Signature Assignment week 11 6105

docx

School

Northcentral University - Arizona *

*We aren’t endorsed by this school

Course

6105

Subject

Psychology

Date

Dec 6, 2023

Type

docx

Pages

Uploaded by ConstableUniverseOryx9

1 PUTTING IT ALL TOGETHER Signature Assignment Case-Specific Alanna Horst MFT- 6105 Couples and Sex Therapy Northcentral University Dr. Servino July 17, 2022

2 PUTTING IT ALL TOGETHER Case Scenario  Lisa is a Caucasian female 38 years old  Ashley is an African American female 37 years old  Lisa is a nurse practitioner, and Ashley makes all kinds of things to sell on ETSY, at which she is rather successful  They identify as a monogamous lesbian couple.  They live in a two-story home in a relatively affluent neighborhood and have several friends.  Lisa’s schedule has included more days working overnight recently.  Ashley feels alone and unattractive. Ashley is almost certain Lisa is working overnights to avoid intimacy and, when together, exhibits passive-aggressive behaviors and language.  Lisa tries to explain this is just a temporary change to the schedule based on current hiring issues and is getting irritated with Ashley’s continued passive-aggressiveness.  Recently, the couple has spent very little time together due to work and sleeping schedules. The couple has not been intimate for over a month.  Instead of openly talking about how Ashley feels, she is acting out; Lisa wants to work more. The couple has come to therapy to improve their sex life and address the difficulty communicating. Case Approach I would look at the patterns of interactions that lead to the responses by each partner and how those affect and promote each of them. Ashey mentions that she feels alone and unattractive and seems to assign those feelings to Lisa feeling resentful and her current work schedule. The

3 PUTTING IT ALL TOGETHER interactions appear to cause Lisa to want to work more to avoid being responsible for Ashley’s feelings and minimize her own frustration with the situation, avoiding the interactions. Ashley feels her needs are not being met, and Lisa avoids the confrontation as she has done many times before. It appears that this is a negative interaction cycle where each continues to exacerbate the problem by continuing those negative responses, leading to overall relationship dissatisfaction. I would probably use Emotion Focused Therapy (EFT). According to Schmittel (2019), EFT is beneficial as it works to elicit second-order change through work on attachment between the couple. Schmittel (2019) suggests EFT works from three stages and nine steps, including minimizing unfavorable repetitions, modifying communication stances, and bringing together and using gained information. As Schmittel (2019) describes, an EFT intervention possibly helps couples assign understanding to problematic responses, identify and express responses and feelings as a result of emotions, and ultimately identify ways to modify interactions as needed to address future problems through readdressing, discussion, and playing out. The goal is to improve the relationship by creating more positive involvement and connection, even for reliance, should problems arise. Another approach might be to use the Sound Relationship House in the Gottman Method. Veldorale-Griffin (2019) suggests the Gottman Method allows couples to gain things to utilize to create a more beneficial connection. Veldorale-Griffin (2019) notes reviewing the Four Horsemen of the Apocolypse as an intervention I might consider includes learning to assign specific remedies to problems: if resentful, try kind discussion; if angry, try valuing each other, to fight efforts to safeguard, try owning up, and if elusive, try calming and remaining centered. Veldorale-Griffin (2019) suggests the Gottman Method allows the couple to set more positive

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

4 PUTTING IT ALL TOGETHER standards and expectations appropriate for a healthy relationship that can connect the couple on a deeper level. Self of the Therapist As I am accustomed to my relationship, including separation due to work, I may feel incredibly sorry for Lisa and begin to relate and work against Ashley and the resolution to the relationship. Upon learning about different relationships and how they work, it is easier for me to provide helpfulness to get each person to value the other and offer support. As I am not in a same-sex relationship, that could affect me. Still, I hope that my continued work in this area has allowed me the skills to navigate even the most different relationship types. I would have to be open to any potential reasons a couple could have difficulty connecting. I consider myself a relatively open individual able to work with anyone regardless. I could see being uninformed and unable to treat the couple effectively due to failure to be knowledgeable. I would also do my best to be informed and educated about the LGBTQ+ community and offer any informational resources for couples. Should it be more complicated, refer to appropriate persons familiar with this community. Sensitivity training may as well be necessary. Case Scenario  John is a Caucasian Male 50 years old  Cynthia is a Caucasian Female 42 years old  John owns a now failing grocery store, and Cynthia is a waitress at a local bar.  The couple is heterosexual and has been married for 20 years.  The couple lives in a condominium that has other older couples.  John is having erection problems.

