Integrative Research Case Presentation

Family Systems Therapy: Integrative Research Case Presentation
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Introduction
Maintaining a happy family takes the contributions of both personality and emotional understanding of each other among the members. In households where lack of cooperation and cohesion is evident runs into several problems. Children are the most affected in such scenarios. As a result, they may tend to side with the parent who shows compassion to them. Further disintegration of families originates from such alignments of the children. Emotional attachment to the ignored parent to the kids and the rest of the family vanishes and as a result, arrogance and in most extreme cases domestic violence emerges (Nichols & Davis, 2017). Without timely intervention of family therapists, the reconciliation of such families can take the time to take place. Furthermore, there is a high possibility of development of hate towards the impassionate parent by the children (Cross & Barnes, 2014). It is, therefore, important that a family whose relationships are not balanced (i.e. giving and receiving) has to seek the intervention of a third neutral party (therapist) to address the challenge.
History of the Family
In the movie True Deception written by Pamela Romanoswky, the family of Mr. Hans had run into a couple of challenges. Initially, the family had a healthy relationship that saw the children grow happily for the early phases of their lives. The differences in opinions of Nina (wife) and Hans (husband) created a dark spot in the lives of the children making it harder for them to develop properly.

Hans was working, and as a result, the children spend more time with their mother, and this made Hans feel abandoned and unappreciated by the children and his family for doing the right thing as he claimed. He started accusing the wife of turning the children to her side. Due to fear of rejection or losing the children to his wife, he opted not to pay for their insurance cover. Whenever a Corry (Hans’ son) got seek, he accused his wife of inventing sickness for the child. Although the truth cannot be seen from the accusations, both parents seem to be more concerned about the relationship with the children than theirs.
After some time, Nina goes missing, and this traumatizes the children. During a session with the psychologist, Corry is unable to talk about the events that lead to the disappearance of their mother. From judgment, it is fear of the wrath of their father. However, the child can draw in the picture the happenings of that day. He draws a picture of a zipped bag that was seen outside their house. On further inquiry about the bag, the child refused to continue talking about the same. These being an indication of emotional response to the events make it harder for the psychologist to continue. Mr. Hans was convicted for the disappearance of his wife and during the court sessions it seen that the children who now stays with a relative address him by his name, Hans other that father. Later, Hans his defense, he says he did what he had to do to protect his children from being misled by their mother. His emotions and anger were orchestrated by the lack of balance between how the children interacted with their mother and with him. However, after some weeks Nina reappeared but had developed dementia. A psychiatrist was assigned to her, and from the sessions, it is evident that she was emotionally deteriorated and had lost a sense of self-worth.
From this history, lack of a third neutral party allowed further disintegration of the family. The children no longer refer to Hans as father and reconciliation between them is imperative. If there were an alternative solution and intervention of a therapist, maybe it would have lessened the impact of these parent’s disagreements. Family therapy would be the best solution in such an instance to assess the root source of the differences and provide a treatment plan that could ensure healing reconciliation among the members of the Hans’ family. Several models can be used to address the issues in this family and provide an intervention plan.
Strategic Family Therapy
Milton Erickson inspired the model’s concept, and Don Johnson assists families in settling their problems by setting measurable goals. Five concepts/stages are found to be instrumental in the success of such a model in solving family issues (Nichols & Davis, 2017). The social stage, problem identification stage, interaction stage, goal setting stage and task setting stage are the major parts for a successful SFT. By following these steps when handling a case of the household, moods, emotions and other external challenges that may impair the process are partly controlled. Hans’ family can follow the same pace for healing and reconciliation to be attained among the members of the family.
Assessment of the family
Evidently, from the family history of Nina and Hans, there is a communication breakdown between the two. This has transferred the effects to the children making them align themselves to their mother with whom they spend their time at home. Although it is not clear why the children had a tendency of circling their mother even when their father was present, it does not justify the actions of Hans. Their mother being a caring mother becomes emotionally disturbed by the actions of his husband. The emotional understanding between the couples has failed, and this presents a danger in their relationship and the well-being of their children. Failure of Hans to pay for the insurance cover of their children and constantly blaming Nina for faking sickness for Corry indicates a deeper misunderstanding and mistrust that exists in the family (Woods, Priest, & Denton, 2015). The children being the source of the misunderstanding are affected too, and due to these, they seem to side with their mother with who they feel comfortable. After the disappearance of their mother, the children became traumatized and were referred to a psychologist. From the sessions, emotional attachment of Corry to the missing of her mother could be evident. At some point, he only drew a picture of that day and what he saw before her mother went missing. Although the children are seen to be young, the memories of their mother are still in them. This may be due to the hostility they saw in their father, Hans.
