The Bowenian therapy
At first, it is possible to speak about the application of the Bowenian approach. This model is based on the assumption that a counselor should increase a client’s differentiation.
In other words, this individual should be able to distinguish his/her own identity from the identities other family members (Ziegler, 20005, p. 80).
This concept can be relevant to Ellen who becomes vulnerable to stress because she associates herself too closely with the feelings and emotional problem of her relatives. However, this behavior eventually poses a threat to her emotional wellbeing and socialization.
This form of therapy includes several techniques that can throw light on the origins of emotional problems faced the family of Grace Brown.
First of all, a Bowenian therapist would construct a genogram of this family. It should be based on information collected during the interviews.
This chart should depict genealogical relations, communications patterns within a multigenerational family, or emotional alienation (Rasheed, 2010, p. 193).
This method of analyzing information can give many valuable insights to a therapist. In particular, it can show that emotional alienation and suicidal ideations are the problems that affected several generations of this family.
For instance, one can mention that Ellen’s grandmother made a suicide attempt. Moreover, her biological father Nick was more attached to his mother, rather than father. To some degree, this behavior is displayed by Ellen.
Additionally, this technique is helpful for measuring the degree of differentiation or fusion within a family. While collecting and analyzing information, a Bowenian therapist should understand Ellen’s emotional relations with other family members.
In this case, one should speak about such a problem as emotional cutoff. The Bowenian therapy implies that very often people try to resolve their emotional conflicts with relatives by reducing or avoiding any contacts with these people (Goldberg, 1990, p. 293).
This is one of the behavioral strategies that Ellen adopts when she distances herself from her stepfather, Henry. Yet, other family members also act in this way. In particular, one can mention Grace and her brother Ted.
The main problem is that these individuals are not able to identify and resolve their tensions (Goldberg, 1990, p. 293). Overall, one can say that the collection and analysis of data can be regarded as critical components of the Bowenian therapy.
Apart from, the Bowenian therapy includes such a technique as taking an “I” position. (Rasheed, 2010, p. 199). The main peculiarity of this intervention is that a therapist objectively expresses his/her opinions about the family without criticizing or supporting some family members.
He/she does not get involved into the emotional conflict. For instance, a Bowenian therapist may argue that Ellen seeks a person who can play the role of a father. Yet, Nick does not call her often enough, while Henry is not willing to be an authority figure for this child.
This is why this child accepts the idea of suicide. The adoption of such a strategy can make a therapist unpopular among some family members (Rasheed, 2010, p. 199). However, this approach is useful for identifying the most urgent problems that should be addressed during therapy sessions.
This intervention can be implemented at the time, when a therapist has collected and analyzed relevant information about the family. Moreover, a counselor should make sure that his/her arguments do not resemble an accusation.
One can say that this intervention involves such a process as de-triangulation (Ziegler, 20005, p. 94). This means that people, who may have some disagreement, are encouraged to respond to each other’s concerns without asking a third person to act as a referee (Ziegler, 20005, p. 94).
For example, Henry should suppose that Grace can always act as mediator between Ellen and him. Such an attitude is not compatible with effective parenting strategies. This is one of the issues that should be considered by a therapist.
Furthermore, the practitioners of the Bowenian therapy lay stress on the importance of role playing. They encourage clients to act out various situations during which they experience emotional distress (Rasheed, 2010). This intervention can be relevant to the needs of these household.
For, a counselor may prompt Grace and Henry to act the situations when they have to demonstrate their parenting skills. At this point, a therapist can modify some of the behaviors than they displays. In this way, a counselor can help this family develop more effective methods of conflict resolution.
For instance, he/she should urge the relatives to communicate more with Ellen. This argument is particularly relevant if one speaks about Nick who does not call Ellen often enough.
He should keep in mind at this point, Ellen is too dependent on her mother, and it is difficult for her to live without the support of a father figure.
This is one of the details that should be singled out because it can be useful for explaining her experiences. Thus, role playing can be an effective intervention.
Apart from that, this model includes such techniques as letter and journal writing. It is possible to ask a client to write about his/her daily experiences (Rasheed, 2010, p. 199). The main advantage of this method is that a counselor can better evaluate a person’s reaction to therapy.
For instance, it is possible to ask Ellen to write such a journal because in this way, a therapist can learn more about the attitudes of this child. Moreover, journaling can help Ellen formulate her major requirements for her relatives.
