Case Conceptualization Family Systems Deidre

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Apr 3, 2024

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Case of Deidre – Family Systems Theory Presenting Problem : Deidre is a 21-year-old African American Latina female who is currently a college sophomore, working part-time as a barista in a coffee shop to help pay her way. She is the only child of an African American father (now deceased) and her Latina mother. Deidre lives in a dormitory on campus about three hours away from her mother near New York City. Recently, due to having chronic headaches and feeling “lost and alone,” Deidre sought help from a medical doctor who observed her to be tired, anxious, and tense and referred her to a counselor because he could find no physical cause for her headaches. Deidre’s main issues are low self-esteem, lack of social support, unresolved grief, and ambivalence about her abortion. She also struggles with her cultural identity and the oppression she faces as a woman of color in a patriarchal society. Some of the contributing factors to her problems are her mother’s emotional instability and negativity, her father’s death and absence, her isolation and withdrawal from others, and her internalized sexism and racism. Hypothesis : Deidre’s anxiety, depression, and other issues may be related to her family’s history of mental health issues, her mother’s emotional instability and negativity, and her internalized sexism and racism. Feminist theory suggests that Deidre’s struggles with her cultural identity and the oppression she faces as a woman of color in a patriarchal society may be contributing to her anxiety and depression. Goal : The goal of counseling is to help Deidre develop coping mechanisms to manage her anxiety and depression within the next 6 months. Family Systems Theory suggests that the counselor should work with Deidre and her family to identify and address any patterns of behavior that may be contributing to her presenting problem. The counselor should also help Deidre develop a stronger sense of self and a more positive self-image. To achieve this, an extremely important goal of the therapist is to remind oneself that an essential aspect of facilitating change within a system is that therapists cannot make or suggest arbitrary adjustments without an in-depth understanding of the prevailing rules as it is crucial to acknowledge that these rules differ across various systems. ( Family Systems Therapy , 1997). Within Family System Therapy, being able to listen more than we talk is something that greatly helps with understanding. Interventions: . First-order Change: Deidre is facing several issues that are affecting her mental health. The first-order change intervention is a therapeutic approach that focuses on changing the behavior of an individual or a system without altering the underlying structure of the system (Musliner, 1980). In Deidre’s case, the first-order intervention could involve helping her develop coping mechanisms to deal with her low self-esteem, lack of social support, unresolved grief, and ambivalence about her abortion. This could be achieved through counseling sessions that focus on building her self-confidence, developing healthy relationships, and addressing her grief and ambivalence about her abortion. The expected outcome of the first-order intervention for Deidre would be to help her develop the skills and tools necessary to cope with her current challenges. This could include improving her self-esteem, developing healthy relationships, and finding ways to manage her grief and ambivalence about her abortion. By addressing these issues, Deidre may be able to reduce her anxiety and depression and improve her overall mental health. It is important to note that the first-order intervention is just one approach to addressing mental health issues, and it may not be effective for everyone.

It is also important to consider other factors that may be contributing to Deidre’s mental health issues, such as her family’s history of mental health issues, her mother’s emotional instability and negativity, and her internalized sexism and racism. A comprehensive treatment plan that considers all of these factors may be necessary to help Deidre achieve the best possible outcome. Genogram : According to Dykeman (2022), genograms incorporate information about birth order, family members, communication between family members, and concerns about relationships. This would make it possible for the counselor to gain a deeper understanding of the family and the challenges they face. In discussing several of Deidre’s presenting problems including low self- esteem, lack of social support, unresolved grief, ambivalence about her abortion, cultural identity struggles, and oppression as a woman of color in a patriarchal society, etc., along with her mother’s emotional instability and negativity, father’s death and absence, isolation and withdrawal from others, and internalized sexism and racism are some of the contributing factors to her problems can help bring more clarity to the family history, especially in the area of family dynamics. With all the death of her father, jolted the family dynamic, and seems like a tremendous void is left in the family dynamic. Moreover, Deidre’s multicultural identity may be contributing to her sense of being lost and alone, due to her distance physically and emotionally from her Latina mother and again from her father in his passing. In many ways, culturally she may be missing out on some major areas that could help her meet her belonging needs rather than feeling different and on her own. A genogram intervention could help Deidre gain insights into patterns and behaviors that have influenced her mental health, understand family dynamics, address grief, resolve conflicts arising from her mixed racial background, and seek support from extended family. According to GenoPro (n.d.), there are four areas where creating a genogram can provide great benefit in Family Systems Therapy. The first benefit is that it can provide further insights into a family's overall medical and behavioral history. For example, the descriptive diagram can also be used to predict the likelihood of occurrences such as sexual abuse, alcoholism, suicide, and illnesses (GenoPro, n.d.). Creating an elaborate genogram can unveil patterns associated with historical and current illnesses, facilitating the identification of these patterns. Consequently, individuals can promptly discern their vulnerability to specific diseases and explain familial disease tendencies. In addition, the utilization of genograms serves to depict the emotional bond among individuals within a family. Additionally, the creation of a genogram enables clients to gain a wide-ranging understanding of the true dynamics within their family relationships. Furthermore, another significant benefit of a genogram, as opposed to a conventional family tree, lies in its ability to depict the emotional connections between individual family members. Within treatment sessions, the therapist will ask clients to construct a genogram as a means by which they can let out feelings that they’re not overtly open to discussing. An additional area of benefit from genogram intervention is found in how it can provide a more effective method for grasping family dynamics. There are occasions when specific events recur throughout generations, echoing previous occurrences. Frequently, families perpetuate - or even exacerbate - their difficulties as they progress. Generational transmission perpetuates issues, actions, and culture, as individuals neglect to recognize, let alone scrutinize, the underlying causes of their challenges. Finally, constructing a genogram and conducting a thorough analysis of it alongside family members might facilitate their resolution of entrenched generational issues; thus, assisting the therapist in making more accurate evaluations which can assist individuals in comprehending the essence of their familial problems, enabling them to

repair their behaviors, activities, and outlook toward encouragement of harmonious relationships within their family system (GenoPro, n.d.). Expected Outcome : Deidre’s anxiety will diminish as she begins to unpack and further understand her family dynamics and relationships. This will help her cope with the anxieties that she is experiencing due to her family system as she will understand how several of the systems and relationships within her family contributed to her feelings of isolation, low self- esteem, and lack of nurturing and caring rather than helping her see value in the unique multicultural, empowered woman that she is. The hope is that Deidre and her family will fully engage in the topics that may not have been available for conversation before; yet, through the genogram interventions, they may gain a greater understanding to be able to make positive adjustments and facilitate healthy change through family dynamics and overall system change. References: Dykeman, C. (2022). Family therapy. In D. Capuzzi & M. D. Stauffer (Eds.), Counseling and psychotherapy: Theories and interventions (7th ed., pp. 287-308). American Counseling Association. GenoPro. (n.d.). 4 Benefits of creating a genogram - GenoPro . https://genopro.com/articles/4- benefits-of-creating-a-genogram/ Musliner, P. J. (1980). Strategic Therapy with Families and Children. Journal of the American Academy of Child Psychiatry , 19 (1), 101–117. https://doi.org/10.1016/s0002-7138(09)60656-7 Psychotherapy.net (Producer). (1997). Family systems therapy [Video file]. Author. Week

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