Relationship Therapy - Case Study Example

Scenario—Anna

In this situation, the therapist has to keep Anna on her side.  There is obviously tension between Anna and her mother, and she obviously loves her boyfriend.  However, there is some concern that this boyfriend, who is older, is putting a lot of pressure on her to have sex.  The professional counselor has to keep Anna on her side, while still recognizing that Anna’s mother is perhaps right to be a bit worried about the situation.  The therapist can do this by communicating with Anna to increase her empowerment and her realization of the social pressures which occur during adolescence.  Therapists know that during this period of life or life stage change, there are also increased pressures on the adolescent in terms of fitting in with a peer or social group, which is replacing the family group in terms of the ways that the individual feels compelled to spend their time.  This is why the therapist should not be seen as siding with Anna’s mother.  The development of a greater cognitive and social sophistication is one side of the adolescent experience, in which thoughts, feelings, and behaviors become more part of an individual’s self-awareness and growth.  There are also changes going on in the adolescent individual from a neuro-chemical point of view.  “Recent imaging studies in humans show that brain development and connectivity are not complete until the late teens or early twenties” (Adolescence, 2006).  However, this is also a high-risk case situation, so the therapist may also want to make Anna more aware and educated about making mature and responsible sexual decisions, including the role of contraception, and effective planning regarding sexual behavior.    

Scenario—Tom and Susan

Tom and Susan are an elderly couple, but they have different bio-mechanical activities going on that the therapist needs to realize.  Sexually, Tom is waning, while Susan may even be waxing in terms of her appetites.  Males generally peak sexually in adolescence; females reach their sexual peak much later.  There are many issues in this case because there are also psychological changes and factors going on with Tom and Susan’s retirement.  There are specific issues to Tom’s sexual performance during late adulthood that are more complicated for him, than for Susan.  The therapist should advise that their transition into retirement is an opportunity to reappraise and modify the sexual structure of their relationship, and to create the basis for a new sort of sexual structure advocated by Susan’s increased appetites.  If Tom is nervous about performance issues such as maintaining an erection, there are pharmacological alternatives that he can assumedly take advantage of.  Holistic and preventative approaches to looking at sexual health in late adulthood are relatively innovative, in that they take the existing paradigm of reproductive health and take it to a new level of promoting wellness so that people like Tom and Susan who are in the stage of late adulthood can learn to maintain a healthy and active sex life instead of just thinking of a decrease in sex as being an inevitable factor of aging.  If Tom and Susan are educated by the therapist, with a focus on Tom, about how to live a healthy sexual lifestyle during these later age stages and how to cut back on his performance anxiety that is hurting the couple and stepping up to the habits that are healthy and worthwhile, they will be more likely to be healthy and require less care from therapy.  The therapist should help Tom and Susan develop a daily routine that they can take past the therapy sessions.  

Scenario—Bill
Since Bill is paralyzed from the waist down, it is assumed that his disability may prevent him from achieving and maintaining an erection for traditional sexual intercourse.  However, thinking that an erection is all that is necessary for a sexual experience is somewhat limited, although all too common.  Since Bill is involved in a romantic relationship, it is assumed that he is undergoing a lot of stress and self-induced pressure to bring the relationship to the next level, but he does not seem to want to bring up the subject with his love interest.  As the parameters state, Bill becomes very nervous and uncomfortable when talking about this subject.  He may be afraid of rejection or performance anxiety.  Optimally, the therapist would use this case scenario for a group therapy exercise in which Bill and his love interest would be able to bring up issues important to them in a neutral and non-judgmental, therapeutic environment.  However, if the counseling is only to be for Bill, the therapist needs to communicate with Bill using empathy and address his feelings. It is hoped that the therapist is a professional who is really and genuinely able to show empathy for the client population.  In communicating with Bill about his nervousness about bringing sex up with his new partner, showing empathy is arguably more important than any other method which can give Bill a feeling of being empowered.  To be truly empathetic, the therapist must accurately reflect on what Bill is feeling and show that they can relate to it.  And if Bill sees empathy as an accurate display of what he/she is feeling, trust is formed, and more honest answers ensue.  What Bill is most likely feeling is a shame about his inability to have traditional sex.  The therapist can suggest other activities and aids which are appropriate regarding Bill’s disability.