Family Systems Theory: A Case Study

Family Systems Theory: Vignette II

Discussion of what's going on in this family

Claudia and Margaret had suffered violence at a young age and therefore, are prone to commit acts of aggression, with the chances of developing more symptomatology like anxiety, aggression, depression and low levels of self-esteem, as compared to those who led a violence-free childhood. Being victims of, and exposed to, family violence during childhood years can make Claudia and Margaret victims or offenders. Margaret was a victim of violence when she was young and resorted to aggression as the means to resolving conflicts in her relationships; her personality structure incorporates shame, anger and guilt. Claudia, also being victimized in childhood, cannot regulate her emotions, particularly anger, and exhibits more tolerance to adult intimate abuse. As they were both victimized or exposed to abuse, they not only display aggressive behaviors, but also possess ineffective ways of coping and weak communication skills (Beatty, 2013).

In conducting therapy of couples and families, it is clearly understood that past unresolved wounds become prominent factors that affect intimate relationships in adults. Calcified wounds such as these have resulted in ineffective communication, high distress levels, heightened frustration, as also greater risks of domestic violence (Beatty, 2013). Consequently, though Claudia and Margaret wanted to escape their past relationship patterns, they appear to have re-erected attachment styles or relationship dynamics which continue to propagate violence. Margaret had suffered at the hands of abusive, controlling parents, and this imbued in her the nature of wanting to dominate over others, and an environment that, misleadingly, makes her feel secure. She finds it difficult to empathize with others, Claudia being the one she is callous towards, in this instance. Therefore, she resorts frequently to partner violence at a later time. The kind of attachment to his/her primary caretaker(s) partly determines the degree of resilience or traumatization in a child. Attachment is complimentary, and is the process of inter-connecting intimate messages which develops over several exchanges and experiences.

The attachment styles which can be seen in this particular family are two in kind- namely, insecure and secure. Claudia consistently shows an insecure style of attachment, which comprises dismissing, fearful-avoidant and preoccupied. A childhood attachment style in Claudia which was insecure-disoriented/disorganized became a fearful-avoidant attachment style in her adulthood; insecure- resistant/ambivalent became insecure-preoccupied, while insecure-dismissing childhood attachment style continued to remain insecure-dismissing in her adulthood.

Naturally, the kind of attachment style which was established during childhood for both cases remained consistent in adulthood as well. While fluidity is seen in relating to other individuals, the attachment styles remain relatively constant. Research findings reveal that those adults who had enjoyed encouragement, affection, warmth and empathy in their childhood years show greater likelihood to attach themselves securely to their primary figures and are less likely to be violent in their adulthood relationships (Beatty, 2013). While Margaret shows good social and communication skills that make her stronger and inclined to develop more secure adult relationship attachments, Claudia requires repeated attention and assurance, and being partnered with an individual who possesses a more independent personality, makes Claudia all the more prone to intimate abuse.

Lesbian or adult intimate / domestic violence may involve anything from verbal, emotional and psychological violence to sexual abuse and coercion. In this instance, intimate violence takes the shape of put downs and intimidation (Beatty, 2013). In this particular case, domestic violence stems from the controlling and coercive behavior of Margaret, and limits, directs as well as shapes the feelings, thoughts and actions of the partner.