5 PUTTING IT ALL TOGETHER  Cynthia thinks she is the reason John has problems and is considering saving for breast implants, but she also has difficulty reaching orgasm.  John is uncertain whether he wants to get evaluated to determine a possible medical cause.  Cynthia recently began an affair. John feels his wife pulling away and is drinking heavily.  John and Cynthia come to therapy to address John’s erection difficulty and work on deeper feelings of inadequacy. Case Approach In this case, I would like to see an evaluation by a medical professional to rule out any medical problems with the erection issue before intensive therapy. John speaks of erection problems, and as a result, Cynthia feels the need to change herself and may be exhibiting addictive behavior. Cynthia engaged in an affair, and due to the change in relationship, John begins to drink far too much in reaction to Cynthia removing herself. This could be a repetitive causal relationship whereby Cynthia’s behavior impacts John’s ability to get and keep an erection. His inability to do so results in Cynthia looking elsewhere and considering altering herself. She may be suffering from some self-esteem issues as well. I might consider Cognitive Behavioral Couples Therapy (CBCT) to help to deal with what seems to be possible addiction issues. Molla et al. (2018) CBT is a therapy that focuses on how ideas, attitudes, and perceptions seriously impact feelings and actions in interactions. Molla et al. (2019) suggest CBT attempts to undo and modify illogical and unhealthy thoughts and contorted objectifying and, by doing this, allows for positive responses to emerge. Molla et al. (2018) suggest that one intervention I might recommend in CBT would be to utilize thinking

6 PUTTING IT ALL TOGETHER tracking to look at specific illogical thinking and make the couple look for actual or imagined proof to either be for or against that thought to help look at things realistically. I may also consider Narrative Therapy as a way to help the couple beyond the medical evaluation. Muhammad (2022) suggests narrative therapy allows couples to avoid assigning problems to the other person by addressing the expectations formed by others through behaviors, feelings, thinking, and language that may differ from their partner. Muhammed (2022) suggests that one intervention I might employ is creating a more involved story, which includes identifying times when things weren’t as bad, or it was easy to move through and what assistance or persons were available so that good can be identified. Muhammed (2022) states Narrative Therapy can assist the couples’ sense of self and how they want to be and go forward. Self of the Therapist Infidelity is a hard pill to swallow, as in my relationship, that is a line that, if crossed, will result in the end of a marriage. I could potentially have an issue with the person who cheated. Thinking that her behavior is causing not only impotence but alcohol abuse as well could be the potential pitfall. As noted in Hacenecz (2010), the therapist needs to keep from assigning blame and help the couple to understand being unhappy does not force infidelity or other addiction; the couple must each take personal accounts of their part in perpetuating the problem with trust in the relationship. It is essential to recognize that many factors lend themselves to the many reasons addiction and infidelity occur. I would frequently need to self-assess and ask for direction should I feel myself holding one person accountable based on my own feelings. I can ask for help when needed and expect that I will be able to do so if I focus on one person. Case Scenario  Bruce is a Chinese American Male 52 years old

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

7 PUTTING IT ALL TOGETHER  Michelle is a Chinese American Female 51 years old  Bruce is a financial consultant, and Michelle is a part-time stay-at-home mother who works at a local flower shop.  The couple is heterosexual; their marriage was traditionally arranged, and they were married at 18 and 19 years, respectively.  The couple lives in a home in the suburbs of San Francisco.  They had a daughter Kim who earned her master’s and is now moving away from home.  Michelle is feeling a loss of purpose and is also losing a confidant.  Bruce struggles with his wife’s perceived sadness and lack of sex drive, often feeling angry but unable to express it.  The couple is not communicating and hasn’t been out on a date since the birth of their daughter.  The couple has come to therapy to address the lack of sexual interest, relationship, and communication. Case Approach I would look at the patterns of interactions that might suggest how each person views the other and if there is a match of relationship values. Bruce mentions that he feels unsure about how to handle Michelle’s sadness and begins to get irritated, possibly leading to Michelle refraining from engagement. Michelle suffers a loss because her daughter is gone and is learning to deal with it. There is a lack of interactions as Bruce fears any indication he is sexually frustrated may push Michelle even further away. Hence, it is easier to remain quiet, which increases Bruce’s frustration. Michelle may not be disinterested; she just may be emotionally overwhelmed and

