Integrative Project In Counseling

Choose a therapeutic scenario from the options at the end of the case study to serve as a direction for therapy.

Create a personal theoretical orientation based off the theories that were discussed in this course.

Write a 1,050- to 1,400-word paper to integrate theory and counseling skills with this family. Include the following:

  • A complete assessment of the family, using the assessment approaches associated with your theoretical orientation.
  • A discussion on which dyadic assessment tools you would utilize for assessing the couple and how you chose these tools.
  • A conceptualization of the family, according to your theoretical orientation.
  • A description of how you would utilize the interventions associated with your theoretical orientation with this family.

Include a minimum of 5 sources.

Format your paper according to APA guidelines.

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  Miller Family Case Study

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University of Phoenix Material

Miller Family Case Study

Review the following case study.

Choose a therapeutic scenario from the options at the end of the case study.

The Miller family consists of married parents (Jim, 43; Stacie, 41), and their 4 children (Mike, 19, is a freshman at the state university on a baseball scholarship; Liz, 17, is a senior in high school; Erin, 15, is a sophomore in high school; and Sarah, 11, is in the 5th grade). They live in a very comfortable, suburban, middle-class neighborhood, and have resided there for the past 10 years.

Jim came from a lower middle-class family that seemed to always struggle to make ends meet. Both his parents are still living in a town about 3 hours away. His dad worked long hours at the factory and would often head to the bar after work. The family didn’t see “Grandpa Jimmy” as an alcoholic, but he definitely liked to unwind before coming home. He was never abusive — just sort of “absent” emotionally. Jim’s mother was a homemaker and did what she could with what the family had. Jim had one older brother, but he died in a boating accident when he was 5 and Jim was 3.

Committed to providing a better life for his family, Jim learned to work hard. He is a sales rep for a large pharmaceutical company, with an annual salary of $95K. But during the last 2 years, he has earned approximately $105K. He attributes his higher earnings to his hard work, long hours, “wining and dining” his physician clients, and staying up on the latest research on the medications he reps. He was promoted to regional sales manager 3 years ago, but it didn’t go well. He did not like managing people as much as taking care of his clients, so he requested to return to his old territory and has been much happier (although his long hours mean he is home less frequently). He enjoys being a dad and sees his primary role as a provider. He misses coaching Mike’s youth baseball and basketball teams, and has adjusted to Mike being away at college by working longer hours. His daughters are his “angels,” although he admittedly feels like he is losing touch with them, their interests, their friends, etc. He believes the best thing he can do is continue providing for them the best he knows how, even though it means he spends less time at home.

In addition, the arguments between him and Stacie seem to have increased. She is beginning to resent his increased time away from home and tells him the extra money isn’t worth it. Jim resents being caught in the middle of her inconsistencies — on one hand, she wants him home more, and yet on the other, she always seems to talk about traveling, getting “upgrades” for the house, driving a nice car, etc. “You can’t have your cake and eat it too,” he reminds her. And while he would like more leisure time too, he doesn’t mind avoiding the emotional “drama” by working longer hours.

Stacie is a small-scale entrepreneur and has made a business out of her artistic and fashion interests by making custom jewelry and selling the merchandise online and in small boutiques. Her business occupies about one-quarter of the basement but is content spending 10-20 hours a week with it. Stacie has a small group of loyal customers and feels like she has found her niche. She also has visions of growing her company, but feels like she carries most of the parenting load and doesn’t have the time to expand her business. In particular, Stacie feels like there are days when she can barely keep up with the girls’ activities and demanding schedules. While she appreciates having a fairly comfortable lifestyle, she feels growing resentment that the vast majority of household and parenting obligations fall on her shoulders. She has attempted to talk with Jim about her frustrations, feeling like she is alone on the homefront, but it doesn’t take long before they both become defensive, even argumentative, so she has learned it’s best to not even bring it up.

Stacie grew up in a comfortable, middle-class home. Her father, who passed away 4 years ago from pancreatic cancer, was a strict authoritarian and was deeply entrenched in what Stacie used to call “prehistoric gender roles.” He never did any of the household work, and the only parenting Stacie remembers her father taking part in was the role of disciplinarian. She was close to her mother, but could never understand why she put up with his lack of involvement in the home. She recalls her mom would always defend her father, saying “He works hard all day providing for the family; that’s what a good father and husband does”). Stacie remembers thinking, “That’s not how my family’s going to be when I get married!” Her mother lives alone and is healthy and active. Stacie has an older brother and a younger sister, with whom she gets along well. They both have “nice” families and both live within 45 minutes of Stacie.

