Introduction
Case conceptualization is a common technique utilized by family therapists supporting the structural family therapy approach. Salvador Minuchin and colleagues initially developed the method to explain “how families maintain problematic behaviors while also providing direction for how to intervene in the family system” (Reiter, 2016, p. 25). Structural family therapy divides families into subsystems and gradually restructures family organization to create functional interaction patterns (Reiter, 2016). The present paper offers an example of case conceptualization of a family presented in the video “A House Divided: Structural Therapy with a Black Family” by Harry Aponte (n.d.).
Family Background
The present paper focuses on the family of three, including the father of the family, Carl, the mother of the family, Rosalind, and their ten-year-old son. The initial concern of the parents was the fact that their son was caught stealing in the store. The clients are a middle-class African American family, and the child is not known to have any mental or health conditions. Carl communicates neither with the child nor with Rosalind regarding the upbringing of their child. The relationship between father and child is restricted to occasional punishments for inappropriate behavior. Rosalind tries her best to develop positive values in the child; however, she fails to do so.
Conceptualization of the Family
The family members are disengaged interpersonally and experience pressure due to legal problems after their child was caught stealing from a store. According to Reiter (2016), a case should be conceptualized using the 6P technique, which is problem, process, pattern, proximity, power, and possibility. The central problem is that the parents prefer to live separate lives and display repetitive dysfunctional behavioral patterns that negatively affect the psychological well-being of the child.
The family process is also dysfunctional in terms of upbringing the child, as the parents do not share their concerns about the child’s behavior and do not have a shared set of values that would guide decision-making. As for patterns, the parents tend to punish the child for misbehavior rather than addressing the core of the problem. When speaking of proximity, the family members are distant from each other and rarely realize themselves as members of the family. As for power, it is not shared by the parents for functional relationships with their child. Instead, the father of the family holds all the power, and the mother subdues to him while the child rebels.
However, the family has many possibilities for improvement, as the child is very open, and the parents have a deep affection for him. The family members are capable of self-reflection and do not appear to be hostile to the therapist. They do not seem pessimistic about the therapy and actively engage in communication with the therapist. The child can be considered demanding. Carl is under-functioning while Rosalind is over-functioning.
Process of Treatment
In order to treat the family, the therapist allows the family members to look at the situation from another angle. According to Gladding (2015), the central belief associated with the structural family therapy approach is that symptoms are best understood when rooted in the family transaction pattern. Therefore, Aponte (n.d.) shifts the attention of the child’s misbehavior to the relationships between the parents. Aponte suggests that the central reason for the unwanted behavior of the child is the lack of alliance between the parents, which makes the parental subsystem dysfunctional.
The therapist switches roles from an observer to an active expert to warm the relationships between the spouses by joining the discussion. As a result, Rosalind notes that her husband has never talked so much before, and the session was revealing. Aponte (n.d.) focuses the attention of the parents on the strengths of the couple by suggesting that they are both strong people, and they can be much better parents if they start talking to each other.
The therapist also restructures the relationships between the child and each of the parents. According to Gladding (2015), reframing is a different interpretation of a family’s situation or behavior. In other words, Aponte (n.d.) explains that the dysfunctional relationships between the child’s parents are the reason for the child’s misbehavior and not vice versa.
After the session, Aponte (n.d.) insists that further interventions should utilize the joining techniques. In this case, therapists needed to gain the trust of the family members and gradually restructure the relationships inside the family. Such an approach is expected to help family members to relate to each other in a more functional way. The effect can be multiplied by assigning homework to the family members to emphasize action over insight.
Conclusion
Structural family therapy is an effective approach to family therapy as it helps to define family as a structure and examine the relationships between its constituencies. Case conceptualization helps to acquire a bird’s eye view of the situation and describe the situation in the family using concepts and terms of a theoretical approach. Case conceptualization of the family observed in the video helps to gain valuable insights about the structural approach to family therapy and how it can be applied in practice.
References
Aponte, H. (n.d.). A house divided: Structural therapy with a black family. Psychotherapy. Web.
Gladding, S. (2015). Family therapy: History, theory, and practice. Pearson.
Reiter, M. D. (2016). A quick guide to case conceptualization in structural family therapy. Journal of Systemic Therapies, 35(2), 25–37.