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Systemic Case Conceptualization For use with individual, couple, or family clients Date: 4/25/ Clinician: Courtney Morgan Client/Case #: Munez Family I. Introduction to Client & Significant Others List persons who will regularly participate in sessions
Adult 1 Gender: Male Age: 38 Ethnicity: Argentinian Relational Status: Married heterosexual Occupation: Healthcare Administrator Other identifier: Does not apply Adult 2 Gender: Female Age: 36 Ethnicity: Argentinian Relational Status: Married heterosexual Occupation: Stay at home mom Other identifier: Does not apply Child 1 Gender: Male Age: 15 Ethnicity: Argentinian Grade: 9th School: San Diego Met High School Other identifier: Does not apply Child 2 Gender: Female Age: 12 Ethnicity: Argentinian Grade: 6th School: Mesa Verde Middle School Other identifier: Does not apply Others Participating in Sessions Regularly: Felipe, Martina, Liam, and Emilia
II. Presenting Concern(s) Client’s Description(s) of Problem(s): Adult One: The adult male gets easily angered at the male child. When the adult male is angry at male child, he tells male child how he is unappreciative and throwing his life away. Adult male has also been consistently arguing with adult female due to their parenting style differences creating tension in the home. Adult Two: The adult female is worried about male child due to his behavioral issues and that he is withdrawing from others. Adult female tries to spend more time with male child. Adult female feels like her husband is being too strict on male child. Child One: The male child feels like his parents do not give him enough freedom. Male child has tried to gain a little more independence and his parents would not allow that. Male child has recently not been completing homework and at times is not turning in homework. Male child is struggling with academics as his grades are slipping. Male child has recently started ignoring curfew and coming home late. Child Two: The female child has been feeling a little bit left out due to her parents focusing a lot on her brother.
Extended Family Description(s) of Problems: Adult Male does not have a relationship with his parents. Adult female feels judged by her parents and that nothing she does makes them happy with her. Adult female is not close with her parents, but they are civil with each other. Adult female’s mother had a substance use issue when adult female was growing up. Adult male’s father had a substance use issue when adult male was growing up. The biological mother of male and female child has been accused of physical abuse and neglect as well as substance use.
Broader System Problem Descriptions: Description of problem from referring party, teachers, relatives, legal system, etc.: The family was referred by the male child’s high school guidance counselor due to male child’s change in his academic performance.
III. Background Information Trauma/Abuse History (recent and past): Adult male grew up in poverty in Argentina. He was forced to quit school in order to start working to provide for his family. Adult male married adult female and they immigrated to the United States at a young age. Adult female does not have a close relationship with parents, but they are civil. Adult female was sent off to a private boarding school and was kicked out in the eleventh grade. The male and female child were adopted by adult male and adult female after being taken from biological mother due to physical abuse, neglect, and substance use.
Spiritual: The family have been discussing find a church to attend. There have been disagreements between adult male and adult female. Diversity: Resources and Limitations Identify potential resources and limitations available to clients based on their age, gender, sexual orientation, cultural background, socio-economic status, religion, regional community, language, family background, family configuration, abilities, etc. Unique Resources: The family is not connected with many community resources.
Potential Limitations: The family does not have any support from their extended family. The adult male does not have a relationship with parents and adult female is not close with her parents either. They have a lack of a support system.
V. Family Structure Family Life Cycle Stage (Check all that apply) Single adult Committed Couple Family with Young Children Family with Adolescent Children Divorce Blended Family Launching Children Later Life Describe struggles with mastering developmental tasks in one or more of these stages: The adult male and adult female struggle with allowing male child more freedom and independence. The adult male and adult female have differing parenting styles. Adult male and adult female need to find ways to work better together to provide healthy growth and development for both male and female child.
Typical style for regulating closeness and distance in couple/family: The adult male has a more strict, rigid relationship with the children. Adult female has a more relaxed, nurturing relationship with the children.
Boundaries with/between Primary Couple Enmeshed Clear Disengaged NA Description/example: The adult male is not considerate of adult female’s opinions in regard to parenting style and religious decisions. Adult male believes his parenting style is more effective in teaching the male child discipline. Adult male works about fifty hours weekly therefore he is away from home more. There is a lack of quality time between adult male and adult female. Adult 1 & Children Adult male rigid boundaries with male and female child. Adult male feels that this is the way to Enmeshed Clear Disengaged NA Description/example: teach male child from continuing to try and throw his life away. Adult 2 & Children Enmeshed Clear Disengaged NA Description/example: Adult female has close relationship with both children. Adult female is considerate with male child due to his past trauma.
Siblings Enmeshed Clear Disengaged NA Description/example: The children have clear boundaries with each other. They have a close relationship due to being close in age. Extended Family Enmeshed Clear Disengaged NA Description/example: The Munez family is not considerably close with their extended families due to substance use issues. Friends/Peers/Others Adult male and adult female do not have many friends and no connection with extended family. Enmeshed Clear Disengaged NA Description/example: Male and female child have many close friendships and connections.
Triangles/Coalitions Cross-generational coalitions: Describe: The adult female, and male child feel that the adult male is the reason for the tension and arguments in the home which have resulted in change in behaviors with male child. Coalitions with family of origin: Describe: Other coalitions: Hierarchy between Parents and Children NA
caused more concerns. Male child blames adult male due to lack of freedom and independence causing more behavioral concerns. Female child tries to avoid any conflict with the family.
Gottman’s Divorce Indicators NA is Partner 1; is Partner 2 Criticism Partner Partner 1: Partner 2: Describe: Adult male believes adult female is too lenient. Adult female believes adult male is too strict. Defensiveness Partner Partner 1: Partner 2: Describe: Adult male and adult female criticize each other’s parenting styles. Adult male believes his parenting style is the only way to raise children.