Mike is the only son and seems to be the “golden child.” He is good looking and charismatic, and has always been an exceptional athlete. His grades were never stellar, but he was always able to somehow pull off decent grades without much effort or extra studying. Growing up, he was fairly mischievous, but not really a behaviorally-challenged boy. Mike pushed the boundaries a bit — he got caught smoking weed once in high school — but was generally well-behaved throughout his adolescence. Mike is adjusting to college life, has worked his way into a starting position on the baseball team, and is managing to maintain a low B average while pursuing his Recreation Science degree.

Liz is a senior in high school, but has drifted from her previous plans to attend medical school and become a pediatrician. Up until the end of her sophomore year, she was a stellar student, almost obsessed about getting straight As and took pride in her academic achievements. She dreamed of saving the world one sick child at a time. However, during the summer between her sophomore and junior years, she met a group of free-spirited kids who seem to have influenced her toward a different path. She became a bit more defiant at home, and while she is not “out of control,” there is definitely a confrontational approach behind her interactions with family, especially toward Jim. In responding to her father’s requests, she typically makes comments such as, “You’re never here anyway, so why should I listen to you?” Rather than argue with her, Jim’s typical response is to withdraw, making an under-the-breath comment like, “It’s your life — screw it up if you want to.” He feels sad about the conflict, but doesn’t seem to have the energy to take a stand. Stacie has also felt the pain of the growing distance between her and Liz. She is confused about how their relationship changed so drastically, but despite the increase in arguments between them, they both report getting along “OK.”

Erin loves school and has always gone above and beyond in her studies. She takes pride in her organization skills and recognizes she is a bit more mature than many of her peers, especially the out of control boys who always seem to disrupt class). She is already preparing for college by reviewing the SAT manual and usually spends her free time reading, programming, etc. Erin is disgusted that Liz seems to have “thrown her life away by hanging out with those losers” and rarely spends time with friends her age in typical social settings. She is not socially awkward, but rather sees her peers as uninteresting, and going nowhere since all they talk about is dating, music, and the latest fashions. Erin frequently stays up after bed time, as Stacie confides in her about some of the frustrations of managing the household. This usually leads to Erin taking on extra chores, preparing meals, etc. in order to feel as though she is taking some of the load off mom’s shoulders. She is quick to volunteer to pick up the slack and seems to enjoy her relatively new role as mom’s confidant.

Sarah has always been the quiet, yet sometimes “odd” one of the family. She likes to play with her dolls and stuffed animals alone in her room, sometimes for hours. Stacie noticed some aggressive play on one occasion, where one of the stuffed animals was “killing” all of the other characters and Sarah was speaking in very angry tones. She has never had any social or general behavior problems at school, but tends to be quiet and stays to herself most of the time. Sarah doesn’t seem to be shy; she just seems uninterested in interacting with the other kids at school. According to Stacie, Sarah is just different from the other girls. When they were her age, they were into fashion dressups and wanted to wear makeup. Meantime, Sarah has shown no interest in that sort of thing. She does, however, enjoy going on picnics, visiting her grandmother, and sitting down to read. During the last few months, however, she has not wanted to visit extended family and has begun reacting to her mother’s requests to do her chores with angry outbursts that include yelling and then shutting down. Stacie assumes Sarah is going through a phase and misses her older brother.

Possible Therapeutic Scenarios:

1. Jim and Stacie have agreed to see a marriage counselor to improve their relationship.

2. Jim and Stacie are seeking family therapy, because they are worried about Liz’s defiance and Sarah’s “odd” behavior.

3. Jim and Stacie are seeking child counseling for their youngest daughter, Sarah, to help her work through her recent reactive and odd behavior.

4. Jim and Stacie are bringing their 17-year-old daughter, Liz to counseling to discuss her recent lifestyle shift and adversarial behavior. They are concerned she may be using drugs.

Copyright © XXXX by University of Phoenix. All rights reserved.

