Family Assessment Therapy - Case Study Example

RUNNING HEAD: ASSESSMENT TOOLS USED IN FAMILY THERAPY .  Topic: Assessment Tools Used in Family Therapy Name: Institution: Assessment Tools used in Family Therapy Family assessment therapy is based on the fact that people are best understood by assessing the entire family whereby signs in individuals are considered as expressions denoting dysfunctions (Nichols & Shwartz, 2008). Since a family is treated as an interactional unit, a change in the behavior of one member affects the whole family unit/members. According to family therapists, the most influential factor in a person’s life is interpersonal relations and hence therapists employ a systematic perspective noting that one family member may denote a symptom for the entire family thus the person’s behavior denotes that family’s functioning (Sprenkle & Bischof, 2005). This consideration though, takes into account that some symptoms displayed by individuals may not necessarily reflect the family’s symptoms thus notes that these symptoms have ramifications for other family members. In this case, therapists employ varying family therapy assessment tools to diagnose problems and develop appropriate solutions. The assessment tools are a conceptualized representation of the phases of family analysis (Corey, 2006). These tools further aid in the process of developing and organizing the volume of information obtained during the short duration of interviewing an individual. Despite the tool employed for the assessment, its applicability is as effective as the assessing therapist is creative and imaginative. Over time, increasing importance has been laid on the validity and reliability of assessment methods and this has seen a significant growth in the process of developing assessment tools for family therapy (Sprenkle & Bischof, 2005). Psychologists then base their actions on the data obtained, intuition and impressions resulting from the interview. Family assessment tools are research instruments that have been predominantly developed to help in assessing: relationship satisfaction levels, parenting issues, communication, trust, parent-child attitudes and emotional expression (Haley, 2007). All these are considered as consensus and conflict areas. Being primarily self-report questionnaires, these tools are used in family assessment therapy to obtain an individuals subjective opinions regarding the relationship and thus within the interview’s duration, a therapist is able to derive the differences and similarities in the attitudes between the two parties as in the case Roger and Jeff (Nichols & Shwartz, 2008). Through this understanding, the therapist can understand the severity of the problems in the relationship between Roger and his father and thus would able to develop reliable therapeutic goals to address the problem and assess the effectiveness of this remedy. The qualitative assessment method would be the best for assessing the genogram or family history for a therapy session with Jeff and Roger. This method is greatly resourceful and falls under the behavioral psychology approach to family therapy (Apponte, 1982). Behavioral psychology therapy would thus include various learning principles to reduce or alleviate unwanted reactions to a person’s feelings and thoughts, external situations, and bodily functions or sensations. The method deals with the events of which an individual is aware of or can easily become conscious of, rather than dealing with the unconscious conflicts (Hardy & Laszloff, 2001). Thus, Jeff and Rogers’s case would best be served through this approach since it involves conscious conflicts which the two parties are ware of and which are the result of the change in behavior. In a qualitative assessment method, the therapist employs a humanistic oriented approach to asses the family history so as to get data that would provide an insight to the behavioral issue at hand (Haley, 2007). Under this method, the client is involved in active participation in assessment exercises which are integrated into the therapy sessions. Thus, the therapist would involve Roger and Jeff to develop a lifeline that would be paramount in mapping significant events and experiences through their life’s continuum. Since the method is qualitative, it involves other procedures such as likert scales, numbered intensities to evaluate the strength of these experiences and genograms. The assessment method would thus be very crucial in developing a genogram which is very crucial in evaluating possible solutions to the issue at hand. Behavioral issues demonstrated by Roger are as a result of a number of events that have occurred through his life, thus, assessing the family history would be paramount to help the therapist to understand the basis of conflicts in Jeff’s family. According to (Joan & Harry, 2007), systematic family therapists use a central principle that connects clients to living systems that reverberates through other parts. The genogram is thus an important tool for mapping the family history as it scans historically the family system and evaluates previous life cycle transitions hence placing present events within the context of the evolutionary patterns of the family (Aponte, 2002). For instance, in the case of Jeff and Roger, the genogram, being a tool in the qualitative approach would help them to recognize how the circumstances through their life relate to destructive behaviors that been upheld by generations before them and hence can be able to effectively alter them. Under this method, the therapist would be able to know the family and deduce appropriate data that would help to asses the reliability of the information given by the clients. In a nutshell, the qualitative method would help the therapist to place Jeff and Roger in an ‘expert’ position thus teaching the therapist who then easily maps the family history. The method would thus provide an effective means of developing a genogram that records key facts, a family system’s complex relationships and life-changing situations (Sprenkle & Bischof, 2005). This comes as an interpersonal event in which the therapist is able to collaborate with the clients to facilitate in recording and interpretation of data regarding family relationships. As compared