Contempt Partner Partner 1: Partner 2: Describe: Adult male believes that his parenting style is the only way for the children to learn discipline and be successful. Stonewalling Partner Partner 1: Partner 2: Describe: Does not apply. Failed repair attempts Partner 1: Partner 2: Describe: Adult female has made attempts to make things better. The adult male denies any attempts the adult female makes. Not accept Influence Partner 1: Partner 2: Describe: Adult male is less likely to be influenced to raise his children any differently. Harsh start up Partner a difficult upbringing which is currently affecting how they raise their children. Partner 1: Partner 2: Describe: Adult male and adult female had
VI. Interactional Patterns Problem Interaction Pattern Start of tension: The tension in the family started when the male child began having behavioral (A B): issues. Adult male and adult female had conflicting views on how to help male child.
Conflict/symptom escalation: Disagreements between adult male and adult female on how to help male child began to cause more tension. Adult male is more concerned with the children learning clear boundaries and being held accountable. Adult female is more concerned with how to help the children with things that they are struggling with.
Return to “normal”/homeostasis: Adult male and adult female must learn to communicate with each other better and be able to set clear boundaries that they are both in agreement with to promote positive growth and development. The family as a whole will listen to each other’s viewpoints in order to better understand each other. The adult male and adult female will learn to take each other’s thoughts and opinions into consideration in regard to how to raise their children and find a church for the family to attend.
Hypothesized homeostatic function of presenting problem: How might the symptom serve to maintain connection, create independence/distance, establish influence, reestablish connection, or otherwise help create a sense of balance in the family? The family will build a stronger bond with each other and feel safe discussing how they are feeling about things without the fear of an argument starting up. VII. Intergenerational & Attachment Patterns Construct a family genogram and include all relevant information including: Names, ages, and birth/death dates Relational patternsOccupations Psychiatric disorders and alcohol/substance abuse Abuse history Personality adjectives Genogram should be attached to report. Summarize key findings below. Substance/Alcohol Abuse: NA History: Currently none of the family members struggle with substance use. There is a family history of substance use. The adult male, adult female, male child, and female child have a history of family members that struggled with addiction during their childhood ultimately affecting them all.
Sexual/Physical/Emotional Abuse: NA History: Adult male suffered from emotional abuse as a result of taking on adult responsibilities as a child. Adult female also suffered from emotional abuse due to being kicked out of a private boarding school. Male and female child suffered physical abuse and neglect during their childhood from biological mother.
Parent/Child Relations: NA History: Adult male did not have a close relationship with his father. Adult female did not have a close relationship with her parents growing up and they still are not close. Male and female child no longer have a relationship with biological mother. Male child has a strained relationship with adult male due to his behaviors.
Physical/Mental Disorders: NA History: Currently none of the family has any mental or physical disorders but adult female has feelings of anxiety. History Related to Presenting Problem: NA History: The Munez family has a history related to the presenting problem. The male child’s current behavioral issues is the reason the
Miracle Question Answer: If the problem were to be resolved overnight, what would client be doing differently the next day? (Describe in terms of doing X rather than not doing Y).
- The family would take time to hear out how each family member feels about different situations.
- The family would have a healthy safe relationship with each other.
- The family would communicate in healthier ways other than belittling each other. IX. Postmodern and Cultural Discourse Conceptualization Dominant Discourses informing definition of problem: Ethnic, Class and Religious Discourses: How do key cultural discourses inform what is perceived as a problem and the possible solutions? The Munez family is looking for a support system within the religious community. Finding a support system within the religious community could improve their relationships and help them in learning appropriate ways to discuss feelings and emotions.
Gender and Sexuality Discourses: How do the gender/sexual discourses inform what is perceived as a problem and the possible solutions? This has not been determined to be an issue. Community, School, and Extended Family Discourses: How do other important community discourses inform what is perceived as a problem and the possible solutions? The male child’s behavior at school has been affecting his family interactions and relationships. The male child’s teachers and high school guidance counselor are concerned about his behavior and how his behavior might impact his future.
Identity Narratives : How has the problem shaped each client’s identity? The male child’s behavior has caused the parents to question their parenting styles which has caused conflict between the parents. Both parents want what is best for their children and family, but they have conflicting parenting styles.
Local or Preferred Discourses: What is the client’s preferred identity narrative and/or narrative about the problem? Are there local (alternative) discourses about the problem that are preferred? There is little information regarding personal truths at this time. X. Client Perspectives Areas of Agreement: do they agree with or are likely to agree with? Based on what the client(s) has(ve) said, what parts of the above assessment
The adult male and adult female are likely to agree that participating in family therapy will be beneficial for the family. Both the adult male and adult female understand the trauma experienced by both their male and female child. Both adult male and adult female are likely to agree to participate in parenting classes so that they can develop healthy relationships, learn coping skills, and learn how to effectively communicate in order to better things for their family. Areas of Disagreement: What parts do they disagree with or are likely to disagree with? Why? The adult female may not agree that the male child’s behavior as him being disrespectful but more as a response to him trauma history. The adult male may not agree that the male child’s behavior is a response to his trauma history due to his time already spent in therapy and would say it is him being disrespectful. How do you plan to respectfully work with areas of potential disagreement? As a therapist working with the Munez family, the therapist would develop a healthy relationship with each member of the family and help them work together to develop a health relationship with each other. Then the therapist would help them develop positive effective communication and appropriate coping skills. Helping the family develop a healthier relationship and learn to communicate with each other will then help each member trust each other. In order for this to be done, the therapist will create a safe and comfortable environment for the family. The therapist will also work to develop boundaries that are clear and appropriate.