Copyright © 2016 by University of Phoenix. All rights reserved.

Comparing Systemic Models

Write a 6–8-page paper, discussing the rationale for selecting Narrative Family Therapy. Include in your rationale a detailed description of the problem you are currently working on with a client or client system.

The Problem: The case study should be about a married couple wanting to get a divorce because of infidelity. They have both been unhappy for many years that they are both having affairs. They are only staying together because of their 16 year old son.

The format of the paper: Introduction

Case Study

Model Selected: Narrative Therapy

Assessment & Interventions

Model Applied to Case

Cultural Impact

Conclusion

  • Written communication: It should be free of errors that detract from the overall message.
  • APA formatting: Resources and citations are formatted according to current APA style and formatting.
  • Number of sources: A minimum of 10 peer-reviewed journal articles.
  • Length: 6–8 double-spaced, typed pages.
  • Font and font size: Times New Roman, 12 points.

*I have attached a few articles but there needs to be a total of 10 peer-reviewed.

Witnessing and Positioning: Structuring

Narrative Therapy with Families and

Couples

Jill Freedman, MSW Evanston Family Therapy Center, Evanston

In this paper, the author describes a way of structuring family therapy that fits with the narrative metaphor, creat- ing space for stories to be understood, deconstructed and further developed. In this process, people move between positions of telling and witnessing. Family members engage in shared understanding and meaning making.

Keywords: narrative therapy, positioning, outsider-witness, couple therapy, family therapy

Key Points

1 For narrative therapists, family therapy is a context where we can deconstruct problematic stories, tell and retell preferred stories, and witness family stories and individual stories of other family members.

2 A witnessing structure in which family members listen to another member tell his or her story can contrib- ute to understanding and meaning making.

3 Through responding to questions we ask members in the witnessing position, they can contribute to thick- ening preferred stories.

4 If it is difficult for family members to listen and understand while witnessing, we can facilitate a particular position from which to listen, such as listening as one would to a friend.

5 If more distance would be helpful for people to really listen and understand, we can offer other options, such as using video so that the witnesses are actually hearing and seeing family members tell their stories at a later time.

The narrative metaphor suggests that people make sense of their lives through stories (Brown & Augusta-Scott, 2007; Duvall & Beres, 2011; Freedman & Combs, 1996; Madigan, 2011; White & Epston, 1990; White, 2007; Zimmerman & Dickerson, 1994). Although each of us has a huge number of experiences, only a few of these become the stories that shape us and through which we shape our lives. Some of these stories are about individual people and others are about family and relationships. When couples or families come to therapy each person may have different stories that are prominent for them and that they think are most relevant; there may be some shared stories that different family members tell; and there may be similar stories that different family members tell but that they have made different meaning of, perhaps emphasizing different aspects of the same event or maybe understanding the same event in different ways.

Narrative therapists focus on rich story development – the telling and retelling of pre- ferred stories. Rather than a single-storied life we are interested in helping people develop

Address for correspondence: Jill Freedman, MSW, Evanston Family Therapy Center, 1212 1/2 Elmwood Avenue, Evanston, Illinois 60202 USA. narrativetherapy@sbcglobal.net Jill Freedman is the Director of the Evanston Family Therapy Center. With Gene Combs she is the author of ‘Narrative Therapy: The social construction of preferred realities’ (W.W. Norton).

Australian and New Zealand Journal of Family Therapy 2014, 35, 20–30 doi: 10.1002/anzf.1043

20 ª 2014 Australian Association of Family Therapy

 

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Freedman, J. (2014). Witnessing and positioning: Structuring narrative therapy with families and couples. Australian and New Zealand Journal of Family Therapy, 35(1), 20–30.
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multiple stories. Our focus is not on solving or eliminating problem stories. We are interested in multiple stories contributing to people’s experience. Often when a problem story becomes a single strand of a multi-storied life, the problem looks quite different or becomes less significant and people have different options about how they relate to it.

Additionally, we think of our identities as both storied and relational (Combs & Freedman, 1999; Freedman & Combs, 2004; Hedtke & Winslade, 2004; White, 1989; White, 2007). We make ourselves up as we go along in relation to each other. So not only are the stories we tell ourselves important, but the stories we tell others about our- selves and our lives, and the stories others hear us tell, and the stories that they tell about us, are important because they shape our identities.