8 PUTTING IT ALL TOGETHER unable to give more at this time. It appears there are problems with the sexual style and potential arousal issues related to emotions. I would likely start to evaluate the relationship style in which the couple is engaged. McCarthy & Ross (2019) suggest the sexual type for couples may vary for each individual and may or may not be in line with the couple’s bond style. In this case, it would appear perhaps the traditional sexual style is appropriate. According to McCarthy & Ross (2019), the traditional style focuses on clearly delineating expectations and assignments based on sex. McCarthy & Ross (2019) mention this style is often exposed and raw because as a male matures, his sexual performance becomes less reliable. McCarthy & Ross (2019) suggest the female also feels that because of his emphasis on having sexual relations, her wants for contact and connection are being ignored. McCarthy & Ross (2019) ideally detail that in this case, the intervention most appropriate that I would likely employ is twice yearly, one partner leads a fun or sexy date with the option of penetration or not, and the other organizes a passionate date with restrictions on sex and climax. Schwartz & Southern (2018) suggest another approach I might consider: the Sensate Focus, which allows the couple to refocus their awareness on the present and immediate feelings and openly share what each needs for the couple through a series of intimate moments. Schwartz & Southern (2018) suggests Sensate Focus is a set of organized caressing and discovering ideas that allow a couple to experience each other’s bodies in an adventurous, non-demanding manner without worrying about the other person’s internal thoughts. Schwartz & Southern (2018) offer immediate concentration defeats sexual conduct and demand patterns that fuel unease, annoyance, evasion, and boredom. The goal is to allow the couple to come together in a healthy sexual way without worrying about other factors.

9 PUTTING IT ALL TOGETHER Self of the Therapist I could see an inability to relate to the traditional style of another culture or, in some way, find a commonality as a mother to her child leaving. I do not currently have any issue with alternate traditions or cultures. Still, should this become a problem, I may need to consider the following: I imagine some sensitivity training or referring to another person and reviewing the expectations of a marriage and family therapist. I would need to refer back to the American Association of Marriage and Family Therapy (2015) and adhere to 1.1 nondiscrimination, which states that care should be provided to persons regardless of age, sex, gender, religion, etc. I would also need to consider the AAMFT (2015) also 1.10 referrals which states that if I am unable or unwilling to work with this clientele, a referral must be made to an alternate professional. I am open to being educated about any culture with which I am unfamiliar, which is helpful when working with others. Case Scenario  Michael is a Hispanic male 29 years old  Ray is a Caucasian male 36 years old  Both men work in the hotel industry. Ray is a Chief Operating Officer, and Michael is in Information Technology.  The couple has been together for six years and identifies as gay.  The couple just moved to take care of Michaels’s family, who disapprove of their sexual relationship.  Ray has an alcohol abuse problem.

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

10 PUTTING IT ALL TOGETHER  The sex life was great until recently, and Ray wants to include other people in the relationship, and Michael does not. Michael is aware of Ray’s past infidelities (previous relationships).  Ray goes out drinking excessively five to six days a week, and Michael often picks him up as he is too incapacitated to drive.  Michael is resentful of Ray’s drinking and doesn’t trust him to be faithful, and Ray is bitter about the time Michael dedicates to his family and excessive spending.  Michael and Ray are coming to therapy to discuss trust in their relationship and whether or not to end the relationship’s current connection and Ray’s drinking. Case Approach It appears the couple is experiencing difficulty managing changes in the relationship. Michael is spending a great deal of time with his family, and in response, Ray seems to feel more alone and is acting out; as a result, this is causing a lack of trust. Ray is drinking excessively and is potentially looking to add another person to offset potential loneliness. Michael may be spending money as a coping mechanism to deal with the strain of caring for family members. Neither seems to be able to support the other emotionally in the face of challenges within the family. As a result, the couple appears to be causing a strain on the relationship itself; this causes each person to act out Ray’s drinking and Michael’s spending. Getting an idea of the couple’s fears, their responses to one another, and the core of what their relationship means to them is one of the things on which I would like to focus. Also, it is vital for the couple to ensure that their values and ideals are their own, even if they are simply modified. I would like to consider Narrative Family Therapy due to the ability to navigate the preconceived notions provided to the couple by society and their surroundings. Su & Parker