Margaret also suffers from alcoholism, and the possible reasons why she resorts to alcohol dependence and abuse may be depression and stress, social isolation, self-medication, physical and verbal abuse. Stress comes in the form of internal or external events which an individual finds too difficult to endure, and may lead to physical or psychological problems. Lesbians such as Margaret suffer from increased stress as a result of the negative attitude of society towards their sexual inclinations. This stress then relates to alcohol consumption and drug abuse in lesbians. Homosexual women can be seen to be highly prone to stress, as well as, likely to have negative experiences with regards to their sexual leanings. Thus, lesbians, in this instance, Margaret turns to substance abuse for self-medication and suppressing of depression and stress. She uses alcohol to defend her homosexual orientation to avoid any embarrassment that she may experience regarding her sexuality. Alcoholism also gives the opportunity to gain acceptance from others, and being inebriated can offer a satisfactory explanation for the individual's homosexual behavior. Social isolation is greatly experienced by many homosexual women, and this contributes towards the increasing alcohol abuse problem as seen in Margaret. The bid to hide one's sexual leanings results in increased isolation and loneliness; mainstream society shuns homosexuals, thus they feel isolated. Hence, through consumption of alcohol, Margaret gains special opportunities to interact with society and experience human contact; this positively reinforces, and increases the frequency of, substance use. Apart from this social isolation associated with lesbians, Margaret also lives in fear of being an object of verbal and physical abuse, owing to her sexual inclinations. Lesbians have to cope with isolation, rejection, violence and harassment, and this increases the risk of the development of problematic behaviors. This can be seen in the abusive manner in which Margaret behaves towards Claudia. Every one of these stress-causing factors faced by homosexual women creates a history that influences their interpretation of the world (Substance abuse and dependence within the gay/lesbian community, 2008).

Child abuse includes physical, psychological/emotional or sexual aggression, in addition to being exposed to domestic abuse. These can be both verbal as well as non-verbal behavior towards juveniles (less than 17 years of age). Psychological or emotional abuse that causes harm to a child includes threats, words, isolation, intimidation, control, or jealousy. Unsupportive behavior, non-encouragement of goals and dreams and disrespect of another individual's feelings, in this instance, implies psychological or emotional abuse in children.

Question 2: A possible treatment plan for this family including the children

Solution focused therapy

SFBT is different from traditional therapy in that the traditional treatment technique lays greater emphasis on exploration of problematic feelings, behaviors, cognitions and interaction, confrontation, providing interpretations and education of clients. The competency-based SFBT model, in this instance, gives lesser importance to past problems and failings, focusing instead on the previous successes and strengths of the clients. Focus is given to working from the interpretation of the client regarding their situation/concern and the change wanted by the client (Trepper et. al, 2008).

Solution-Focused Therapeutic Process

This therapy uses the same procedure irrespective of what concern/situation is brought by every individual client to the therapy. This approach lays stress on how individual clients change, instead of focusing on diagnosis and treatment of problems. It adopts the language of change, with the trademark questions put forth in SFBT interviews aimed at setting up of a therapeutic procedure wherein specialists listen and absorb meanings and words of clients with regards to what is significant to clients, their wants and their related successes; later, they formulate and put forth the succeeding question by way of connecting to the phrases and key word of clients. Therapists continue listening and absorbing the clients' answers from their reference frame, and yet again frame and put forth the following question by a similar connection to the response given by the client. This ongoing process of listening and absorbing, and then connecting and absorbing further client response allows the therapist and client to co-construct new, altered meanings and build towards a solution (Trepper et. al, 2008).

General elements of Solution Focused Brief Therapy

SFBT mainly comprises of conversations. There are 3 major general ingredients in SFBT conversations. First come the overall issues; SFBT conversations mainly focus on clients' concerns- who the clients are and what is important to them, visualization of a desired future, the clients' strengths, resources and exceptions relating to the vision, enhancing clients' motivation levels and their confidence in obtaining solutions, and a continuous client- progress scaling towards reaching the desired future. Secondly, as indicated previously, solution focused conversations comprise a therapeutic procedure entailing co-construction of new or altered meanings in the clients. The process sets into motion by therapists questioning clients using SF questions regarding the conversation topics mentioned in the preceding paragraph; they then connect to and build from resulting meanings which are expressed by the clients. Thirdly, therapists make use of several specific questioning and responding techniques which encourage the clients in co-constructing a favored future vision, and use their past successes, resources and strengths to convert that vision into a reality (Trepper et. al, 2008).

Goal Setting and Subsequent Therapy

One of the main components of SFBT is setting of concrete, realistic and specific goals. These goals are framed and improved through the SF conversation regarding what future differences the client wants. Thus, it is the client who sets the goals in SFBT. Once the initial formulation is prepared, the therapy emphasizes on the exceptions relating to goals, regular scaling of how close to their goal/solution the clients are, and co-construction of the next useful steps to reach their preferred future (Trepper et. al, 2008).

