Find a volunteer family to work with. Interview at least three family members and then answer the following questions that are designed to assist you in developing a hypothesis, direction, and strategies for family-focused treatment.
Family description—or “who are these people?” Be sure to list all family members you interviewed and how they responded to the assessment (each family member will most likely have their own perception of the family; this is to be expected).
What is the pertinent history? Be sure to address cultural and ethnic factors relevant to who they are and how they relate to their environmental context .Family Therapy Essay Discussion Paper
What current life events are impacting the family—or “what is happening in their lives right now” (chief concerns, strengths, and resources, developmental issues)?
According to each family member interviewed, what do they see as the family’s “next steps” (both personally and collectively as a family) in their progress toward happier, healthier lives? Be sure to discuss areas of discrepancy between members. What does this mean? Do they all seem to agree? What would that indicate? What do they see as goals, or what do they want to have happen next in their lives as members of the family unit?
What challenges or issues are blocking that next step (obstacles to progress, real and imagined, or anticipated)?
As a nurse psychotherapist, how can you help this process? Given the above data and your knowledge of family therapy models, what theory would you use to explain your observations of the family? What theory-based interventions would you most like to try with them, and why? If you have been able to intervene, evaluate how well your interventions worked and what you would do next if you would continue to work with them. What data would lead you to believe that their issues were beyond the scope of skills of the nurse psychotherapist and would require referral to a family therapist?
What are some legal and ethical considerations working with this family and with other families like them?
While you may reference the textbook, you must also use a minimum of five peer-reviewed scholarly articles related to family therapy.
Family therapy is a type of psychotherapy (psychological counseling) setting that focuses on helping family members to resolve their conflicts and improve communication. A licensed therapist, clinical social worker or psychologist who can engage either all the family members or some of them in teaching skills to deepen the family connections and get them through stressful times delivers it. Family therapy is conducted to improve the relationship between the family members to include addressing impact of mental illness, substance abuse, conflict, marital problems, or financial problems on the family. In fact, it is useful in family situations that cause conflict, anger, grief or stress, helping the family members to understand each other better and learn coping skills that bring them closer together (Metcalf, 2018). This paper discusses the use of family therapy in a family situation.
The interview was conducted with a family of three members. First, the husband named Anthony who is 45 years of age and works as a police officer. He has been a police officer for 18 years. Second, the wife named Adina who is 44 years of age and works as a licensed clinical social worker (LCSW), working primarily with adolescent populations for the 13 years. Third, the son named Avery. The issue of concern for the family for which they are seeking family therapy intervention is that Anthony has been unfaithful and is looking to the psychotherapy intervention as an opportunity to preserve his family. He feels that his unfaithfulness was wrong and that the psychotherapy could improve relationship and trust within the family. In contrast, Adina is reluctant to attend the family therapy and is instead considering seeking a divorce and getting custody of her son, Avery. She feels betrayed and that Anthony eroded her trust in the marriage. On the other hand, Avery does not express much of an opinion except for his family will stay together and that he will have a complete home. He feels that the family home has become gloomy over time and that his parents are having more conflicts with reference to the unfaithfulness. He does not want to be a witness to the escalating conflicts and indicates that it would be good if the conflicts could be resolved, but if they cannot be resolved that he would stay with his mother as his father did wrong first by cheating.
Anthony and Adina indicate that they met in college and got married immediately after graduating from college. Over the course of their marriage, Adina has suspected Anthony of cheating on a number of occasions although she did not have any definite proof. Adina confronted Anthony on some of those occasions, but he always denied cheating and insisted that she was being paranoid. She is apprehensive of Anthony’s ability to change and be faithful to change, stating that she no longer trusts him to change. In addition, she reports that Anthony has a father and two older brothers who have each gone through diverse because of infidelity. Besides that, Adina reports that her father destroyed her home because of infidelity and that he eventually left them. She feels that it is better to have the divorce now when she is prepared, rather than later when she is unprepared. Anthony reports that although his father and brother each divorced because of infidelity, he had no intention of cheating on his wife again. He insists that while there has been some infidelity leading to divorce among the male members of his family, this does not mean that he is pre-disposed to cheating. His cheating case involved a colleague at work, and he developed that relationship from working in close proximity with her over a long period.