to other methods, this is the only method that can help the therapist to draw data by involving the clients to report memories of events which are then easily recorded in form of standardized symbols indicating dates, events family secrets and perceived relationships known to their clients (Haley & Richeport, 2007). The Qualitative assessment method involves the development of a family map or a series of family maps which chart dynamics regarding interpersonal issues within the family context and thus helps separate development and intergenerational legacies from relational issues. The qualitative method particularly through the basic genogram enhances the exploration of both community and kinship affiliations and also gives guidance on the appropriate therapeutic solution to the unique needs of the client’s issue at hand (Nichols & Schwartz, 2008). It is only under the qualitative assessment method that a basic genogram that considers issues of family relationships such as divorce, marital patterns, parenting can be developed since in most instances, issues of divorce or multiple marriages creates a confusing scenario that is key in addressing relationship issues. From Jeff’s and Rogers’s context, this method would be most appropriate since it considers family issues such as divorce under the basis genogram and hence a therapist would be able to effectively handle the situation. However using the method presents a number of shortcomings. Under the qualitative method, the therapist may not be able to take into account some cognitive aspects that potentially influence one’s behavior and thus may end up leaving out some important issues (Carter & McGoldrick, 2005). This means that the therapy designed for the treatment of the issues at hand may fail to cause an overhaul change in the behavior that is targeted. This is unlike in other methods such as the multimodal assessment which takes into account a wide range of cognitive factors. The method also fails to provide an operational manner of answering the constant question: what or who is most suitable for the client. Unlike with other methods, tools such as genogram used in qualitative assessment of family history provides the therapist with an opportunity to link the relationships and events in Jeff and Rogers case to the reported individual merimoies and which are of great importance in deriving objective facts as a persons interpretation of present events is influenced by memories. This is because qualitative tools particularly the genogram depicts dates, describes an evolved context regarding the family history and relationships and gives a sequence of significant nodal events (Joan & Harry, 2007). All this provides a clear picture from which family problems can easily be derived by the therapist. More over, the genogram can be used to identify other systems and community interacting with the family and also culture, rituals and beliefs as the aspect of cultural diversity affects all people thus enabling therapists to be sensitive to the extents of cultural practice. Qualitative methods are also useful in helping the therapist to chart a family’s uniqueness as pertains to diverse family relationships and forms thus improving the effectiveness and accurateness of handling therapy sessions. According to Corey (1996), the genogram, being a qualitative assessment method, is widely and extensively used by family therapists to evaluate family dynamics that are either focused on certain issues or are general. Thus the tool is of paramount importance in consultation with its value residing in both subjective and objective assessment together with the collaborative development of a history map for the client’s family. The assessment for Jeff and Roger’s situation would involve questions such as: What patterns are there for time together, and how does the structured family life facilitate spending of time together? Is communication between the two open, direct and congruent? Are there strong kinship attachments and parental coalitions; is there both emotional and physical attunement and closeness between the two? Does the family system encourage uniqueness as regards to individuals, the understanding for an individual’s needs and motives, and know if they show concern of each other’s happiness and well being. What degree of security, encouragement and support is provided by each to the other, what are the marriage patterns in the family, the circumstances prompting these patterns and what are the resultant stresses following these patterns? The line of questioning is based on the fact that the therapist would be addressing a case that relates to attachment issues. Hence, this line of reasoning should be based on attachment theory which according to Cassidy (2004) attachment theory is a psychological theory whose concern is development of relationship between humans. Its applicability in this case is on how Roger would develop relationship with the care giver who in this case is both of his parents for emotional and social development. Jeff did separate with his drug using wife when Roger was only six years and by then, Roger hardly had the slightest idea of her mother’s conditions to be able to let go. This impacted negatively on the attachment between Roger and his mother since they were separated from each other. According to Bost Et al. (2006) separation of parents has negative psychological effects to the children hence for recovery it is therefore important to know the structured family life if it facilitate spending time together. This line of questioning would thus try to assess the level of kinship relationship between Jeff and Roger, the extent of concern for individual feelings, well being and happiness. Thus, the therapist would have an opportunity to identify and evaluate the cause of the relationship problems so as to develop a therapy that would address both sides of the matter. That is, both on Jeff’s side and Roger’s side. Identifying the facts to the issues addressed by the questions would be of paramount importance in the event of assessing who or what is the most appropriate remedy for each individual. The evaluation of parental coalitions and marriage patterns would help in identifying the relevance of Rogers’s mother in the family and help in