Identify the theoretical orientation you will use to conceptualize the cause of the clients’ distress.

The paper is designed to give students an opportunity to utilize a systemic approach to conceptualize the cause and maintenance of distress and dysfunction in a couple or family. The paper should be completed using 12-point font size, Times New Roman font, double-spaced, with a total page limit of 10 pages of text (excluding a title page and reference pages). All references must be properly quoted and referenced as per APA style. The information below provides a recommended structure for your paper and some guidelines re: how to write the case conceptualization.

The Graduate

2.) As you view the film, reflect on the following:

• the couple or family members in conflict and the most significant challenges or problems confronting them The Braddock Family, Boundary problems, dysfunction

• ideas about systemic issues causing conflict Poor Rules & Boundaries result in poor behavior passed down generationally

• issues of Leads to infidelity, poor lifestyle choices, narcissistic behavior

• the theoretical orientation Structural Family Therapy (Minuchin) that may be most relevant to understanding the distress or conflict the film showcases

• empirical research relevant for the type of conflict or issue featured in the film and intervention approaches that have been demonstrated to be most effective

• the major factors that would challenge a clinician in working with the couple or family

• your prognosis for this couple or family based on your preferred treatment strategy

3.) Use the organizational structure for your paper outlined below:

Writing a Film Case Conceptualization

Your paper should be organized in the following sections:

Section I: Introduction (1 page)

• Provide a brief summary of the film

• Identify the couple, family subgroup, or family members that will serve as the “client” whose issues you will be conceptualizing in the paper.

• Identify the major problem, distress, or conflict you feel the film showcases

• Identify the theoretical orientation you will use to conceptualize the cause of the clients’ distress

Section II: Case Formulation (3 pages)

• Summarize the major concepts, constructs, and theoretical views of the orientation you chose for this paper

• Describe in detail how the film’s characters and plot attest to the validity and provide examples of 3 constructs or principles of the theoretical orientation (Structural Family Therapy) you chose that are identifiable in the film

• Discuss one way in which the film’s characters and plot do NOT support a key tenet or principle of the theoretical orientation you chose

Section III: Empirical Research (2 pages)

• Choose one major factor (distress, psychopathology, conflict, problem, issue) featured in the film and provide a brief critical review of the efficacy of couple/family therapy in treating this factor (for example, if incest occurs in the film you chose you would perhaps review what, if any, family or couple therapy approaches have been utilized and proven effective in treating an portion of the family system

Section IV: Treatment (2 pages)

• Imagine that you are the clinician treating the clients in a couple/therapy modality and working within the theoretical perspective you chose

• Summarize the major therapeutic techniques and strategies you would attempt, and anticipate how well these might work given what you know about the characters from the film

• Identity what changes would occur with regard to these characters if treatment was very effective.

Section V: Conclusion (1 page)

• Summarize your paper.

• Make an original statement about something you realized concerning systemic thinking and its application to couple or family dilemmas

Use Clinical Handbook of Couple Therapy, Gurman as one of the references

APA Manual: Read and the study the newly-revised current APA Manual. Pay particular attention to the sections that deal with constructing references, headings, and how to write and phrase ideas. This manual is the guide to the creation of all documents at Argosy University. Remember the APA manual is also a guide that addresses style issues, and goes beyond structure and format. Use Systems Theory, primarily the following

Structural Family Tx (Minuchin)

• Biography of Salvador Minuchin (1921-present)

o Father of Structural Family Tx

o Child psychiatry, psychoanalytically trained

o Started seeing families at school for delinquent boys

o Believed anorexia was psychosomatic illness w/ origins in family

o Head of Philadelphia Child Guidance Clinic

o Started his own in NY in 1981

• Overview

o Therapists work as coaches or consultants rather than experts

o Strives to ID subsets w/in a family construct in order to isolate dysfunctional subsets & remap into healthy relationship

o Therapist must ID patterns of dysfunction & establish healthier ones & coping skills

 Respect the family’s unique culture (Does it work for them?)

o Uses/established family rules to ensure that the subsets are in the proper orientation (can more family members physically introduce other elements to enhance change?)

o Real emphasis is on boundaries b/w subsystems

• Structure

o Focuses on family organization, rules & boundaries

o The proximity/distance b/w members in a system

 Subsystems (w/in or b/w systems) are subgroupings w/in the family system based on age (generation), gender, & interest or function (ex: parenting, spousal, sibling)

– Set up by implicit/explicit rules of who participates in which subsystem & in what manner

– May change over time

 Boundaries are invisible (often unconscious) barriers that regulate contact b/w members

– Invisible set of demands that organize the way in which family members interact