Current life events impacting the family
The interview reveals that there are two life events impacting the family. First, Anthony has been cheating on Adina. A private investigator was hired who collected tangible proof that Anthony has been cheating. Anthony insists that his cheating was a temporary lapse in judgment as he spent a lot of time with his partner at work during which time they developed feelings. He indicates that the affair is over and that the he was given a male partner after they applied for the change.
Second, Adina has been spending a lot of time away from home on her career. Anthony accuses her of not being a wife and abandoning the family. Adina reveals that although she had been spending a lot of time on her career, it is with the prior approval of her husband. Besides that, the time spent away from home is only a temporary measure as she has been improving her education to advance her career, earn more money and improve her family’s financial situation. She insists that although she has not been there for her family, Anthony should have been more understanding and not taken the opportunity to cheat on their marriage. Family Therapy Essay Discussion Paper
What do the family members see as the next steps.
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Anthony expresses the opinion that the family can recover from his infidelity. He feels that he cheated because of the circumstances and there is no chance of that occurring in the future. In addition, he feels that the family therapy will improve the relationship and communication between the family members, allowing them to better express themselves and resolve their issues. Besides that, he feels that the psychotherapy will enable Adina to be a more attentive wife and mother.
Adina indicates that although the psychotherapy can improve the family communication and relationship, it stands little to no chance of succeeding. She draws on Anthony’s family history, as well as her history, insisting that Anthony will still cheat irrespective of what she does as that is wired into his genetics.
Avery expresses hope that the family therapy will work in getting his family to stay together while improving the family communication and relationship. He does not look forward to his parents divorcing, and feels that his father should have a chance if he is truly repentant.
It is evident that the three family members are welcome to the idea of the family staying together and not breaking up by improving family relationship and communication. They feel that the family therapy can be helpful in this regard as it engages the services of a trained therapist who would apply professional methods in helping them to resolve their issues and arriving at a mutually acceptable solution that they can stick to. The hope is that Anthony and Adina do not divorce.
Challenges and issues blocking the next step
Three issues have been identified as hindering the family therapy. First, lack of communication. This is especially seen with Anthony who appears to be complaining about the time that Adina spends away from home, yet he does not want to express his dissatisfaction. Anthony is not expressing his thoughts and feelings. Besides Anthony, Avery is also not expressing his feelings and thoughts well as at one point during the therapy he joked that he is a parentless child, yet did not expound on this issue. It appears that his parents are spending a lot of time away from home and he is not happy about this, yet has not clearly expressed his dissatisfaction. This lack of communication has caused the therapy to focus on Anthony’s infidelity, while ignoring the parent’s absenteeism from home (Hanna, 2018).
Second, Adina has much mistrust, resentment and anger. This has caused her to act out of charter and lash out a lot as she question’s Anthony’s commitment to the marriage even when he is clearly working on preserving the marriage. Adina has a lot of repressed pain underneath the anger, with some of that pain and anger having been carried on experience with her parent’s divorce (Patterson et al., 2018).
There, unhealthy family dynamics as Anthony and Adina believe that it is enough to financially provide for the family. The two parents spent a lot of time away from home advancing their careers and earning more money for the family. This has caused them to spend less time with Avery such that they do not know what he wants and are not ready to listen to him. This means that much of what Avery says in the therapy is ignored by Anthony and Adina who are mainly keen on what they have to say (Gladding, 2018).