We think of family therapy as a context where we can deconstruct problematic stories, tell and retell preferred stories, and witness family stories and stories of other family members.

This process is not quite as simple as it sounds. One complication is that people often orient to therapy not as a place to tell and retell stories, but as a place in which a ‘neutral’ third party will weigh in on different versions of a problem or advise people in terms of solutions or evaluate the situation to determine the ‘real problem’ or ask questions to connect the problem with family history or teach communication skills.

We are up to something quite different.

A Witnessing Structure

In order to accomplish the telling, retelling, and witnessing of stories, it is very useful to set up a structure. We can call this a witnessing structure (Freedman & Combs, 2004, 2008). As one family member tells a story we ask the others to be in a reflect- ing or witnessing position to hear and understand the story as it is told by the first family member. We then ask those who have been acting as witnesses to contribute to the telling and meaning making of the story. We think of their contribution as a retelling that thickens and adds richness to the story. The original speaker becomes a witness to the retelling of the story that he or she has told. We may then ask ques- tions to invite the family member who spoke originally to engage in a retelling of the retelling. Through this process family members gain understanding of each other’s stories and engage in developing and thickening preferred stories.

Initiating and/or Negotiating a Witnessing Structure

We can initiate this structure informally by beginning to engage in it or we can explicitly describe it and ask family members to join in. We usually begin informally with the therapist simply talking directly to one person and respectfully referring to the others in the third person. It is important to watch other family members to make sure that they are engaging in the process. If they seem not to be engaged or if they interrupt, it can be helpful to explain the process. We might say something such as, Would it be okay if I talk to Bethany for a bit? Then I’ll ask you some questions about our conversation. At another point each of you will also have some time to talk and I’ll ask everyone else to listen. If family members continue to interrupt or indicate by their actions that they disagree it can be helpful to reassure them about how we are listen- ing by saying something like, I am guessing that your experience of this and what you think is most important to talk about may be different than what Bethany is describing.

Witnessing and Positioning

ª 2014 Australian Association of Family Therapy 21

 

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I understand that family members often have different understandings of the same events. I am keeping that in mind and I will make sure there is time for us to listen to what you think is most important, too.

If even after this kind of reassurance family members continue to interrupt or state their disagreements we may say something like, Have you had a conversation already about this? Did it go this way with each of you saying how you disagree and what you think? Was it helpful? Is it okay if we try something different? These questions pave the way for explicitly negotiating the witnessing structure.

We may say, In our experience when people talk directly to each other about some- thing problematic, what they are listening for is how they disagree or what they want to say to counter what is being said. It is extremely hard to really listen and understand when your attention is on what you want to say next or on how someone is wrong or how they are leaving something out. We would like to create a space where you can really listen to each other. Would that be okay?

Our questions – Is it okay if we try something different? and Would that be okay? – are real questions. On occasions people have told us that they have not spoken at all about something and that they were waiting until they came to therapy to say some- thing to other family members, which they would like to do directly. We are negotia- ble about the structure. Usually though, we find the witnessing structure extremely helpful and most families and couples are happy to join in with this kind of conversa- tion.

Unpacking Problem Stories and Identities

Once we have set up the structure our task is to ask questions that will eventually help family members move into the development of preferred stories. In order to be able to do this it is usually important to have some understanding of the problem and its effects. Often it is very meaningful for people to have the experience of other family members listening to and understanding what they find problematic. As we lis- ten we can ask questions to deconstruct or unpack the problematic story. Through deconstruction we hope to expose how the problem was constructed. We are inter- ested in deconstruction to the extent that we can develop gaps that allow people to see beyond the problems to other events that may be openings to preferred stories and so that problems do not take over people’s identities. One very basic practice of deconstruction is externalizing. Through externalizing conversations we unpack prob- lem identities that are constructed through psychological and linguistic practices that identify people as problems (Epston, 1993; White, 1988/1989; Russell & Carey, 2004).

For example, a family came to therapy because in their words, Sean, the 7-year- old was ‘fearful’. His father had worries that a boy at the end of first grade who was afraid to spend the night at a friend’s house, clung to his parents’ legs at the top of the sledding hill as the other kids reveled in the snow, and would not go on a class field trip unless one of his parents went along, was likely to be made fun of by the other kids and that that was just the beginning of things that Sean deprived himself of.

