Monday, July 9, 2012

Structural Family Therapy: Case Analysis


 Structural Family Therapy: Case Analysis
            As a practitioner, it is imperative to analyze, diagnose, and treat clients in a favorable manner.  One of the most critical components to such therapeutic processes is the ability to select and employ an applicable method of therapy.  Considering the given scenario concerning John and Mindy’s family, the implementation of structural family therapy (SFT) is quite appropriate.  This system allows the practitioner to examine the family’s organizational framework and interactions from a comprehensive approach consisting of the existing subsystems and boundaries which explicate role expectations and enduring patterns (Nichols, 2010).  As the family’s dysfunction is addressed, the therapy “is directed at altering family structure so that the family can solve its problems” (Nichols, 2010, p. 176).  In effort to offer advantageous diagnosis and treatment, the following analysis provides an overview of the symptoms that suggest a problem within the family system, positive and negative familial interactions, the application of SFT, and strategic modifications.
            In regard to the symptoms which perpetuate various issues within John and Mindy’s family, job loss, alcohol abuse, impatience, avoidance, lack of affection, delinquent behavior, insolence, and unproductive arguing are apparent stressors.  First, John was laid off from a factory position.  This alone may be the cause of his impatience and frequent consumption of alcohol.  Early in the process, the practitioner should question John and his family as to whether or not these conditions existed prior to the job loss.  Next, Mindy’s avoidance and lack of affection towards John is a problematic factor as well.  These symptoms exemplify disengagement yet simultaneously encourage constant bickering which enables the couple to vent without realizing a constructive resolution (Nichols, 2010).  Again, John’s recent job loss may have been a trigger for these behaviors.  Lastly, poor conduct and delinquent behavior among the children are a direct result of the parents fighting.  All of these indicators promote the negative tension on varying levels within the family system.  Each individual’s behavior is caused by and adversely influences the family as a whole.
            Along with the recognition of the symptoms afflicting this family, the positive and negative interactions must be acknowledged as well.  From a positive perspective, it appears that Mindy, a part-time preschool teacher, is more hands-on with the children and astute to the fact that therapy may be beneficial in particular for Mitch.  However, John is under the impression that Mindy is too lenient.  This suggests that he is either the disciplinarian or completely refrains from disciplining the children leaving the responsibility to his spouse.  This promotes negative interaction between the couple as they argue about role expectations.  Additionally, their avoidance of one another and the family’s distressful issues is another form of negative interaction.
            Now, as the practitioner analyzes the case utilizing SFT, he or she must keep in mind that the goal is to restructure or shift the organizational framework of the family in effort to relieve their problems (Nichols, 2010).  As the assessment occurs, the practitioner will join the family in a leadership role in order to establish an alliance with each family member and promote an environment in which the family may interact through a series of enactments in which the practitioner may observe their communication firsthand.  In such instances, “the therapist may elicit an enactment either for the sake of assessment or as an intervention” (Simon, 1995).  Each family member’s input is required as the practitioner pinpoints prevalent and underlying issues.  Furthermore, as the practitioner identifies the primary issue, he or she must examine the family’s response to it (Nichols, 2010).  In this case, the foremost concern is the relation between John and Mindy.  Their communication and behavioral patterns must improve in order for their children to conduct themselves accordingly.  The children are quite young and impressionable, consequently mirroring their parents’ actions and increasingly acting out. 
            In effort to modify family structure, the practitioner must implement various strategies.  These include structural mapping, highlighting and modifying interactions, boundary making, unbalancing, and challenging unproductive assumptions (Nichols, 2010).  First, the practitioner may employ structural mapping by ascertaining the desired family structure as issues are addressed.  Second, highlighting and modifying interactions may be achieved by pinpointing the circular causality of the parents’ negative behavioral patterns which perpetuate the children’s poor conduct.  It should be duly noted that transformation “seems to occur when dysfunctional sequences are disrupted through a change in behavior or perceptions” (Fish & Piercy, 1987).  Thus, the practitioner may begin to alter the family’s communication and demeanor through the use of intense and direct dialogue.  Third, boundaries must be set.  Again, addressing the rules of the household and the imperativeness of authoritative respect are vital for the children to understand and comply with.  Next, unbalancing is a necessary component of the relations between John and Mindy in particular.  The practitioner should initially side with John and reiterate the fact that Mindy should not avoid him, yet display attention and affection instead.  Then the practitioner should side with Mindy and express that John should refrain from drinking heavily, become more involved with the children, actively seek employment, and work on improving his patience.  Finally, the practitioner must defy unproductive assumptions by rephrasing statements and reestablishing role expectations which are evident to each party.
In conclusion, considering John and Mindy’s familial issues, SFT would serve as an advantageous method.  This process would enable the practitioner to effectively assess the situation and assist them in achieving positive results beneficial to each member of the family.       

References:

Fish, L.S. & Piercy, F.P. (1987). The theory and practice of structural and strategic family
            therapies. Journal of Marital & Family Therapy, 13(2), 113-125.
Nichols, M. P. (2010). Family therapy: Concepts and methods (9th ed.). Boston: Allyn &
            Bacon.
Simon, G.M. (1995). A revisionist rendering of structural family therapy. Journal of Marital &
Family Therapy, 21(1), 17-26.

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