How to help the process
It is evident that communication issues are of concern in the family situation. The present conflict has made the communication even more challenging. A nurse psychotherapist can help in improving the family communication by aiding them in examining their communication strategies to determine whether their individual communication styles convey their goals, needs and thoughts. The intervention would facilitate the improvement of interfamily and interpersonal skills by helping them improve the frequency, nature and quality of their communications. This entails having respectful communication, dialogue, mediated communication, questioning stereotypes, dialogic listening, active listening, and opening lines of communication (McGoldrick & Hardy, 2019).
Besides improving communication, a nurse psychotherapist can apply a systematic model that focuses on the unconscious communication and meanings behind the behaviors exhibited by the family members. This therapy model requires that the therapist be distant and neutral, allowing the family members to dive deeper into their problems and issues as a family. In applying this therapy model, a nurse psychotherapist would observe how the family members interact, evaluate and resolve their relationship problems, and guide them through the transitional crisis (infidelity and possible divorce). In addition, the nurse psychotherapist would highlight the problematic behavioral and relational patterns, replace dysfunctional behaviors with healthy alternatives, and apply a mind-body (holistic) approach to wellness (Blow, 2020).
The choice of the systematic model is based on the understanding that Anthony’s infidelity that is causing Adina to contemplate seeking a divorce seems inextricably tied to problems with Adina. He indicates that Adina is spending a lot of time from home and appears to have abandoned the family, causing him to similarly spend a lot of time away from home, leading to the affair with his former partner at work. The model allows the nurse psychotherapist to perceive the infidelity as deeply rooted in problems with other family members, such as the goal of therapy is to address the contributing issues and mitigate or solve the effects of this pattern of problems (Blow, 2020).
The nurse psychotherapist may refer the case to a family therapist if the family members do not respond to therapy in terms of coping with the stressing, and embracing the present reality while working for a better future. For instance, if Adina sabotages the therapy by refusing to attend sessions, then the case would be referred to a family therapist (Minuchin, 2018).
Legal and ethical considerations
There are legal and ethical considerations in working with any family in therapy. First, professional competence as the therapist must meet the practice requirements before providing family therapy. Second, informed consent in requiring the family members to consent to the therapy before participating. Third, confidentiality and its exceptions has an influence on determining what disclosures that be kept confidential and what information can be disclosed to others. Finally, duty to warn that arises when any family member communicates an explicit threat of imminent serious physical harm or death to a clearly identified/defined victim. If the individual has the apparent intent and ability to actualize the threat, then the therapist would have a legal responsibility to warn the relevant persons of that threat (Minuchin, 2018).
Blow, A. J. (Ed.) (2020). The Handbook of Systemic Family Therapy, Systemic Family Therapy with Couples. John Wiley & Sons.
Gladding, S. T. (2018). Family Therapy: History, Theory, and Practice (7th ed.). Pearson.
Hanna, S. M. (2018). The Practice of Family Therapy: Key Elements Across Models (5th ed.). Taylor & Francis.
McGoldrick, M., & Hardy, K. V. (Eds.) (2019). Re-Visioning Family Therapy: Addressing Diversity in Clinical Practice (3rd ed.). The Guilford Press.
Metcalf, L. (2018). Marriage and Family Therapy: A Practice-Oriented Approach (2nd ed.). Springer Publishing Company.
Minuchin, S. (Eds.) (2018). Families and Family Therapy (2nd ed.). Taylor & Francis.
Patterson, J., Williams, L., Edwards, T. M., Chamow, L., & Grauf-Grounds, C. (2018). Essential Skills in Family Therapy: From the First Interview to Termination (3rd ed.). The Guilford Press.
Family of three- Husband is Anthony (45 y/o), Wife is Adina (44 y/0) and Son is Avery (11 y/o)
Anthony is currently working as a police officer for 18 years, Adina is a LCSW who primarily works with the adolescent population for 13 years.
Anthony has been unfaithful and wants to go to marriage / family counseling but Adina is reluctant to go to therapy and would rather seek divorce and custody of their 11y/o son.
Family Therapy Essay Discussion Paper