Working with the Martinez family for therapy
You are working with the Martinez family for therapy. Marta and Jose have been married for 4 years and have 2 children together. They are coming to see you due to increasing conflict and arguments about a lack of intimacy in their relationship and differing views on parenting. Utilizing structural family therapy, please identify how you would begin work with this family. What would be your strategies for the first three sessions? Consider each of the following scenarios and identify a behavioral intervention to address each issue in family work.
A teenager not complying with curfew.
One member of the couple not picking up their dirty clothes from off the floor.
A child who comes into the parents' bed in the middle of the night.
A teen that has been using the computer in an irresponsible manner.
Provide a brief scenario in family practice in which there are two conflicting areas of ethical guidance from the NASW Code of Ethics. For this question, you are expected to give a brief description of the practice issue and identify the two conflicting ethical standards.
Aida and her teenage daughter, Maya, started seeing you for therapy. Maya has been getting in trouble at school for truancy, lateness to class, missed homework, and last week she was caught smoking in the school bathroom. Aida reports frustration in how to handle Maya’s increasing poor decision-making at school and defiance at home. Using the family theory of your choice, discuss how you would begin work with this family. To answer this question, you must select an appropriate family therapy theory discussed in this course and use that theory to develop a plan of work with this family. You should discuss how that theory will guide your assessment, interactions with the family, and intervention selection.
Greg and Aleeya began seeing you due to family conflict related to Greg’s alcohol abuse. Greg recently returned home from his third inpatient rehab placement for alcoholism, and the couple is struggling to redefine their marriage without alcohol as their main argument topic. Utilize solution-focused therapy to discuss a treatment plan for this couple. To answer this question, you should provide a brief treatment plan - one goal, two SMART objectives, and an intervention for each objective (what will you do, utilizing the theory, as the licensed social worker to support the family in achieving the objective?).
- Strategies for the First Three Sessions:
- Session 1:
- Joining and engagement: Building rapport with each family member.
- Mapping the family structure: Conducting a genogram and exploring the family's current dynamics.
- Identifying presenting problems: Understanding each member's perspective on the conflict.
- Session 2:
- Enactment: Observing and intervening in the family's interactions to identify dysfunctional patterns.
- Boundary setting: Clarifying and strengthening boundaries between subsystems (e.g., parental subsystem, marital subsystem).
- Highlighting interactional sequences: Helping the family see how their interactions contribute to the problems.
- Session 3:
- Reframing: Helping the family view their problems in a new light.
- Challenging dysfunctional hierarchies: Supporting the parents in establishing a clear and effective parental hierarchy.
- Beginning to teach healthy communication.
- Session 1:
2. Behavioral Interventions:
- Teenager not complying with curfew:
- Intervention: Implement a behavioral contract with clear consequences for violating curfew and rewards for compliance.
- One member of the couple not picking up their dirty clothes from off the floor:
- Intervention: Implement a chore chart with a reward system for compliance and a logical consequence for non-compliance.
- A child who comes into the parents' bed in the middle of the night:
- Intervention: Implement a consistent bedtime routine and a reward system for staying in their own bed. Use a gradual extinction method, such as returning the child to their own bed each time.
- A teen that has been using the computer in an irresponsible manner:
- Intervention: Implement a computer usage contract with clear rules, time limits, and consequences for misuse. Use parental controls to monitor usage.
3. Conflicting Ethical Guidance (NASW Code of Ethics):
- Scenario:
- A social worker is working with a family where a parent discloses child neglect. The child is a teenager, and the parent requests that the social worker not report the neglect, as it would severely damage their relationship.
- Conflicting Ethical Standards:
- 1.07 Privacy and Confidentiality: Social workers should respect clients' right to privacy.
- 1.02 Self-Determination: Social workers respect and promote the right of clients to self-determination and assist clients 1 to clarify and articulate their goals.
1. books.google.com
- 1.01 Commitment to Clients: Social workers' primary responsibility is to promote the well-being of clients.
- 1.07(c) Disclosure of Confidential Information: Social workers should disclose confidential information when mandated by law or when necessary to prevent serious, foreseeable, and imminent harm to a client or other identifiable person.
4. Aida and Maya (Family Systems Theory):
- Initial Approach:
- Using family systems theory, I would view Maya's behavior as a symptom of dysfunction within the family system. I would focus on exploring the family's interaction patterns, communication styles, and boundaries.
- I would assess the family's homeostasis, and how Maya's behavior effects the families balance.
- Plan of Work:
- Assessment:
- Explore the family's communication patterns and identify any dysfunctional cycles.
- Assess the boundaries between Aida and Maya, and identify any enmeshment or disengagement.
- Explore the family's history and identify any past traumas or unresolved issues.
- Interactions:
- Help Aida and Maya develop healthier communication skills, such as active listening and assertive communication.
- Facilitate open and honest discussions about their feelings and needs.
- Help Aida establish clear and consistent boundaries with Maya.
- Interventions:
- Implement communication exercises to improve their ability to express themselves and listen to each other.
- Teach Aida effective parenting strategies, such as setting clear expectations and consequences.
- Help Maya develop problem-solving skills and coping mechanisms.
- Assessment:
5. Greg and Aleeya (Solution-Focused Therapy):
- Treatment Plan:
- Goal: To establish a healthy and fulfilling marriage without alcohol as the central issue.
- Objective 1 (SMART): Within one month, Greg and Aleeya will identify and engage in three new shared activities that do not involve alcohol.
- Intervention: I will help Greg and Aleeya brainstorm activities they enjoy and encourage them to schedule these activities into their week.
- Objective 2 (SMART): Within two months, Greg and Aleeya will demonstrate improved communication by using "I" statements and active listening during conflict resolution.
- Intervention: I will teach Greg and Aleeya communication skills and facilitate role-playing exercises to practice these skills.
Let's break down each of these scenarios and develop therapeutic approaches using various family therapy models.
1. Structural Family Therapy with the Martinez Family:
- Initial Approach:
- As a structural family therapist, I would begin by focusing on the family's structure, boundaries, and hierarchy. I would join the family system by building rapport and demonstrating empathy.
- I would conduct a genogram to map out the family's history, relationships, and patterns of interaction.
- During the initial session, I would observe the family's interactions, paying attention to power dynamics, communication styles, and boundary issues.