Family Therapy The objective of this case study was to conceptualize the couple's difficulties from two theoretical perspectives and then describe what the best approach to treating them would be based on the perspective for each theory as it pertains to the causes of the family's difficulties, the type of intervention to be used, how to assess the efficacy of intervention and outcomes (effectiveness and projection testing). The case should also gather all additional types of information needed based on the theory chosen.

Because theoretical perspectives are options into viewing and categorizing reality, they make excellent tools of analysis that provide insights that help an observer to organize, and then interpret what is seen. The theoretical perspective also provides a researcher an opportunity to focus in on the parts of the family issues that are of interest to them. But more importantly, they provide explanations of why certain patterns are being routinely performed. Of the number of different theoretical perspectives on families, this case study will use the Conflict and the Systems Theory theoretical perspectives. Often different perspectives complement each other but there are times where they contradict each other. Because of this fact, we will think of each these two theoretical perspectives as nothing more than a point-of-view on this family and we intend to observe them from two fixed points.

This case is about Tim and Kelly; both aged 32 years old and have been married for 6 years. They have no children, and have each had a previous marriage. They are both employed, Tim is a general contractor and Kelly is a waitress. The couple's insurance will allow 6 counseling sessions annually. They are seeking counseling in order to learn how not to fight with each other as much. After the first session, Kelly described the difficulties they were having in her opinion. Kelly tentatively stated, "Our Marriage is like a roller coaster. One day we're telling each other how much we love each other the next day its back to WWIII! Just last night we had yet another one of our huge fights."

Theoretical Perspectives 1 -- Conflict

Conflict from a theoretical perspective has a theme that implies that social and economic relations in a family are not equal in regard to the family member's standing. Often the families have one alpha individual and many lower echelon followers and the family structure is then full of conflict and exploitation. The family often characterizes relationships that are not equal, that there is a definite class structure. In this case, so far we only have one side of the story so it will be critical to get the husband's point-of-view before any final interpretations are made. It would also be of benefit to rule out any ongoing mental diseases such as male/female bi-polar disorder or Multiple Sclerosis which each on to themselves create havoc in families by creating roller coaster like atmospheres. "The therapist starts with the basic tenets of any good therapy: She listens to each partner's perspective and tries to understand what each expects from the process. She explores the history of the couple's relationship: how they met, what attracted them to each other, when they started having problems, and how they have been trying to solve them. (Scheinkman)

Cause

On first evaluation, the couple may be in a recurring pattern where Kelly may do something, real or imagined, that triggers Tim so he then complains and calls her names, she fights back or possibly evades a fight and then he evacuates to his safe spot only to come back renewed and loving. When a couple is caught in a "conflictual pattern" the partners tend to attack and counterattack symmetrically. For some, in a matter of seconds the conflict becomes explosive. For others, the conflict simmers, escalating through soft put-downs or bickering that over time corrode the positive aspects of the relationship." (Scheinkman) This cycle may be based on learned habits by each participant over the course of their lives including their first marriages. The pattern also seems to end with a pattern of disengagement because as either Tim or Kelly back off, the more likely the other is to also back off as evidenced by the assumption by Kelly that he is hitting bars after the fight. But the partners may be trapped in this type of cycle. Would a simple apology make all of this go away or is that the problem, apologies are supposed to answer all ills? "How should spouses respond to their partners' negative behaviors? A growing body of mostly cross-sectional research has suggested...

In the conflict perspective, the intervention should address that family practices currently being practiced may not be good for all members equally because some behaviors take away from the family's well-being.
It is important that the intervention to be used addresses potential domestic violence as demonstrated by the holiday ritual, "Then this morning he's all nice to me like nothing happened." Because of the conflict theory, the intervention used will be required to pay attention to both party's overall familial power structure. The goal of therapy will be to begin to equal out the power base of the family structure if it is out of balance. This may entail evaluating fiscal status and work that is being done in and out of the house. Household labor in the Conflict theory is often treated as insignificant between husband and wife because power within the household may actually gain its power from who has the better job. One job may be seen as insignificant but another job may be seen as all powerful. "It started like always, I was in the kitchen cleaning up after dinner." "Tim is a general contractor and Kelly works as a waitress at a local restaurant." And yet he saw her as not having a real job, "One has enough brains to go get a decent job." Balancing out the family power structure would be the main type of intervention.

How to assess the Efficacy of Intervention & Outcomes (effectiveness and projection testing)

The utility of Conflict Perspective examines inequality within the family structure. Therefore, the best measure of the desired intervention and the associated outcomes would be to measure the equality base before and after the couple's counseling sessions. The overall effect on the partners based on the perceived economic or social inequality in the household is the key to outcomes and projection testing.

In order to accomplish the desired outcome, it would be important to have each partner do additional self work in order to acquire self-evaluations of whether each partner sees themselves in the same light as the other does. "Cognitive dissonance occurs when what a woman knows does not correspond with what she sees or experiences." (Fourre')

There needs to be self-esteem evaluations for Kim and diversity training for Tim in order to balance out their current self-worth assessments. This would be in addition to basic conflict resolution training where each partner learns to show respect to the other through more reasonable conversational skills.

There are many unanswered questions here so there will need to be additional types of information needed based on Conflict perspective.

An initial observation based on the Conflict Theoretical Perspective point out that the husband may feel that he is superior to his wife in the family pecking order as demonstrated by the statement, "I knew what was coming next and sure enough, he started telling me how worthless I am and how he'd be so much happier if he had married a real woman: One that had enough brains to go get a decent job." The belittling of her job, questioning the calls to her mother and calling the mother, 'Mommy' as well as they name calling, like worthless bitch, slut, whore, and frigid fat old pig are indicative to a potentially very violent relationship. Kelly described the event as a huge argument but what she described was more of berating. In other words, it does not sound as though the fighting is a two way street in this scenario. "Tim came in and started yelling about the phone bill being so much…" and then "After awhile, he just stormed off and left the house. He didn't get back home until 3:00 in the morning, after the bars closed." This may be an underlying cause of this family's difficulties if her observations are accurate, but it would also be wise to understand her part of the problem. Is she instigating or sheepish in Tim's presence? "The therapist positions herself in a balanced way, giving each partner equal time, empathy, and consideration. She must hold both perspectives, no matter how polarized the couple is." (Scheinkman)

Both individuals need to provide family history in regard to the power structure of their parents, grandparents and overall family. Is this current scenario an on-going family cycle?…