Models of Family Therapy Case Study Paper

SOCIOLOGY AND SOCIAL WORK

Sociology and Social Work: Case Study Paper- Models of Family Therapy

Identification of Family System

Demographics

Family name: The Grape Family from the movie “What’s Eating Gilbert Grape?”

Family ethnicity: Caucasian

Family SESS: Low socioeconomic status since they live in a small town in Iowa, facing the repercussions of a restructured American economy (Denton, 2018).

Number of family members: 5

Family member names and ages: Bonnie (the mother- age 54 years), Ellen (the elder sister- age 16 years), Gilbert (elder brother- age 24 years), Amy (younger sister- age 34 years), and Arnie (younger brother- age 18 years). 

Reason for Social Work Involvement 

From the family’s perspective, they seek treatment for physical, psychological, and social burdens that they face from the chronic illness of one family member, Arnie. The circumstances show that the physical burden has increased upon the shoulders of Gilbert and Amy while taking care of Arnie. 

They seem to show a willingness to work on the increased stigma. Stress and depression that is associated with their family member’s illness. Self-stigma is due to the perception that a chronic illness is societal stereotyping. They feel uncomfortable that they would be looked down upon by others who have to look after a family member with mental illness. Also, Gilbert is the only person earning for the family. He feels helpless that he cannot leave such circumstances or become independent. Consequently, they want to cope with their risk of depression, which could be referred to as caregiver burnout or compassion fatigue. The stability of the family is in danger, and they feel the vulnerability that needs social work involvement. 

Family Background and Situation 

The background of the family is quite intricate. The father, Mr. Grape, tried to commit suicide as he found himself helpless in coping with stress. The entire family had to face the death’s consequences and the already poor financial state. Again, Gilbert is now the only breadwinner for the family in such tight financial conditions where one of the family members is a chronic illness patient who himself needs treatment. Arnie is mentally unwell and seems to be obsessed with the idea of climbing the water-tower present in the vicinity. Gilbert feels he cannot own his independence ever.

Bonnie, the mother, suffers from stress and depression as well as she thinks she cannot earn money after her husband’s death. This physical and psychological complication has taken her over in the form of social isolation. She does not take care of herself and is obese. It leads to another risk to physical health too.

Amy is in a critical state as well as she thinks she cannot get married due to her current family situation and financial limitations. She believes that no apt proposals could come to the small town where they live. Amy has become a mother-like figure in the house as she has to help her mother and look after home chores. 

Ellen is a student and works as well. She wants to be an adult and has her worries regarding her thoughts on this side. Despite all the individual and distinct challenges each member has to face, they still help each other and show care. However, living in such a house is a stressful job and will create depression and anxiety for all of them. 

Family Dynamics 

The family dynamics are faced with the challenge of changing roles and never-ending pressures of feelings and outbursts, making it inevitable to get affected. The interaction of changing roles, such as maternal and paternal, are to be fulfilled by the children themselves since one has to do household work and the other has to earn for the family. It seems as if the family hierarchy is disturbed as the power mechanism is changed along with the roles.

Gilbert has accepted his position and feels he is in power as he is earning for the family, whereas his mother, Bonnie is no more authoritative since Amy has taken over her job; mother is dependent on her. Gilbert does take serious care of Arnie. Ellen is conspicuous for the matter that she can get along well with all of them, though she feels embarrassed about her obese mother. The relations seem to be working well with the roles taken by each one of them. Still, they are on the verge of collapsing due to the disturbance because of deterioration in their physical and psychological tiredness, leading to personal dissatisfaction. 

Family Roles 

As mentioned earlier, the role distribution is slightly absurd within the family under discussion. Gilbert is just one of the siblings of the family, but he had to take on the role of his ‘father,’ especially after his death, to earn for the rest of the members. Amy had to look after the family members since her ‘mother’ could not fulfill her role appropriately, being a victim of self-imposed stress after her husband’s death. Ellen could be considered a loner since he cannot find new opportunities in life and feels nothing new is left to be excited about. She thinks that her family members do not understand her and do not let her be on her own. Arnie already has his mental difficulties, earning the title of the lost child. The mother herself, Bonnie, cannot live without the support of her eldest daughter as she takes care of her and the entire house. The mother seems to have lost hope of surviving alone and has to face her poor fate since her partner is no more. 

Family Myths 

There are no particular family myths observed for the Grape family; however, some understood cues might suggest that they are myths. For instance, when Gilbert mentions nobody touches Arnie, this could reflect his protective nature about Arnie. The rest of the family members try to ignore Arnie’s illness. 