Furthermore, journaling can benefit other people such as Grace who should also reflect on her experiences and interactions with close and distant relatives. These are the main benefits of this intervention.
Additionally, it is important to speak about such an activity as coaching. At this stage, a therapist should explain how clients may resolve their emotional conflicts. The main task of a counselor is to help clients anticipate possible challenges that they can encounter in the future (Rasheed, 2010).
This intervention can also be applicable to the needs of this family. In particular, it is necessary to describe the parenting strategies that Grace and Henry should adopt while interacting with Ellen and her stepbrother Todd.
Grace and Henry should demonstrate that they are equally attached to both children. Their failure to display this attachment can be underlying cause of her alienation and suicidal thoughts. On the whole, these people should place themselves in Ellen’s position.
In this way, they can understand why their daughter remains distant from them and even her peers. Thus, a therapist should clearly communicate these ideas to the parents. This is one of the main goals that should be achieved by a counselor.
Finally, it is possible to discuss the so-called Bowenian conference.
At this stage, a therapist should encourage family members to express their concerns or opinions about the behavior of other family members. For example, Ellen may speak about the roles that Grace, Henry, and Nick should play.
Secondly, Grace may air her views about her needs as a wife and a mother. It should be kept in mind that the recommendations or suggestions made during the Bowenian conference should not be regarded as imperatives.
However, they can be viewed as a roadmap that family members can use in the future (Rasheed, 2010, p. 201). It should be kept in mind that the participants should not immediately express their agreements or disagreement with the opinions of others (Rasheed, 2010, p. 201).
Instead, they need to think about the experiences of their relatives. At this point, a therapist should reduce the risk of mutual accusations because they are not likely to benefit the participants.
This is one of the limitations that should not be disregarded. Yet, one can say that this technique is critical for promoting empathy.
These examples suggest that this form of therapy can benefit Ellen and other members of the family. It is possible to say that by using the principles of this model, a counselor can help them resolve various emotional problems. In particular, these people can become more autonomous.
Moreover, various interventions can eliminate the risk of suicidal ideations. The main advantage of this model is that it can people identify and resolve conflicts, instead of avoiding them. This is why this approach can be considered by a counselor who works with this family.
Narrative Therapy
It is possible to apply other models of therapy. For instance, one can speak about such an approach as narrative family therapy. This approach is premised on the idea that there are no objective standards according to which reality should be evaluated.
Instead, it is necessary to examine the subjective perceptions that are constructed through language (Bitter, 2010, p. 497). Moreover, a therapist should pay attention to way in which people portray themselves and others through their narratives.
Therefore, it is critical to focus on the stories that Ellen, Grace, Nick, or Henry can provide. It is quite possible that they can offer different interpretations of the same events.
Additionally, a therapist should pay attention to the way in which these people portray their close and distant relatives. These are the main aspects of this approach. Thus, one should discuss the specific techniques that be applied.
A supporter of narrative therapy can implement several interventions. First, a counselor should try to externalize a certain problem (Gabbard, 2007, p. 750). In other words, he/she should emphasize the idea that certain difficulties or negative feelings should not be attributed to some in-born characteristics of a person (Gabbard, 2007, p. 750).
This externalization means that a problem can be resolved or removed (Gabbard, 2007, p. 750). For instance, a therapist may show to Henry that Ellen is not an alienated and troubled girl.
Instead, this professional should emphasize that she suffers from alienation and anxiety because she passes through a difficult period in her life. In this case, the use of different words can eventually change people’s attitudes towards one another. This is one of the points that can be made.
To a great extent, this intervention is necessary to demonstrate that these suicidal ideations can be effectively addressed provided that parents improve their parenting strategies. Additionally, a therapist should pay attention to the way in which family members describe each other.
For instance, from Henry’s perspective, Grace is often high-sprung. Instead, a counselor should urge Henry to remember she is just a person who can be affected by anxiety due to some reasons.
She is extremely concerned about the wellbeing of her family, and these thoughts increase her nervousness. However, one should not suppose that she is always nervous.
Additionally, it is vital to demonstrate to Ellen that she is not a bad person who has no reason to live.
Instead, a therapist should emphasize that her depression is just the result of external problems; however, Ellen should not be overwhelmed by this feeling because it can prevent her from enjoying her life. This is the most important issues that should be addressed.