Rigidity is evident in this family in adaptations to changes. The domination of negative feedback from Hans makes it harder accommodate changes. To shield this deficiency in him, he openly becomes arrogant and distances himself from the family. This may be the source of the problems Nina underwent that led to her disappearance. This rigidity has altered the standard functionality of the family (Combrinck-Graham, 2014). For Nina, it seemed reasonable for the children to be all over her all the time since they spend most of the time together. The expectations of Hans to get the same attention were not met, and this infuriated him to the extent of terminating their insurance cover. The false accusations on Nina for faking sickness for his son are among the indicators of lack of positive feedback and flexibility in Hans in handling different circumstances.
From a further observation, there is a lack of communication in the family, and this may be the reason the children were decisive on whom to side with during conflicts. As for Hans, it would have been better first to assess the situation and learn the dynamics of the change in the behavior of his children. Also, Nina could have guided the children on how to interact with their father whenever he is home. It cannot be termed as rebelling, but to Hans, it seems to be the case for his family members. He ran into the judgment of the family and in his efforts to punish them, more damage was caused. His wife disappears and reappears and diagnosed with dementia. His children distance themselves further from him and now call his by his name. The healing process of this family thus ought to take into account the perceptions of all the members about the family status. Although it will now be difficult for Nina to cooperate completely, the children and their father can be of help in pulling the family back together.
Treatment plan
For a treatment process to be successful there ought to be a clear understanding of the problem and the dynamic changes that lead to its emergence. This is helpful in making the therapist sets goals that are realistic and neutral to all the parties involved. In doing so, the relationship triangle will be completed (Cross & Barnes, 2014). In the case of Hans, Nina, and the children, the goal will be reuniting the family and bringing an understanding of the conflict that occurred. In setting up such milestones to be achieved, as a therapist, it will be essential first to get the views of all members of the family. Getting to know the emotions and a general feeling of each member enables therapists and other psychologists in devising unfavorable, goal-oriented, natural and realistic solutions for the problem (Nichols & Davis, 2017). Since the major problem has been identified as poor communication and lack of emotional understanding among the members, it is best to let them share a controlled platform first. This is always the third step of strategic family therapy.
During this occasion, giving directives can ease the pressure from both sides since no one will feel greater than the other. However, considering the condition of Nina, it may require some adjustments to the requirements of the directives given. For instance, all the family members can be asked to give a version of what they need to reconcile with each other. Additionally, the members can be called upon to keep records of what ways he/she is using to create a peaceful atmosphere for the reuniting of the family for one week (Williamson, Trail, Bradbury, & Karney, 2013). Such deliberate goals are meant to track and keep the family observant of the set rules and directives. The cohesion and healing process can be quick in such instances when all the members cooperate. For the case of the children, as a therapist, a directive of the having a mandatory seating at least twice a week to discuss family matters and reporting the progress during proceeding sessions can boost their healing. Finally, to wash away the emotional breakdown among the members, watching, fun-making together can be significant in achieving such milestones in a family that lack coordination of emotions.
Experiential Family Therapy (EFT)
This is a model that works on the concept of inside-out. The inner, real and honest emotions individuals from the family, are uncovered, and genuine family tie is developed from this authenticated information. In most cases, emotions serve a communicative function when displayed. However, suppressing it leads to anger, aggression, apathy and anxiety. For a relationship that experiences emotional suppression of any kind, there are possibilities of a disjoint to occur in their daily routine and practices. For this reason, it becomes essential for any family to develop a mutual understanding of oneself and others together with their emotional reactions to different circumstances (Williamson, Trail, Bradbury, & Karney, 2013). The absence of such in a family may lead to the breakdown of communication and consequently the whole relationship and family togetherness.
Family Assessment
Basing on this model and focusing on Nina, Hans, and the children especially Corry, the emotions they had over each other cannot be used to blend a suitable family tie. The disjoint in their emotions shows the vulnerability of any of them developing anxiety because of feeling emotionally suppressed. According to most therapists, a family is supposed to be placed for exchanging experiences and flourishing in immeasurable limits (Woods, Priest, & Denton, 2015). It needs the contribution of every member both physically and emotionally. In Hans’ family, this is missing, and a flaccid interaction is evident. The children are not growing in a manner that the parents respect their emotions, and lack of adequate support is making things to be a little hard for them. Already anxiety has set in, and the children have even moved to stay with a relative. They no longer recognize Hans as their father since his conviction. Furthermore, during a session between the children and a psychologist, Corry who is the elders is not able to adequately express himself due to raised emotions. It is these psychological changes that have made the children fail to have self-confidence and courage to talk about the happenings of their family.
