethnicity as this serves in most cases to inform them of their identities and to help them see who they are and what it is important to them. Family considerations should also be made so that the clients can better understand what their family situation actually is and how it impacts their lives in diverse ways. Respecting ethnicity, family dynamic and culture should always be a top priority of a counselor no matter who the clients are. For Teri and Miles, these considerations would allow both to be open and free with respect to their particular problems so that all issues can be addressed honestly and with fear of violating a social taboo (such as the possibility of divorce). Potential Counselor Bias Issues Potential counselor bias issues might include a counselor having a prejudice against the stigma of divorce and not being willing to accept this outcome for the Teri and Miles. Should Teri and Miles both agree that this is the best solution for them and for the family and that it can work out in a positive manner for them and for the family without negative repercussions, the counselor should be willing to accept this goal. The counselor should not try to press goals onto the clients that originate with the counselor because these may not be satisfactory for the clients. Rather, the counselor should always strive to provide the right balance of guidance and support so that clients are led in a positive direction but ultimately decide for themselves what the right choices are for their own lives and families. Current Public Policies in Chicago, Illinois, USA A certificate to counsel is needed at the local, state and federal levels in Chicago, Illinois and practitioners must have a requisite number of hours in the field under the guidance of a qualified professional before being allowed to practice on their own as a certified counselor. The City of Chicago is also devoted to assisting families with counseling under the Department of Family and Support Services. According to the City of Chicago (2018), “The Chicago Department of Family & Support Services (DFSS) is dedicated to supporting a continuum of coordinated services to enhance the lives of Chicago residents, particularly those most in need, from birth through the senior years. The department works to promote the independence and well-being of individuals, support families and strengthen neighborhoods by providing direct assistance and administering resources to a network of community-based organizations, social service providers and institutions.” This department can provide counselors with a helpful platform in finding the support they need at the local level for helping families with FLC. Professional Issues Professional Issues related to the practice of marriage, couple, and family counseling, including recognition, reimbursement, and right to practice will depend on the professional’s approach to providing this service. Recognition can be achieved by marketing online or through physical advertising; it can also be obtained by joining onto a larger staff or facility where services can be obtained. Reimbursement considerations will have to be mad according to the professional’s approach to accepting payments from insurance providers and how that might be arranged. A professional is not obligated to approach this situation of reimbursement in a particular away by may be obliged to accept state reimbursement for clients who are covered by state subsidy. Right to practice issues will have to be settled locally once certification is issued at the state level and federal guidelines do not interfere with this issue at all. Referral Organizations Referral organization and resources for clients in the identified FLC stage are the following organizations: 1) The Family Institute at Northwestern 8 S. Michigan Ave. Suite 500 Chicago, IL 60603 Contact: 312-609-5300 About: The Family Institute at Northwestern is notable for their high quality academic backgrounds, professionalism and lifelong commitment to advancing their skills. Their treatment is empirically informed, theoretically grounded and culturally responsive. Behind each clinician is a team of 75 clinicians allowing for ongoing information sharing, consultation and effective referrals at four Chicagoland locations. 2) Khalil Center – Chicago Western Suburbs, IL   998 N Lombard Rd Lombard, IL 60148  Contact: 1-855-5KHALIL About: The Khalil Center offers a holistic integrative approach to counseling/therapy. Cultural/Spiritual competence is emphasized and Khalil Center integrates aspects of the psychological literature on best practices for application in counseling/therapy.