weighing out options to mend the situation without necessarily generating fresh rows between the parties. Basing on the attachment theory as illustrated by Nichols & Schwartz (2008), people develop behavioral and psychological problems following disruptions, disturbance or deprivation in care giving relationships early in life and in family representation of others, self and relationships. These representations are considered to guide thoughts, feelings and expectations for relationships later in life. The attachment theory stipulates that young people are attached to their care givers who provide comfort, emotional security and protection (Hardy & Laszloff, 2001). This question line would thus work to establish the effect that Roger’s deprivation of his care giver (the mother) has had on his behavior and psychology. The question line would thus stress the propensity for Roger to be in a closer relationship with his mother in his life span. In Roger’s case, many years of his mother’s absence, creates a vacuum as regards to this propensity and hence his behavioral change. Through such an approach the matter would then be handled form the right perspective and hence the best solution established. Among the various therapies available for solving relationship and psychological issues, operant conditioning is the most suitable to iron out the issue affecting Jeff and Roger. Other therapies such as modeling or counter conditioning do not address the problem from the right approach. Emulating another person’s behavior as in the modeling therapy or changing responses as in counter conditioning therapy, would not change the internal issues presenting the problem (Haley & Richeport, 2007). With the operant conditioning therapy, both Jeff and Rogers would be required to change their behavior and the therapist then monitors this progress. In the case of Roger, the therapist can employ the use of token economies (objects that have no worth) to reward Roger for good behavior change and these tokens can be exchanged for some other valuable thing in the future. Operant conditioning is a technique of behavioral contracting whereby the therapist establishes a contract that stipulates the behavior and responsibilities expected to be met by both parties (Nichols & Schwartz, 2008). The contract would further oblige both Jeff and Rogers to uphold to the terms of the contract. The therapist then keeps record of behavior change of the two to asses the effectiveness of this therapy. This method is very applicable in the situation at hand since it involves behavioral change in that both Jeff and Rogers will have to change their attitudes and hence their behavior as regards to their relationship. To strengthen this therapy, specific parenting strategies would be crucial in helping Jeff to change his attitude towards his son and thus be able to ensure him more support and security. The parenting strategies will require Jeff to change his approach to the matters involving his control over Roger so as to make the operant conditioning therapy wok effectively on Rogers. There is a shortcoming in that both or one of the parties may fail or may be slow to adapt to the therapy due to one or more reasons. For instance operant conditioning may not be as effective on Jeff as is on Rogers. It’s the simplest and easiest though to adopt for such situations as others such as behavioral activation may take long to address the very causes of the problem (Sprenkle & Bischof, 2005). The family therapist can use the second ordered approach in changing the communication patterns between Jeff and Roger. Jeff presumes to have ‘entire’ control over Rogers’s life and thus tends to ignore his son’s feelings thus denying him a chance to express him self freely and this has impacted on his behavior negatively. With an understanding of the recursive and indivisible status of their relationship with the family, the therapist can use this understanding to effect a collaborative therapeutic system rather than establish a hierarchical one that would change the family structure or individuals. Thus he/she can implement changes or specify certain procedures that would need to be adopted by either so as to improve the means of communicating between the two. Through the various therapy sessions, the therapist is able to derive the faults in the communication methods in the family and since he/her being a professional understands the pattern better, it is best to use the second ordered change where both Jeff and Roger would be introduced to communication techniques such as nonjudgmental brainstorming, feelings reflection or even expressing feelings in turns (Haley & Richeport, 2007). Unlike other methods like family sculpting which provide for the family system recreation through a family’s physical arrangement, second ordered techniques are easily and strategically tailored to change communication pattern as best understood by the therapist. Second ordered changes thus are easy to implement and can be easily evaluated to assess their effectiveness (Joan & Apponte, 2007). References Aponte, J., Harry. (2002). The Cornerstone Of Therapy: The Person Of The Therapist. The Family Therapy Networker, March-April, 6(2), 19-21. Bost M., Barumandzadeh T & Poussin G. (2006). Psychological Effects of Parental Separation on Children. Archives of Pediatrics. 4(9), 886-892. Carter, B & McGoldrick, M. (2005). The Expanded Family Life Cycle. Boston: Allyn & Bacon. Cassidy, J. (2004). The Nature f a Child's Ties. New York: Guilford Publishers Corey, G. (2006). Theory and Practice of Counseling and Psychotherapy. California: Brooks/Cole Publishing Company. Hardy, K., V & Laszloff, T., A. (2001). The Cultural Genogram: Key to Training Culturally Competent Family Therapists. Journal of Marital and Family Therapy. 21(7), 227-38. Haley, J & Richeport-Haley, M. (2007). Directive Family Therapy. New York: Haworth Press, Joan, E, Winter & Harry, Apponte. (2007). The Person And Practice Of The Therapist. Journal of Psychotherapy and the Family. Spring, 3, 85-111. Nichols, M & Schwartz, R. (2008). Family therapy: Concepts & Methods. Boston: Allyn & Bacon. Sprenkle, D.H & Bischof, G.P. (2005). Contemporary Family Therapy in the United States’. Journal of Family Therapy. 16(1): 5-23(19) Read More