From an experiential point of view, denial of impulses and suppressing the feeling of one another is the cause of many problems experienced in families (Parfitt, Pike, & Ayers, 2014). Hans denied the children and his wife Nina the chance to openly express their feelings about the family problem. The inbuilt pressure and emotional reactions may have caused Nina to disappear from the family for some time and this time with a mental deterioration disorder (dementia). Hans, in this case, was seeking for security rather than satisfaction. Without inquiring from his wife he terminated the insurance cover for the children and unexpectedly started domestically abusing Nina for the reason that she is brainwashing the children. To Nina, she was doing what any mother will do for her family, and the actions of Hans send her to the great depression. The children too were not spared, and the pain inflicted to their mother indirectly transferred to their suffering in her absence. Emotional accessibility and responsiveness are missing in this family. As a result, their minds are preoccupied with other things hence forgetting the virtue of togetherness in a family.
Judging from the actions of all the family members of Mr. Hans, it is clear that there is a lack of safe bonding and emotional representations. The children are not able to adequately express their disappointments on how their father is treating their mother. Nina too is unable to directly show her husband how she feels since he became ignorant of family responsibilities. These create a buffer between getting on the same page as a family and further disintegration. Due to pressure, Nina withdraws and moves out without caution and the children are left traumatized. Hans also moves into further depression because he becomes convicted of the disappearance of his wife. Such instances only indicate a lack of bonding and communication plan among the members. The anxiety developed, and the emotional suppression can only be resurged from by experiential therapy.
Treatment Plan
Under EFT, the principal focus is not on solving the problem but bringing a better understanding among the concerned members and enhancing bonding in emotions. For the case of Nina and Hans, their detachment is caused by a weak bond that connects them emotionally. As a therapist, aiming at strengthening the attachment among them is that ultimate solution to their family problem. Firstly, in prompting the inner feelings and perceptions of the family from the members, aggression is paramount as a therapist (Cross & Barnes, 2014). In this manner, they will open up to their inner feelings and be honest on their dissatisfaction with the happenings in the family. After completing such steps during a directed session, experimentations of their understanding can now be adopted. Techniques such as allowing them to address each other directly and addressing their individual flaws and providing their inner feelings to each other will allow them to recreate the broken bond. However, this cannot be done in one session. It requires a series of meetings with all the members. Furthermore, experientialists believe that emotional attachment is created when fantasy is created. As per this, the family members can hold hands and talk to each other on directed topics by the therapist to enhance their interaction and healing process. It brings back the feeling of togetherness in a family.
Finally, getting to the root of individual’s experience assists in breaking defensive squabbling. Individuals usually play defensive by not seeing the positive side of the other partners. As for the children, their detachment is to their father who they currently call by his name. In solving such, it is best to allow them directly address Hans of his mistakes and why they feel he neglected them. During all these processes the rest of the members are to listen and not distract. The therapist will later join and display his/her emotional understanding of the problem and provide motivation to the family members of being able to address each other without yelling. It brings them to a realization of their capability of reforming the family to its greatness. To Hans’s family, this may be the building stone.
Bowen Family Systems Therapy
Murray Bowen developed the model dwells on several concepts including self-differentiation, emotional cutoff, societal processes, multigenerational processes, and triangles (Nichols & Davis, 2017). According to his theory, people have less autonomy to their emotions and most are reactive than others than they think. The blending of ideas in a family incorporates the efforts of all the persons in the household. Emotional understanding coupled with self-differentiation makes people more autonomous, and this enhances bonding and strengthening of ties within a family setup (Nichols & Davis, 2017). Regarding the well-being of the children in a family setup and depending on their ages, the parents have a vital role to ensure their development is well shaped in agreement with societal requirements and processes.