Specific Active Ingredients

Some main active ingredients included in SFBT are (a) development of a cooperative alliance, for effective therapy, with clients; (b) creation of a solution vs. problem focus; (c) setting changeable and measurable goals; (d) concentrating, by way of future- oriented discussions and questions, on the client's future; (e) scaling up continuous goal attainment to receive the evaluation of the client on progress made (f) laying emphasis in the conversation on the exceptions to the problem of the client, particularly relating to what the client requires different, and providing encouragement to clients to work more in the direction of making exceptions happen (Trepper et. al, 2008).

Nature of the Client-Therapist Relationship

The therapist, in SFBT, plays the role of a consultant and collaborator and assists clients in achieving their goals. Clients are more active in the conversation with the use of SFBT, and what the clients speak about is the basis of resolving their complaints. SFBT therapists usually adopt more indirect techniques like asking extensive questions regarding previous solutions as well as exceptions. With SFBT, the client becomes the expert, while the therapist, through the use of SF questioning/responding, adopts the stance of "unknowing" and "guiding from a step behind" (Trepper et. al, 2008).

Format and Session Structure

Main Interventions

Taking a solution-focused, collegial, positive stance: One among the key aspects of the solution-focused therapy is the broad theme and stance adopted by the practitioner. The general attitude is respectful, hopeful and positive (Trepper et. al, 2008).

Seeking previous solutions: Solution-focused therapists have discovered that a majority of the people have successfully solved problems in the past. This can have been at any other situation, time or place (Trepper et. al, 2008).

Seeking exceptions: In such cases where clients do not possess previous solutions that may be repeated, most clients will possess a recent example of exceptions to their problems. Exceptions are thought of as times when the problem could potentially have occurred, yet did not.

Questions vs. interpretations or directives: Questions are the main intervention and communication instrument used by SFBT therapists. The therapists take care not to make any interpretations, and seldom confront or directly challenge a client.

Present- and future-centered questions vs. past-oriented emphasis: Questions put forth by the therapists nearly always focus on present or future; emphasis is almost entirely on what clients want transpiring in their lives or what is already taking place according to their wants.

Compliments: These are another important component of SFBT. Compliments are nothing but offering encouragement to clients to work towards change by validating whatever they are doing well, acknowledging the difficulty of their problems, and also conveying to them that their therapist listens and understands their problems, and cares.

Gentle nudging towards doing what works: After creating a positive mindset with the use of compliments, and discovering previous solutions or even exceptions to aid with solving the problem, SFBT therapists nudge their client to work more towards their goals or try the changes brought up by them, which they feel like trying; this is often termed "an experiment" (Trepper et. al, 2008).

Specific Interventions

Pre-session changes: At the start, or early into the first session of therapy, SFBT therapists generally ask about the changes which have happened or begun to happen, that the client noticed, since calling and making an appointment for the therapy session (Trepper et. al, 2008).

Solution-focused goal: As in many of the psychotherapy models, a fundamental component of the solution-focused therapy is specific, concrete and clear goals (Trepper et. al, 2008).

Miracle Question: Certain clients find it difficult to articulate any goal, much less one which is solution-focused. The miracle question offers a way to question the client for goals in a manner which shows respect and an understanding of the problem's immensity, at the same time resulting in the client offering more manageable and smaller goals (Trepper et. al, 2008).

Cognitive Behavioral Family Therapy

As there are diverse individual problems and family circumstances linked with family conflicts, there is a necessity for an all-encompassing treatment strategy which targets the factors contributing to the caregivers' behavior as well as to the children's consequent emotional and behavioral adjustment.

Treatment Phases

The AF-CBT (Alternatives for Families: a Cognitive- Behavioral Therapy) consists of 3 phases of treatment, each possessing important content designed to apply to both the caregivers as well as the children.