«Case Study Paper: Models of Family Therapy» - Free Essay Paper

Case Study Paper: Models of Family Therapy

Identification of the Family System

The Green family consists of a mother and three sons. The 39-year-old mother, Veronica Green, is of African American origin and works as a waitress in the local bar. The woman was married once, but had a number of boyfriends living with her and her sons after her husband’s death. She has three sons: John, who is 21years old, Steve, who is 15 years old, and Reed, who is 14. Steve and Reed study at school and live in Norfolk, Virginia, with their mother. The eldest son is John. He has been under the Residential Therapeutic Community (RTC) Program for already nine months and should be back to the community soon. The father, Edward Green, died in a car accident when John was 14 years old. It was rather difficult for all family members to cope with the tragedy both morally and financially. Currently, the situation is rather complicated, because John will need housing after release as he is not willing to live with his mother and brothers for multiple reasons.

Reasons for Social Work Involvement

John Green has been under the RTC for 9 months. He has passed phase 1, phase 2, and phase 3 of the treatment, and the last phase implies bringing him back to the community. However, he is struggling with drug addiction and PTSD. He was raped when he was about 17. It happened at the time when John was on drugs, so he blames himself. He is confused about his sexuality, because, although he states that he likes women, he has a boyfriend. The relations in the family are quite complicated. Steve loves his brother and wants him to return, while Reed is sure that he is a drug abuser, homosexual, and the worst person he could ever be. Even though his brother Steve came to visit him during the program, John is afraid to become a bad example for him and Reed. Their mother is mostly busy with her personal life, and she is sure that her son is mature enough to take care of himself. At the same time, she is neither for nor against John’s living with them. She understands that her son needs help, but tries to get involved in his problems as little as possible.

Family Background and Situation

PTSD, which was initially caused by the father’s death and further aggravated by sexual assault and confused sexuality, predetermines the patient’s drug addiction. Before John was 14, the Greens could be considered as an exemplary family. His mother, Veronica Green, was young enough when she married and gave birth to the first child, so her husband, Edward Green, was the only breadwinner in the family. He supported the entire family by working as a long-distance trucker, while Veronica was a housewife. The atmosphere in the family was quite positive, and all family members had strong emotional connection with each other. Three brothers were especially friendly, and since early childhood, parents taught John that he had to be a role model to his siblings. It is also interesting that Reed was even more devoted to his older brother John than Steve. However, after the father’s death, the mother had to go to work. Hence, she was depressed not only because of the husband’s loss but also due to the inability to get a well-paid job to support her three sons. The family had to move to a poorer district as they could not afford much since then. There, John met new friends, with whom he began to smoke, take drugs, drink alcohol, and party. The mother could not pay much attention to his activities and behavior because of her desire and attempts to find a new husband and because of working late at the bar. The behavior of John and the fact that he was raped at 17 received publicity, which created a number of rumors and led to further aggression of his younger brother Reed. Since that time, he was not willing to communicate with his brother. Only Steve remained loyal to John: he refused to believe in what people were saying about his brother and wanted to support him. In such a way, the death of the father broke the previously existing emotional connection between the family members.

Family Dynamics

Veronica was obviously depressed after her husband’s death. Having no relatives and financial support to bring up the children, she became withdrawn. Besides, she often avoided communication with them. John also felt estranged from his family and found consolation in drugs and parties. In such a way, he gradually declined in the eyes of his brothers and mother. As a result, he started to communicate with them more rarely. After the rape, John’s depressed state was even aggravated, and the idea of being righteous and becoming a good sample for his brothers disappeared, thus making his connection with the family almost completely vanish. For a long time, he did not live at home, but came just to spend the night once or twice per week. Before he got to prison, he communicated with his family very rarely. The only person who came to visit him was his brother Steve. According to his words, John greatly changed and was very different form what he remembered him to be years ago. He seemed strongly depressed, unwilling to communicate or share any problems, and not as self-confident as he used to be. He appeared to be interested in what was happening in life of his mother and brothers, but was not willing to see them or talk to them. The mother’s position is not completely clear. She gives an impression of being worried about her son and is not against his living with them. However, she could not find time to visit him, always stating that she had duties that are more important. Besides, she believed that he could solve all his problems only independently. Reed is quite aggressively disposed towards his brother John and has no desire to communicate with him. Certainly, he is absolutely against welcoming John in their house, where they used to live together.