On the whole, the externalization of a problem is important for changing the perceptions and attitudes of family members. It is the first step that each of the clients should take in order to reduce the impact of traumatic experiences on a person. This is one of the arguments that can be advanced.
Furthermore, it is important to speak about such a technique as the deconstruction of a problem. In other words, a therapist should encourage a client to explain the specific aspects of the problems that he/she experiences (Bitter, 2010, p. 497).
It is much easier to view an emotional problem as a set of experiences that have certain causes. In this way, a therapist can demonstrate that the challenges faced by the family are more manageable (Bitter, 2010, p. 497).
For example, both parents agree on the idea that Ellen is too dependent on her mother. However, the statement is too generalized because it does not describe the specific instances that explain her dependence.
For instance, this girl may act in this way because she cannot rely on Henry’s support and encouragement. Additionally, her biological father does not talk to her on a regular basis. Thus, a counselor can encourage parents to discuss Ellen’s behavior in greater detail.
Much attention should be paid to the emotional experiences of Ellen. It is vital to understand why this girl believes that she is not a good person. Such a view can produce disastrous effects on a person. In turn, a therapist should identify situations when such thoughts overwhelm her.
This information is critical for reducing various risks. Furthermore, one should find out why she chose to write a suicide note. It is possible that in this way, she attempted to raise parents’ awareness about her problems. Yet, this is just a hypothesis that should be verified.
Overall, by deconstructing Ellen’s experiences, a counselor may understand the origins of her behavior. So, this intervention is critical component of this therapy. Yet, a therapist should not force responses from clients.
So, these are the main pitfalls that should be avoided because a counselor should make sure that he/she does not misinterprets the experiences of family members. Instead, this professional should prompt them to create their narratives freely.
Moreover, a therapist should focus on the way in which family members can describe the most important events in the life of the family. In many cases, their accounts can differ significantly from one another (Bitter, 2010, p. 497).
Therefore, a counselor should ask Grace, Henry, and Ellen to describe any disagreement that they could have. By examining their depictions of possible emotional conflicts, a therapist can understand the relations within a family.
Moreover, a counselor may ask Ellen and Nick to describe their relations with one another. Nick should see that his daughter wants to communicate with him. The main benefit of this intervention is that it helps people to empathize with one another (Bitter, 2010, p. 497).
They must see that the same event can be examined from various perspectives and it is difficult to find a single interpretation of any conflict. So, this technique is an important part of narrative therapy since family members gain a better idea about the attitudes and values of the close relatives.
Moreover, in this way, they can identify the shortcomings of their behavior. So, a therapist should help them to achieve this transformation during the therapy sessions.
Additionally, a therapist should prompt clients to think about the positive events that produced a strong impression on them. Therefore, the main task is to attract people’s attention to those experiences that they find most enjoyable.
For example, a therapist may ask Ellen whether she likes anything in Henry’s behavior. By acting in this way, one can make this girl less restraint and alienated from Henry. Furthermore, a counselor should prompt Ellen to speak about the most joyful moments in the life of her family.
This approach is useful for promoting the positive attitudes of the child. At this stage, a counselor should assist a client in identifying the so-called unique outcomes or those events and feelings that contradict the depressing thoughts of an individual (Gabbard, 2007, p. 750).
If one can cope with this task, it is possible to eliminate suicidal ideations. However, this goal can be effectively achieved provided that Grace and Henry adopt effective parenting strategies.
So, they are primarily responsible for Ellen’s emotional well-being. This is the main point that they should keep in mind.
Finally, a narrative therapy is aimed at constructing a positive story that can increase people’s attachment to one another. Very often, relatives are asked to create an idealized version of their family.
Similar, Grace, Ellen, Henry and Todd may be encouraged to describe the expectations that they set for each other. Certainly, it is possible that clients may not necessary meet the expectations of each other.
However, this positive narrative can remind these people of the things that they value most. Overall, the interventions which have been described can strengthen the internal cohesion of this family. Moreover, they can elaborate people’s skills that can be used to address various emotional conflicts.
This discussion shows that the narrative family therapy can be a useful approach to various problems within a family. By examining the individual stories of family members, a counselor may better understand the nature of different emotional conflicts among close and distant relatives.
Furthermore, this model is useful for describing and changing their perceptions of each other. The model can be applied if a therapist can interview each of the clients.
