Case Conceptualization and Treatment Plan

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CASE CONCEPTUALIZATION 1 Case Conceptualization and Treatment Plan Brittany Spann Department of Psychology, Houston Baptist University COUNS 6329: Assessment/Counseling Couples & Families Dr. Katherine Pang October 20, 2023

CASE CONCEPTUALIZATION 2 Case Conceptualization and Treatment Plan The case I chose for review is case study 1.2, “A Traumatized Family Rebounds from a Sudden Crisis (Goldenberg et al., 2017, p. 8).” In the case study Paul and Margaret are a young married couple who lost their home and jobs during Hurricane Katrina. My conceptualization of this case is a young couple that recently married, began to expand their family, and purchased their first home has lost everything due to an environmental disaster. Paul and Margaret attempted to utilize Paul’s family as support but found the stress of their financial stress and the addition of their young child increased their unease about relying on Paul’s parents during this time of crisis. Paul eventually reaches out to friends as connections to find employment and Margaret is able to reevaluate her change in roles from working mom to full-time stay-at-home mom and finds satisfaction in her new role. Both Paul and Margaret also reevaluate their situation to alleviate the stress they imposed upon themselves by coming to terms with the fact that they are young and able to recover from financial crisis. If I were working with this couple the first assessment, I would utilize would be a self- report questionnaire. By requesting both Paul and Margaret to complete separate questionnaires it would allow me to get a sense of their perceived roles in their relationship as well as their satisfaction in their relationship and satisfaction with their role in the relationship and family structure. I would most likely use the Dyadic Assessment Scale (DAS). The DAS can be used to measure couple satisfaction and correlate their measured satisfaction in relation to other areas such as the Satisfaction with Married Life Scale (Ward, Lundberg, Zabriskie, & Berrett, 2009 as cited by Goldenberg et al., 2017, p. 433). For Paul and Margaret, I would use Narrative therapy to change the family’s narrative about their current financial situation. Narrative theory “asserts that to achieve change, people

CASE CONCEPTUALIZATION 3 need to learn to consider alternate ways of examining the values, assumptions, and meanings of their lives and see how existing stories dominate their views of themselves and their problems (Goldenberg et al., 2017, p. 371).” I would use the respectful, non-blaming conversations that are pillars of Narrative theory to address prescriptions and satisfaction reported in the couples’ self- report questionnaire or DAS. Externalization would be beneficial for Paul and Margaret to help separate their view of themselves from the problems they are currently facing (Clark, 2023). I would utilize externalizing conversations to help Paul and Margaret separate themselves from their financial problems and the stress of trying to establish their family in secure housing. I would focus on objectives that encourage Paul and Margaret to “externalize” their problems to reframe the problem to an objective that can be resolved by the family uniting. I would likely recommend inviting Paul’s mother and father into treatment to externalize the issues that occurred between Paul and Margarete and Paul’s parents once they moved back into the parent’s home with their daughter. By inviting the parents to participate in externalization conversations Paul and Margarette can view their problems with Paul’s parents as a problem existing outside of the family as such their stress of losing their home and jobs is separate from their established relationship with Paul’s parents. By externalizing this problem, it can help to repair the damaged relationship and offer additional support as Paul and Margarete reestablish themselves. Deconstruction is used to break down the couple’s narrative into smaller parts that are more manageable to assess and identify problems (Guy-Evans, 2023). For Paul and Margaret I would guide them to identifying the three separate issues, the problem of finding jobs, the need to find a home, and the need to reevaluate their expectations of success to ensure their satisfaction. The deconstruction process allows the client to talk about the problem and see the

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CASE CONCEPTUALIZATION 4 problem in a new light, by deconstructing these problems the couple is able to begin changing their previously negative narrative into a more positive one as key components of the narrative are now viewed from a more positive view or have a positive resolution (Psychology, 2023). For the case study, Margaret was able to address her problem of finding employment by finding satisfaction as a stay-at-home mom. For Paul, he was able to resolve the problem of finding a job by networking and finding employment in an area that was different from his initial career field. Paul and Margaret both were able to resolve the problem of their expectations of success by accepting that they are a young couple that will face many trials that they can work through together. Research supports that faith or spirit integration into to therapy treatment is desired and effective for clients regardless of age and gender (Rosmarin, 2023). It is argued that “by not making more of an effort to incorporate spirituality in treatment, we are doing a disservice to patients (Rosmarin, 2023).” I would integrate faith into my treatment plan for Paul and Margarete by assessing their faith practice and traditions and offering connections to community churches or faith groups that Paul and Margarete can utilize to continue to make connections. For myself, I would consider bible passages that offer inspiration for situations that are applicable to the families and couples I work with and base objectives and techniques with that inspiration in mind. For Paul and Margaret, I based my treatment plan on Ecclesiastes 3:1 “To everything there is a season, and a time to every purpose under the heaven (Bible Gateway, 2023).” I would ensure that I act as a guide through Paul and Margaret’s season of difficulty and change by remaining positive and helping Paul and Margaret change their narrative from a negative focus of what they lost to a positive narrative about how they weathered the storm and changed for the better by finding satisfaction in new roles in their relationships and jobs.

CASE CONCEPTUALIZATION 5 References Clark, J. (2023, May 5). How Narrative Therapy Works . Verywellmind. Retrieved October 20, 2023, from https://www.verywellmind.com/narrative-therapy-4172956 Goldenberg, I., Stanton, M., & Goldenberg, H. (2017). Family Therapy: An Overview (9th ed.). Cengage Learning. https://bookshelf-activate.vitalsource.com/books/9781305855649 Guy-Evans, O. (2023, September 21). Narrative Therapy: Definition, Techniques & Interventions . Simplypsychology. Retrieved October 20, 2023, from https://www.simplypsychology.org/narrative-therapy.html (n.d.). Ecclesiastes 3:1 . Bible Gateway. Retrieved October 20, 2023, from https://www.biblegateway.com/passage/?search=Ecclesiastes%203:1&version=KJV Psychology, P. (2023, October 8). Narrative Therapy Techniques . Practical Psychology. Retrieved October 20, 2023, from https://practicalpie.com/narrative-therapy-techniques/ Rosmarin, D. H. (2021, July 15). Psychiatry Needs to Get Right with God . Scientific American. Retrieved October 20, 2023, from https://www.scientificamerican.com/article/psychiatry- needs-to-get-right-with-god/#

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