Family Roles

John is the eldest brother, and father regularly treated him as an adult. He was also convinced that it is his duty to be responsible and look after his brothers. However, the death of the father appeared to be a crucial moment for his morals’ re-evaluation. Children’s roles changed after their loss, and John was supposed to become a hero. This means that he had to be responsible and successful (Radina, 2013). However, he transformed into an anxious and lonely child after he had lost the main authority in his life. At the same time, his status after the mental trauma was similar to the role of a “scapegoat.” According to Radina (2013), this notion refers to a problematic child who regularly faced troubles. Regarding the role of the other two brothers after their father’s death, Reed can be estimated as a hero, who seems responsible and clever. However, he is not ready to accept mistakes of others, and particularly of his own brother. Hence, such a “hero” is angry and dependent on the opinion of his school friends, who told him many unpleasant things about John’s negative life experience. Steve makes some efforts to reunite the family and can fulfill the role of a “mascot.” Radina (2013) defines this role as the one who wants to break the tension between the family members.

Family Myths and Rules

Family members did not discuss the tragedy that happened to the father. However, it became a real trauma for all of them. The mother rarely talks to her sons, and she has little time for them. The Greens do not have a tradition to dine together either. In case some problems appear in their lives, they are more likely to discuss them with friends rather than look for a solution in the family circle. With regard to John’s problem, he could not discuss his feelings with family and found support in drugs and noisy parties instead. Even now, when letting him live with the family has become an urgent issue, the mother does not try to convince her sons or to ask their opinion.

Physical Functioning and Health of Family Members

None of the family members reports any serious problems with health. Reed and Steve stay physically active as they quite often play volleyball and basketball. They do not complain about how they feel. The mother does not suffer from serious mental disorders but for the non-lengthy depressions mostly caused by ending relationships with boyfriends. She can also have some problems with sleeping, but she uses a hypnotic in this case. Moreover, Veronica looks quite calm and not worried about the problems of the elder son. She does not abuse alcohol even though she drinks from time to time. Reed and Steve are active at school, they study well, and neither of them smokes nor consumes drugs or alcohol. Regarding health and physical functioning, John displays himself as the most problematic family member, who abused drugs and alcohol, got into prison, and suffered from PTSD. While he is fighting his abuse now, he reports anxiety, problems with sleeping, and various disturbing thoughts. He also feels ashamed to talk to his brothers and mother, which makes him unwilling to live with them.

Intellectual Funсtioning of the Family Members

The intellectual level of John is not very high. He managed to finish only the high school. However, he missed many classes. Whenever he tries to analyze the situation, he cannot explain his motivation absolutely clearly. His cognitive processes are satisfactory, but he is not interested in learning new information and insists on his viewing the situation without accepting the alternatives.

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Having married right after finishing the high school, the mother did not study at the college or university. She was not excited about reading any scientific or analytical literature that would develop some critical views on the children's upbringing or treatment either.

The potential of Reed and Steve is more promising. As a 14-year-old, Reed has already participated in the technological contests many times and has won some of them. He is sure about his future studies and a career of a technological engineer, so he tries to acquire knowledge that will be helpful to fulfil these goals. 15-year-old Steve is also a good student at school. Teachers report that he is intellectually well developed. Apart from that, he is particularly interested in psychology and tries to analyze the problems of John and their family.

Emotional Functioning of Family Members

John is rather depressed, and he has not been demonstrating any positive emotions for a long time. Moreover, his self-blaming for drugs abuse, the rape case, and the inability to meet his father’s expectations aggravates his depression. In addition, he is anxious and confused about his sexual orientation as he is a bisexual. The emotional state of the mother is stable, but quite indifferent to what is happening around her. Reed is an optimistic, confident, and future-oriented adolescent. However, the talks about John always entail aggression from his side. Steve feels the emotional connection with both brothers and tries to support him.