Also, their mother’s obesity is considered a humiliation rather than a taboo. The behaviors they choose to face their family problems could be a sign that they are their own choices as myths. The myths suggest that family and individual developmental problems require intervention on time. 

Physical Functioning and Health of Family Members 

The physical health of the family is not satisfactory. Bonnie, the mother, suffers from obesity, making it riskier for her to adopt other illnesses soon. Hypertension, blood sugar, or heart stroke could be some of the physical health risks that might cause future problems. She does not engage in physical activity and does not even perform home tasks. 

Arnie, the younger son, is already suffering from mental problems that deprive him of his physical, social, and psychological development healthily. He is destitute of the chance to live like a normal human being and have normal friends. Rather, he has become a burden to his own family.

These two major physical health problems need quick attention and assessment requirements for offering an intervention. The health problems hint at the preconditions for deterioration of the family culture and the climate that exists within the house, fiercely impacting other family members’ psychological health. 

Intellectual Functioning (Mental Status) of Family Members 

Outwardly, the family’s intellectual functioning is fine; however, it is subtly affected by the visible conditions due to Arnie’s and their mother’s situation. Each of them has judgmental capacities that allow them to think logically and act accordingly. For example, Gilbert knew that he had to take upon his father/caregiver’s role and give them financial support as the eldest brother. The complex family situation was well-understood by Amy since she comprehended the situation critically and handled the house matters intelligently. 

The only member who is not capable of doing so is Arnie, as he is dealing with his mental hardships. The intellectual functioning seems appropriate for Ellen and Bonnie, too, as they contribute to the family discussions with their input effectively. Their diverse opinions are witnessed with remarkable ability to discern their current circumstances, apart from the death of their father, which no one discusses. It is considered a family stressor and is avoided in discussions, deemed to produce psychological problems in times of present family crisis. 

Emotional Functioning of Family Members 

As reported by the client, the general mood is gloomy and depressing. Seemingly, the family living style is fine, and everyone participates in the functioning of the household; however, the sickness of the mother and Arnie has affected all of them equally. Mother’s self-isolation and obesity and their father’s suicide had already complicated the matters where Arnie’s condition has produced further complications, making it emotionally difficult for all to cope with the stressors. 

Despite visible problems, everyone tries to hide their real feelings and emotions. This could be because they do not want to add to the stress of the family or want to avoid the outbursts of their negative feelings. The Grape Family wants to come out of their current misery but cannot find a positive alternative method. Negativities have occupied them from all sides since the constant buildup of destructive feelings has increased intricacies in their emotional regulation. 

Interpersonal and Social Relationships of Family 

As mentioned previously, all the family members look after each other and try their best to be there as a support system for them. Gilbert supports Arnie and Amy takes care of her mother and the rest of the family members. Social relationships can be seen in Gilbert’s affair with a married woman named Betty. Still, he is ashamed of calling other girls over to their house because of her mother’s obesity. He cannot be close with other girls for this very reason. 

As Amy is mostly at home, looking after home chores, she still maintains her friendships, while Ellen is the opposite. She can handle various social skills independently during her study. Overall, only two persons have difficulty socializing openly, Arnie and Bonnie. Bonnie has left her willingness to mingle with other people as she has self-isolated herself. Arnie has psychological issues due to which social mingling is inconceivable. 

Educational/Vocational/Financial 

In terms of education, every family member is almost on the same status. Gilbert has completed only his high school and cannot gain better employment prospects. Bonnie and Amy stand in the same line too. Arnie cannot get formal education due to his chronic illness. Ellen is still studying and works as well.

In terms of employment, Ellen and Gilbert both work. Gilbert works at a local store, and Ellen works at Daily Dreme. Gilbert’s employment seems unstable as the shop he works at is imperiled by the competition in the locality. Hence, it could be said that the financial stability of the Grape family is also at risk. 

Legal Involvement 

There is no legal involvement as the family does not involve in any criminal activity or legal procedures. 

Substance Abuse/History 

There is no record of substance abuse or alcohol use within the family. 

Religion and Spirituality 

The family does not appear to follow any specific religion and, for this purpose, does not go to any worship place. It shows that religion does not play any part in their lives, and their faith does not overpower their meaning of life. 

Treatment History 

There is no family history of physiological treatment for any family members. 