11 PUTTING IT ALL TOGETHER (2022) state many sexual minority people feel that their sexual desires and sexual events are wrong or embarrassing since those couples’ sexuality has been stigmatized and labeled as aberrant. Su & Parker (2022) suggest that these internalized messages can result in unfavorable perceptions of one’s identity and sexual demands, which can sometimes make it challenging to develop emotional and sexual intimacy with one’s partners. Su & Parker (2022) detail that deconstruction is one intervention that could potentially help the couple, which helps to recognize taught ideals and examine connections between self and environment on views. Su & Parker (2022) continue that deconstruction helps to reveal their beliefs and values regarding themselves and their relationship and regain a sense of independence by separating the couple from the issue. Fye & Mims (2020) suggest another option may be to identify the protective factors of monogamy theory in an experiential manner. Fye & Mims (2020) detail that one way to do so would include role play to learn to comfort one another and find what causes division, talk honestly about problems and find stability by sharing hurt. Fye & Mims (2020) provide that it is vital to know how to attain happiness and meet want, explore what promotes the idea of infidelity and fight it, and work to gain personal autonomy and wellness. Fye & Mims (2020) say it is imperative to discuss this as some health issues, including melancholy, worry, murderous and self-slaughter thoughts, Aids, intimate partner violence, dissolution, and problematic drug use, have been reported to be associated with infidelity. Self of the Therapist I believe the only possible bias would be that I am a firm believer that we as people should not surround ourselves with people who cause us pain, even if they are family. I have difficulty allowing others to determine how things should be handled or when their beliefs

12 PUTTING IT ALL TOGETHER negatively impact someone else. It might be beneficial in this case to refer back to the teachings and focus on the work remembering personal feelings aside; the role is to help the client. In that vein, Su & Parker (2022) provide that the narrative method, in contrast to conventional practices in family therapy, emphasizes the interpersonal and community circumstances in which passion occurs. It is essential to be nonjudgmental and be open to all family structures; empathy and compassion must be the focus. I have a very open mind and should be able to navigate this situation with great respect and understanding.

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

13 PUTTING IT ALL TOGETHER References Fye, M. A., & Mims, G. A. (2020). A Training Case of the Theory of Protective Factors of Monogamy. The Family Journal , 28 (2), 131-137. https://doi.org/10.1177/1066480720911886 Hasenecz, N (2010). Surviving infidelity- couples therapists’ best practices. Social Work Today, 10 (3), 10. https://www.socialworktoday.com/archive/052010p10.shtml McCarthy, B., & Ross, L. W. (2019). Relational Style and Couple Sexual Style: Similar or Different. The Family Journal, 27(3), 245–249. https://doi.org/10.1177/1066480719852986 Molla, E., Tadros, E., & Cappetto, M. (2018). The Effects of Alcohol and Substance Use on a Couple System. Family Journal , 26 (3), 341–350. https://doi.org/10.1177/1066480718795500

14 PUTTING IT ALL TOGETHER Muhammad, A. (2022). A multi-couple reflecting team program for couples: A narrative therapy approach. In Dissertation Abstracts International: The Sciences and Engineering, 83 (5), 1-18. https://www.proquest.com/docview/2593002583 Schmittel, E. (2019). Emotionally focused family therapy. In D. Adamson & Y. Watters (Eds.), An introduction to MFT systems theory and foundational models. Schwartz, M. F., & Southern, S. (2018). An integrative model for treatment of sexual desire disorders: An update of the Masters and Johnson Institute approach. The Family Journal , 26 (2), 223–237. https://doi.org/10.1177/1066480718775734 Su, T., & Parker, M. L. (2022). Narrative Couple Therapy with Sexual Minority Couples: Exploring Sexual Intimacy. Contemporary Family Therapy: An International Journal , 1–11. https://doi.org/10.1007/s10591-022-09644-7 Veldorale-Griffin, A. (2019). Gottman Method Couples Therapy. In D. Adamson & Y. Watters (Eds.), An introduction to MFT systems theory and foundational models.

Signature Assignment week 11 6105

Related Documents