Interpersonal and Social Relationships

All family members rely more on communication with friends rather than family members. For instance, Reed obviously considers his friends’ opinions to be very important, especially those regarding John. Mother has a few acquaintances, but no close friends. John’s friends are mostly drug abusers and juvenile criminals, who are not likely to provide a good support for him after his release.

Religion and Spirituality

>The Greens visit church very rarely and only on some big occasions. Although all boys confirm that they believe in God, they are not deeply religious.

Treatment History

John is the only family member who reported PSTD and was receiving treatment with antidepressants for three months after he was raped at 17. However, the therapy was not effective, and the syndromes of PSTD remained until the age of 21. Regarding the family therapy, it is a new experience for them.

Strengths and Problem-Solving Capacity

The family has problems with making decisions. Only Steve tries to analyze the behavior and views of his mother and brothers, but he fails to convince them about his position.

The Use of Community Resources

None of the family members receives free medical assistance. Veronica Green has a private insurance for herself and children. Since John is already 21, he needs his own insurance. However, the Residential Therapeutic Community offers the social worker’s treatment on the regular basis without payment.

Impressions and Assessments

The existing problem is the issue of providing housing to John after his release. Suffering from PSTD and struggling with the drug abuse, he would obviously need support of the close people instead of coming back to the society and living with his friends who consume alcohol and drugs. The main task of the social worker is to define the underlying reasons of the deep misunderstandings between the family members and to restore the emotional connection between the brothers and possibly with a mother.

In this case, the solution-focused therapy will be appropriate. Such therapy offers considering the client as an expert of his life (Roozenboom, 2014). Hence, it can lead the Greens in the right direction and help to find a number of essential solutions. For instance, the example of Steve has already shown that their family has a possibility to treat itself. However, the support of a professional is still necessary in order to ensure that the family members are moving in the right direction. To be precise, it is important for all of the brothers, and particularly for John, to deal with the unresolved emotional tension caused by their father’s death and the loss of emotional bond with their mother. In addition, regarding the Bowen systems therapy, problematic sensitivity, their expectations, and approval of others is effective (MacKay, 2012). Hence, there are good reasons to refer to John and Reed’s expectations. Relying on the family systems theory, the therapist will focus on the strong interconnection of all the processes, related to family members’ communication and attitudes towards one another (Hooper, 2007). It is necessary to focus particularly on the mother’s behavior and the loss of the father as the underlying reasons of John’s problems and disturbance of the adequate functioning of the family system.

In addition to this, the resources provided by the community must be effectively used in order to support John and his family as important parts of the community. It is essential to provide overall treatment with regard to the Saint Leo’s core values (Saint Leo University, 2012). In particular, it is crucial to pay attention not only to excellence, community, integrity, and respect but also to responsible stewardship of the community resources’ application to the treatment. The financial position of the mother, who will not be able to support an adolescent son, must be analyzed. Therefore, fund youth reentry grants and referring for the funds offered by Juvenile Justice and Delinquency Prevention Act will be supportive (Nellis et al., 2009). The sessions aim to inform clearly about all the resources and possibilities of John after release and show the advantages of living with a family.

Goals for Work with a Client

Goal A: The Greens family finds a consensus regarding the housing of John.

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Objective 1: Each family member writes the list of advantages and disadvantages about living together.

Objective 2: At least one possible alternative apart from living with the family is offered by each family member.

Objective 3: Finally, voting can be used as the way to make a decision, but after meeting the above mentioned objectives.

Goal B: The emotional connection between family members must be restored.

Objective 1: finding at least one common occupation for three brothers three times per week (playing football or basketball).

Objective 2: sharing the deeply lying insults of each family member at the meeting the family therapist twice per week.

Objective 3: having dinner together 6 times per week.

Evaluation

Restoration of the emotional bonds with the family and discussion of the issues that must unite it are efficient steps to make the family function as a system and provide supportive atmosphere for John, who needs emotional stability to struggle with the drug addiction and PSTD. The federal programs for the reentry to the community will let him find a job and not become a financial burden for his mother. Understanding of the hidden insults and aggression of the youngest brother will be helpful to discuss the past trauma from the father’s loss and communicate sincerely with one another. The federal grants and programs can also become helpful in finding a job and becoming more confident as well as in overcoming self-blaming for being a bad sample for brothers.

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