Strengths and Problem-Solving Capacity 

The evident strength of the family is the aptitude to support each other even though every individual has their distinct problems. They have an in-born quality of protecting their siblings and even parents, just as Amy is doing for her mother, which is a strength. They try to solve their problems by discussing and creating a collaborative effort. In the past, their father was the one who looked into issues that required problem-solving; however, after his death, all fulfilled this role with coordination. Their mother has also left her part in this coordination, though. 

Use of Community Resources

The family has not used any of such resources as the town does not provide such support. 

Communication of Knowledge of Content – Theory

The theory selected with the client system is Bowen’s family systems theory. It discusses the family as a system in which a family member is an emotional unit and systematically uses thinking to deal with the unit’s complex connections (Calatrava et al., 2022; Goldenberg, Stanton & Goldenberg, 2017, p. 206). There is a connection shown within the family relations that is visible through the interdependence, sometimes in the form of support. Bowen believed that the emotional experiences of the family members help develop the identity of self for each individual (Dolz-del-Castellar & Oliver, 2021). The family of origin’s emotional dynamic could help ascertain self-development individually. Bowen emphasized that self-development is free from age, sex, level of education, or socioeconomic status. However, they can be modified with, for example, psychotherapy procedures to prevent family stressors. 

The theory also suggests that people with lower self-differentiation levels have low chances to remain calm as they lack an intrapsychic component (Dolz-del-Castellar & Oliver, 2021). There is less capability in them to emotionally regulate themselves. The balance of emotions is uncertain, and life stressors create intolerance for ambiguity. The lower level of differentiation also leads to complexities in interpersonal relationships that they depict through an emotional cut-off from the rest of the world. This is their way of responding to stress or coping with it. 

The reason for selecting this theory is that it has been proved in many pieces of research that it helps to cater to the family problems that hinder a family’s interaction with each other caused by problematic or non-problematic behavior (Johnson & Ray, 2016). In contrast to theoretical models that focus on individuals, this theory builds around the family member’s behavior and its surrounding impacts on others. The intentional or unintentional behaviors that cause the circular conception of causality underlined within this theory would help explain the transactional changes of support and feelings towards one another with a provision of a self-perpetuating pattern of the problem-causing behavior. 

Eight interlinked forces formulate the family functioning with the Bowen family theory: differentiation of self, triangles, nuclear family emotional system, family projection process, emotional cut-off, multi-generational transmission process, the position of siblings, and societal regression (Haefner, 2014; Kaplan et al., 2014). These factors could best explain the chronic emotional anxiety that the Grape family has been going through as some level of dysfunctionality is witnessed. The emotional fusion and differentiation of self are the primary elements of this theory that would help base the togetherness and individuality of the chosen family. 

The use of this theory would be to study the Grape Family since there already has been a support system within the family, despite some of the members having a low level of development of self. It might imply that the family interactions are problematic due to Bonnie’s and Arnie’s physical and psychological disturbances. Although, Gilbert and Amy remain a strong source of support and interpersonal connectivity that is required so that the family does not collapse and stays strong. Still, the lower levels of emotional regulation exhibited by Bonnie after her husband’s death have made her limit herself to self-isolation, which could be her mechanism of coping with stress- and emotional cut-off. The same stands true for Arnie, who is already suffering from mental illness that has caused behavioral problems for himself and his family members. Again, Gilbert comes in as strong support for him so that no one else hurts Arnie. 

Communication of Knowledge of Content – Assessment

Based on the initial evaluation of the Grape family and its members, it has been detected that the family needs intervention and assistance to modify their current behaviors. Coping with the stress, they are experiencing and the unrevealed traumas that they do not show to each other but rather cannot deny their existence need to be handled with a certain social work intervention. 

The assessment that follows the theory format would be the Friedman family assessment tool. Most of its features have been elucidated in the above sections of the paper, such as family name, cultural or ethnic background, religion, social network, family residence, socioeconomic status, family coping patterns, etc. 

The client, the Grape family, could be helped with the selected theory since the communication patterns still exist as they want to support each other. The selected theory would help cultivate the behaviors and change them so that the necessary behaviors that need coping with stress should be developed. Understating the emotions of children and the mother is the dire need for a social intervention for persuading her to shun her emotional cut-off or social isolation and play her actual role within the family system. This might help the rest of the siblings to put off the burden on their shoulders and have a sigh of relief. 

Also, the embarrassment and shame due to their mother’s obesity and Arnie’s condition would be relieved a bit once they get emotional support from their mother. The incompleteness that has consumed the family could be filled with the behavior change sensed within the family with a slight reconsideration of priorities with improved attitudes toward the development of self.