Ethical considerations of the case and the chosen theories
When working on this case, a therapist should take into account various ethical issues that should be addressed. One of them is related to the confidentiality of information that will be collected and recorded.
For instance, one can mention the data about people’s mental problems, employment, drug abuse, family relations and so forth. Thus, a therapist must make sure that these records are not used by unauthorized third parties.
This task is critical for safeguarding the rights of clients who put their trust in family counselors. So, this is one of the issues that should be addressed during the therapy. There is another ethical question that should be considered.
The family, which has been described in this case study, faces a variety of problems, for example, conflicts between spouses, low self-esteem, and alienation of some people.
However, one should concentrate primarily on Ellen’s suicidal ideations since this is the most imminent threat that should be lifted.
Thus, a counselor should make sure that the life of this girl is not endangered, even if he/she can enter into a conflict with other family members such as Henry, Grace, or Nick. This is one of the details that can be identified.
Apart from that, there is always a risk that children can be physically or sexually abused. Certainly, the probability of this event is not very high.
Provided that a counselor sees the evidence of abuse, he/she should report this case to the police because the wellbeing of a child is the top priority for this professional. Finally, it is important to obtain the informed consent of clients.
These people should be informed about the main interventions or the way in which the information will be used. These ethical principles should guide the work of a therapist.
To a great extent, these rules can always remain relevant, even though a counselor can choose different approaches. These are the main details that can be singled out.
Additionally, it is important to examine the ethical peculiarities of the theories that have been examined in this paper. First of all, the Bowenian therapy lays stress on the impartiality of a counselor.
The main problem is that an individual can involuntarily emphasize with some of the family members. This is one of the ethical challenges that a person should be aware of, if he/she chooses the Bowenian therapy.
By taking the so-called “I” position, a therapist can increase his/her impartiality. Without this objectivity, an individual cannot provide valuable recommendations to the family members.
Apart from that, a counselor should remember that clients may not necessarily agree with one another, even at the end of the therapy. Some of these people may still believe that their needs are overlooked by their relatives.
This is why these professional must not guarantee that clients will achieve complete reconciliation. Such a promise may not be always fulfilled. This is one of the aspects that can be distinguished.
Furthermore, the supporters of the Bowenian approach should end the therapy sessions provided that he/she is not allowed to obtain relevant information about the family. One should bear in mind that data collection is a vital element of the Bowenian therapy.
At the very beginning, a counselor should construct a genogram that is essential for identifying the most important problem. A continuation of the therapy without accurate and relevant data can be viewed as a violation of the ethical principles.
To a great extent, this behavior can be compared to negligence. This is one of the details that should be singled out since it is important for understanding the strategies of a Bowenian therapist.
Moreover, it is important to discuss the ethical issues related to the narrative therapy. To some degree, this method is aimed at raising a person’s self-esteem. This individual should not believe that he/she has some serious flaws that cannot be removed or minimized.
This is one of the main objectives that should be attained. Nevertheless, a therapist should make sure that a client is able to avoid wishful thinking or even delusions of grandeur. In the course of the family therapy, people should construct collective stories that they can share.
However, these stories must not involve deception. A counselor should keep in mind that this worldview can result in dire consequences for a client, especially when he/she sees that the objective reality significantly contradicts his perceptions of oneself.
This is why this issue should not be disregarded. Furthermore, a therapist interprets the narratives offered by clients. Therefore, this professional should reduce the risks of prejudices and stereotypes because they can profoundly influence the attitudes and behavior of a client.
This is one of the main pitfalls that should be avoided during the sessions. These examples show that a counselor should consider the peculiarities of a certain theory in order to ensure that the interests of clients are not endangered. These are the main points that can be made.
Appendix
Reference List
Bitter, J. (2010).Theory and Practice of Family Therapy and Counseling. New York, NY: Cengage Learning.
Gabbard, G. (2007). Gabbard’s Treatments of Psychiatric Disorders. New York, NY: American Psychiatric Publications.
Goldberg, J. (1990). The Psychotherapeutic Treatment of Cancer Patients. New York, NY: Transaction Publishers.
Rasheed, M. (2010). Family Therapy: Models and Techniques. New York, NY: SAGE.
Ziegler, S. (2005). Theory-Directed Nursing Practice: Second Edition. New York, NY: Springer Publishing Company.