Spirituality and Satir in Family Therapy - Case Study Example

of Spirituality and Satir in Family Therapy Background and History Isaac is a ten year old boy, who lives withhis mother Sara (not her real name) and his older brother Sam (not his real name). Isaac was referred to therapy because he is having problems at home and at school. Isaac is also acting out at home and striking out at Sam. The family is facing many issues that may have an affect on Isaac’s behavior. Both parents are critically ill and divorced three years ago. Al, the father ( not his real name) does not see his children on a regular basis. The boys live with Sara, but she has times when she is not able to deal with her children because of her own perceived physical, emotional and spiritual challenges. Sara also battles depression, which can be difficult for the boys when she is in a depressed state. Isaac seems to be having adjustment problems on many levels. He is adjusting to his parents and their illnesses, and to their divorce. He also has to adjust to living in a small apartment after their house was burned. As he is attempting to adjust to all of these situations, he is exhibiting many different behaviors. He shows passive-aggression toward his mother, wanting to hold her close at times, but also wanting to reject her when he is feeling rejected. He has sudden outbursts that are directed at Sam and at teachers and other children at school. Isaac is also having attention and hyperactivity problems at school, and he has trouble sleeping. Currently, it does not appear that he is on any medication. Assessment Procedure The assessment of this family would begin by asking several questions. According to Satir, Stachowiak, and Taschman (1975) the therapist must not make judgments about the family and/or the child when in therapy. The questions would begin with understanding what is needed for Isaac to help him move forward. As an example, a question to Isaac might ask him why he feels the need to act out in school. Because the family was already tense when they came into the office, the therapist would “crate a climate of informal and relaxed friendliness” (Satir and Baldwin, 1983, p. 17) by allowing them to choose where they wanted to sit for the session. This would help the family have a way to understand where they were in the process. The therapist would pay careful attention to how Isaac sat in relationship to his mother and brother. During the initial stages of the interview, the therapist would build rapport and create a friendly environment. Talking about specific problems would not be initially talked about because the family needs to have a safe place to begin (Satir and Baldwin, 1983). The key in Satir’s work is for the therapist to be cognizant of what is happening between family members, what is being said, how it is being said, and how the family continues to communicate with each other (Satir and Baldwin, 1983). The therapist would also allow therapy to evolve, as it needs to, with direction from the therapist, according to Satir’s model. Questions The therapist would want to know more about the family background. Why is Isaac feeling the need to act out in school? Why is he not sleeping? When did these changes begin? How does Isaac feel about these changes? These questions would be an attempt to understand more about Isaac’s inner world and his self-esteem. According to Banmen (2009), Satir is always looking for ways to connect the individual client back to themselves and to the world around them. These questions would be important toward establishing where Isaac’s self-esteem was in the beginning of the therapy. In addition, there are questions about what will happen to the boys once both parent are gone, and whether there is an advanced directive and will in place. Whether the family has a religious affiliation would be important and a perception from the family as to how the therapist can help them move forward. Satir Model The Satir model that would be used is the Therapeutic Transformational Systematic Therapy Model. The reason this model would be used is that it creates a broader spectrum of assistance for the individual, and takes them systematically through several stages (Banmen, 2009; Smith, 2010). Although the client is Isaac, Sara and Sam will need assistance in order to help the family change and make life more comfortable for everyone involved. A spiritual component may be important if there is a strong spiritual component. The reason for this is that it is a type of pastoral care. Also, Satir’s models align with pastoral care because the work is always centered on the respect and uniqueness of the individual (Tam, 2006). Satir (1988) stated that, "We are all unique manifestations of life. We are divine in our origins," (p. 337). Satir (1988) also stated many times in her books, that humans need a connection with their families, the world around them, and “with the creative life force” (p. 336). In understanding this relationship with a creative life force, the individual learns, through work in therapy, how to see themselves as a beautiful individual, unique, and able to do many things in their lives (Tam, 2006). In working with Isaac and his family, a spiritual base such as described would help them find hope and peace as they move throughout the process. The Therapeutic Transformational Systematic Therapy Model There are basically five components or therapeutic elements to this model, and to any of Satir’s work. These five components include: Experiential, systematic, positively directional, change focus, and self of the therapist (Banmen, 2009). The components of the model will be described, as they would be used with Isaac and his family. Experiential At this stage, the family is experiencing how a past event affects them now (Banmen, 2009). Isaac will be the first concern in this because there have been so many past events that have affected him. The divorce began what appears to be a downhill turn for them. Satir (1983) states that the way that parents feel about each other, will influence how the children in the family feel. Isaac may be unable to understand why this is happening. At ten years old, Isaac is also spending a lot of time taking care of his mother when she is ill, either physically or mentally. He is not old enough to understand a situation like this one, and this can also affect how he is feeling about himself. Systematic Bauman (2009) states that Satir’s systematic change is important to help the family understand the “emotions, expectation, yearnings, and spiritual energy of the individual” (p. 17) and how these emotions impact the intrapsychic systems that each individual develops. This is a very good place to begin to interject spiritual information for the family. This does not mean it must be a specific religion, but there can be a variety of concepts introduced. As an example, Marterella and Brock (2008) states that religion and spirituality are becoming more popular in the literature dealing with family therapy. One of the reasons for this is because marriage and family therapists understand that there is a link between spirituality and mental health. In many ways, for a human being to have a systemic change, there is