Family Assessment
From the history of Hans’ family, there seems to be a deficiency blending a favorable condition for the development of the children. Nina has a different degree of understanding with Hans. Their self-differentiations differ greatly, and this has led to an emotional misunderstanding between the two. Due to fear of recognition and dominance of male chauvinism, Hans decides to punish his entire family by not paying for the insurance cover, accusing his wife of forging sickness for the kids and further distancing himself from the family matter. Withdrawal of Nina from the family without prior notice to any of the members can be said to be the implications of the emotional suppression she underwent in the family. Anxiety being the cause of the disintegration of the family, has also affected the children and Hans himself. The imbalance in their opinions on which the children should be aligned to is the primary propellant of the whole problem (Parfitt, Pike, & Ayers, 2014). According to the actions of Nina, it is clear that she was undifferentiated and this is illustrated by her impetuous decisions like leaving the children to a hostile environment without prior notice. Further, Hans also seems to display the same characteristics as Nina making it almost obvious that both are undifferentiated and have haste in making decisions. For the case of the children, their response was guided by their perceptions and understanding how their parents related. For instance, Corry can comprehend that the actions of his father are unjustifiable and that it’s not right for him to act in that manner.
Emotional triangles are useful in reducing the chances of emotional cutoff in families. Therapists find it convincing to include themselves in the triangles so as to act as the pivotal point of revolution in the household matters. For the case of this family, there is an absolute need for a third neutral party to intervene for reconciliation to take place. All the members are seen to be affected by anxiety due to emotional changes. Furthermore, societal processes piled pressure to Hans to provide for the family which according to hi was ignoring him and distancing from him. As a responsibility of the head of the household, he makes individual decisions that are more of punitive than constructive. Although the origin of both parents is from the same ethnic group, their perceptions seemed quite different regarding the welfare of the children. In this effect, there is an emergence of emotional reactivity in all the members of the family.
Treatment Plan
The usefulness of Bowen’s model in family therapy is explaining the emotional forces and how to regulate them. However, to achieve such milestones, there is a need to evaluate the history of the family carefully. First, the historical background of the family is essential. As a therapist, it is better to identify how the parents met, where they originate from and any locations they have lived in their courtship life (Woods, Priest, & Denton, 2015). Second, determining the worries of each person in the family is vital. These can be done in closed sessions with each member and further combined sessions where they will all talk freely and express their thoughts. Although there will be a deficiency in Nina’s contribution to this due to her state, her contribution is still important. Lastly, for the benefit of reintegration, direct addressing will ease the tension between the members.
Since there are several techniques which Bowen approved to be useful in controlling emotional imbalance and lack of differentiation among family members, process questions are best for Hans’ family. Posting questions like “How do you feel right now about your family?” “What is so wrong about his actions that led to your withdrawal?” Such questions are aimed at getting to the cause of the problem. A further blend with coaching without entering the family triangle will allow the family figure out their emotional responses and their roles in the cohesion of the family. Hans and all the other family members can thus be reunited once again if the Bowen’s technique is utilized and followed up closely during successive sessions with a therapist (Nichols & Davis, 2017).
Conclusion
The diversity of the issues surrounding families relies mostly on the effects of emotions and bonding. Implications of impairment of such effects lead to anxiety and suppression which may further result in the withdrawal of one of the members of the family. However, the interventions of therapists as third parties in such setups minimizes the chances a further drift in a troubled family. Different models of therapy can be used to assess the family and provide an ultimate treatment plan for the family. It is thus vital to seek the intervention of a neutral party whenever there is a misunderstanding in a family.
References
Combrinck-Graham, L. (2014). Being a Family Systems Thinker. A Psychiatrist’s Personal Odyssey. Family Process, 53(3), 476-488.
Cross, D., & Barnes, A. (. (2014). Using Systems Theory to Understand and Respond to Family Influences on Children’s Bullying Behavior. Friendly Schools Friendly Families Program. Theory into Practice, 53(4), 293-299.
Nichols, M. P., & Davis, S. (2017). Family Therapy: Concepts and Methods (11 Ed.). Retrieved from https://bookshelf.vitalsource.com/#/books/9780133826883/
Parfitt, Y., Pike, A., & Ayers, S. (2014). Infant Developmental Outcomes. A Family Systems Perspective. Infant & Child Development, 23(4), 353-373.
Williamson, H. C., Trail, T. E., Bradbury, T. N., & Karney, B. R. (2013). Does Premarital Education Decrease or Increase Couples’ Later Help-Seeking? Journal of Family Psychology. Advance online publication. Doi: 10.1037/a0034984
Woods, S. B., Priest, J. B., & Denton, W. H. (2015). Predicting Improvement in Depression Across Therapies Using Indicators of Romantic Relationship Functioning: A Preliminary Investigation. American Journal of Family Therapy, 43(1), 44-56.