– Repeated transactions establish patterns of how, why & w/ whom to relate

– Can change over time

– Described as clear, rigid or diffuse

 Diffuse: Too weak or “enmeshed” (loss of autonomy that results in family members being overly involved in one another’s emotional lives) Not clearly defined or maintained

 Rigid: Too fortified of “disengaged”

• Well-Functioning Family Structure

o Must have appropriate boundaries (not too rigid/diffuse) b/w subsystems

 Parental/Siblings/Family unit as a whole/Individual

• Dysfunctional Family Structure

o Stems from boundaries that are too rigid/diffuse preventing system & subsystems from achieving goals

o Boundaries are reciprocal: means a weak boundary

 Enmeshment in one relationship usually means that same person is disengaged from someone else (ex: Mom enmeshed w/ child & disengaged from husband)

• Types of Dysfunction

o Enmeshed: Overly close, developmentally inappropriate

o Disengaged: Too distant

o Triangulation: One person is torn b/w 2 others

o Coalition: 3rd member is recruited to go against one of the original partners

 Covert alliance b/w 2 family members against a 3rd

 Usually from across generational boundaries

 Creates power blocks in families

o Detouring: When 2 family members attempt to preserve their relationship by defining their conflict as a disagreement about a 3rd person, keeping focus on 3rd person rather than their problem

o Parentified Child: Functional removal of a child from the sibling subsystem

 Parentified child’s responsibilities are poorly defined & beyond the scope of the child’s developmental capacity

 Often become psychosomatic b/c can’t handle it

• The Parent’s Challenge

o Creating a healthy spousal subsystem

 Must develop complementary patterns of mutual support or accommodation

 Must develop a boundary that separates children from parents

 Outsiders must claim authority in hierarchal structure

• How Problems Develop

o Inflexible responses to developmental/environmental challenges lead to conflict-avoidance through disengagement or enmeshment, which is called cross-generational coalition

• First & Second Order Change

o First Order Change

 Structures can be affected w/out altering the organization of the system

o Second Order Change

 Organization’s rules & structure need to be adjusted w/ Tx

• Therapeutic Interventions

o 1. Joining (in a position of leadership)

 Family is set up to resist therapist b/c you are a stranger & know nothing a/b their struggles or goodness

 Important to join w/ angry/powerful family members

 Build on alliance w/ every family member but respect hierarchy

o 2. Spontaneous Bx Sequences (enactments)

 Family members are either instructed to engage naturally or as advised to do w/ enactments to showcase particular problems

– Experiments w/ strategies to change problem

o 3. Mimesis (a joining technique)

 Therapist gains acceptance by mimicking gestures, communication, & bx’al patterns of family members

o 4. Tracking (an engagement technique)

 Therapist participates in the family dynamic while privately noting dysfunction or unbalanced processes being enacted

 Therapist must assume median position, paying attention to self while engaging w/ family

o 5. Working w/ Interaction

 Inquiring into the family’s view of the problem

 Tracking the sequence of bx’s that they use to explain it

o 6. Mapping Underlying Structure (structural map is essential)

 Map in ways that capture the interrelationship of members

 Family structure is manifested only when members interact

 Ask everyone for the description of the problem

– This increases the chances for observing & restructuring family dynamics

o 7. Probing

 Therapist asks questions, makes provocative comments designed to evoke responses

 Helps obtain info about how the family operates

o 8. Restructuring

 Reframing illuminates family structure, circular perspectives

 Boundary setting

 Challenge assumptions

 Not doing family’s work for them

o 9. Homework

 Should be used to increase contact b/w disengaged parties

 Reinforce boundaries

 Not too ambitious

 Caution family to expect setbacks

• Therapeutic Goals

o 1. In clinical setting is to change the patient’s social context

o 2. Altering family structure (restructuring)

 Need to create:

– 1. An effective hierarchy

– 2. An executive subsystem

 Structural problems usually viewed as a failure to adjust to changes

 The therapist doesn’t solve family’s problems, that’s the family’s job

– Therapist observes family interactions & then seeks to restructure accordingly by manipulating interactions w/in the session (chiropractic adjustment)

o 3. Boundaries must be strengthened in enmeshed relationships & weakened (or opened up) in disengaged ones

 Tx basically consists of spontaneous bx sequences (lead to hypotheses a/b family structure) & enactments (interactions suggested by therapist to diagnose structure & provide opening for restructure)

– Ex: Change seating in office & see what it produces

 Not a matter of creating new structures, but activating dormant ones

 Emphasizes modifying family structure in immediate context of Tx (unique to SFT)

 New patterns that are repeated/improve family relationship will replace old ones

• Therapist’s Role

o 1. Joins the family in a position of leadership (but uses their vernacular)

o 2. Maps the family’s underlying structure (to assess the boundaries, hierarchy, subsystems)

o 3. Intervenes to transform existing structure

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