a need for them to believe that life can become better. Satir also realized (according to Lee, 2002) that there was a power that was greater than the human being that was able to create healing. Positively Directional In this stage, Isaac will begin to understand that there is more happing inside of him, in terms of how he is feeling, and why he is feeling in the way that he does. The therapist must be able to help the family move forward as a unit and embrace their lives together (Banmen, 2009). There are many issues that must be sorted out and dealt with to bring stability back to Isaac and his family. Change Focus This stage brings Isaac and his family together and helps them focuses on the change they have made (Banmen, 2009). By this stage, the therapist would have helped Isaac see his life and his circumstances differently, and the family would apply their new learning to move toward a more cohesive unit. The family would be stronger, and they would have a spiritual base to build upon. Self of the Therapist This final stage provides an opportunity for the family to understand their personal needs as individuals, as well as how they fit together as a unit. The therapist is essential in this stage, because he or she must provide congruence and genuineness , so that clients will see them as genuine (Banmen, 2009). The therapist must have their own spiritual self to further connect with their clients. Planned Interventions Smith (2010) states that the therapeutic model stresses understanding the message that someone else is sending that is below the surface. An example is how Isaac is acting out. His behavior is showing that there may be fear, anxiety, and he may be feeling out of control. Satir spoke of “blockage of innate human resources and energies” (Lee, 2002, p. 61) which created disharmony in the individual. When these blocks were removed, the individual is able to feel better (have a stronger self-esteem), create more positive relationships with themselves and others, and they would be able to pull from their spiritual resources (Lee, 2002). In this case, Satir would ignore the symptoms of the challenges that the family was facing and promote the individual’s intrinsic ability to improve their self-esteem. The first intervention would be to help Isaac and his family understands that they were individuals who were important, and unique. From this vantage point, the therapist would model congruence, so that he or she would be better able to connect with the spirits of the individuals and with each family member’s spirit. The therapist would focus on seeing the individual’s spirit and then helping the client to also see their spirit (Satir, 1988). The more this spiritual essence became apparent to the individuals in the family, the easier they would be to move forward. The work would also entail bring out the good in the family and helping them to see the spiritual connection between what they were doing, and how they were healing (Lee, 2002). The therapist would work with the family to help them evolve as a unit from where they are now, to “connect with their universal life force” (Lee, 2002, p. 63) and become a healthier, more loving, and more caring family. Possible Exercises A beginning exercise would be to use a one-way mirror with the family. This would allow the therapist to listen to what was happening with the family without interfering with what was going on. The therapist would be behind the one way mirror with a tape recorder and earphones so they could record everything (Satir, Stachowiak, and Taschman, 1975). This may work with Isaac and his family after they had received a few sessions and were feeling more comfortable with the therapist. Another interesting intervention would be to have Sara, Isaac and Sam switch roles. It would be interesting to see how Isaac would act as Sara, Sara as Isaac, and Sam as Isaac. This would help each of them understand how the others felt about what was happening in the family. This may be a way for the therapists to understand the power dynamics within the family (Satir, Stachowiak, and Taschman, 1975). Ethical Issues Marterella and Brock (2008) state there are several ethical issues that must be taken into consideration when a marriage and family therapist begins to introduce spiritual concepts into therapy. They state that some therapists feel that the individual religious preferences should be taken into consideration. Although Sara states that she believes in God, she does not provide a specific religious preference. The therapist would need to make sure they did not push their own religion or spiritual preference onto the family. This means they would need to be aware of their own beliefs and how these beliefs affect how he or she does therapy. Also, the therapist must be able to balance between the beliefs of the client and their best interests (Marterella and Brock, 2008). In other words, there may be times when belief systems must be challenged, and the therapist must understand when this is necessary and when it is not. Conclusion Satir (1988) states that “self-esteem is a concept, an attitude, a feeling, an image; and it is represented by behavior” (p. 20), and that it is something that helps an individual learn how to treat themselves better. Throughout this paper, the therapist has presented information that will help Isaac and his family move toward a better self-esteem and to healing. Finding a spiritual path is part of this move toward healing. Many philosophies on this topic abound, but Satir saw spirituality as a life force that all humans had and that they her or she must be in touch with in order to heal. Satir saw this as a resource that all individuals had within them. In Satir’s therapy, the therapist would not try to change Isaac’s behavior but help him to see that he could do this all by himself. By modeling congruent behavior and genuineness, the therapist can help Isaac and his family fined a stronger self-esteem and it will be an opportunity to experience their inner selves. References Banmen, J. (2009). Satir model developmental phases. Satir Journal, 3(1), 14-19. Retrieved from Academic Search Complete, AN: 37143514. Lee, B. K. (2002). Congruence in Satirs model: Its spiritual and religious significance. Contemporary Family Therapy, 24, 51-lS. Retrieved from SocINDEX with Full Text, AN: 36429613 Marterella, M. K., & Brock, L. J. (2008). Religion and spirituality as a resource in marital and family therapy. Journal Of Family Psychotherapy, 19(4), 330-344. Smith, J. (2010). Dead kids talking: Youth suicide prevention using Satir transformational systemic therapy. Satir Journal, 4(1), 84-198. Retrieved from Academic Search Complete, AN: 58151218 Satir, V., Stachowiak, j., and Taschman, H.A. (1975). Helping families to change. New York, NY: Jason Aronson. Satir, V. (1983). Conjoint family therapy. Palo Alto, CA: Science and Behavior Books. Satir, V. (1988). The new peoplemaking. Mountainview, CA: Science and Behavior Books. Satir, V. and Baldwin, M. (1983). Satir step by step. Palo Alto, CA: Science and Behavior Books. Tam, E. C. (2006). Satir model of family therapy and spiritual direction. Pastoral Psychology, 54(3), 275-287. doi:10.1007/s11089-006-6327-6 Read More