At the beginning of my conversation with Sean he didn’t answer verbally but he did nod for yes and shake his head for no. In this way we determined that he agreed

Jill Freedman

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with his parents that the fears were a problem and that they were even responsible for denying him a voice in the conversation with me. When I asked Sean if the fear talked to him he shook his head no. When I asked if it showed him pictures, first he shook his head again but then stopped and said, ‘Sometimes’.

Fallacies To Persuade And Possibly Manipulate

Advertisements exist to sell you a product. It might be soap, music, political positions, or ideas. Most advertisements use a variety of logical fallacies to persuade but some use them to subtlety or overtly manipulate the intended audience.

– Review the list of logical fallacies in your content and study the ads presented.

– Select at least two (2) ads that you feel represent two (2) different logical fallacies.

– Determine how the language and images of the ads appeal to the consumer; identify the kinds of fallacies being used;  and describe what needs or insecurities the ads are trying to reach.

– Explain the ads’ effectiveness.

Here is a list of fallacies

Ad hominem – attacking the person rather than the issue. Sometimes this is acceptable if the reason for attacking the individual is related to the issue.

All or nothing (black-and-white and either/or) – unfairly limiting reader to only two choices when there are most likely more options.

Appeal to authority – appealing to an authority is a fallacy if the authority is not an expert on the topic, cannot be trusted to tell the truth, or is misquoted.

Appeal to emotions – attempting to use emotions as key premises or tools to downplay relevant information.

Appeal to force (scare tactic) – threatening opponent rather than giving logical reason.

Appeal to ignorance – saying that something is false because it is not known to be true.

Bandwagon – saying that a claim is correct because it is what most everyone believes.

Begging the question – using circular reasoning to prove a conclusion that is included in the premise.

Circular reasoning – beginning an argument with what the reasoned is trying to prove.

Either/or – unfairly limiting reader to only two choices when there are most likely more options.

Exaggeration – overstating or overemphasizing a point.

Rationalizing – providing reasons that may not be our reasons for supporting our claim.

Red herring – like using a smelly fish to distract a bloodhound, using a digression to lead reader off track from relevant information.

Scapegoating – blaming an unpopular person or group for a problem.

Self-fulfilling prophecy – not recognizing that an act of prophesying will produce the effect that is predicted.

Ethics Case Study

In this assignment, you will use professional guidelines and tools to devise a strategy to address an ethical dilemma and evaluate the usefulness of those guidelines and tools.

Instructions

  • Resolve the ethical dilemma and multicultural issues presented in the case study scenarios linked in Resources, and apply the material to this assignment.
    • To create an effective resolution, reflect on your responses to related discussion questions and review the recommendations made on your posts by peers.
  • Use the Ethics Case Study Template linked in Resources to build your PowerPoint presentation.
    • As in the previous assignment, you may enhance the design of the presentation to make it more effective.

Your PowerPoint should include the following:

  1. Title slide:
    • Enter a descriptive title of approximately 10–15 words that concisely communicates the heart of the case study. It should stir interest while maintaining professional decorum.
    • Enter your name, a job title, and an organization that would fit with your case study. These last two elements may be fictional.
  2. Case Study Overview slides: Provide the briefest possible narrative of the professional conflict in the case. Additional supporting details and references may be added in the notes section below the slide. The overview should include:
    • The professional setting of the case.
    • Short descriptions of the people involved and their roles.
    • A concise summation of the ethical dilemma.
  3. Ethical Concerns slides: Bullet three or more ethical concerns in the case and apply one or more ethical standards to each concern. Additional supporting details and references may be added in the notes section below the slide. Be sure to include links to pertinent elements of the code.
  4. Comparison of Ethical Theories slides: In the first row of the table provided, identify two ethical theories that you think would be the most appropriate for the situations in the case. In the following rows, compare relevant features of the two theories. In the notes section, evaluate which theory provides a more functional framework for your case and explain why.
    • Note that ethical theories and ethical decision-making models are two different things. Please make sure you are comparing, contrasting, and evaluating two ethical theories.
  5. Ethical Decision-Making Model slides:
    • Use Fisher’s ethical decision-making model and identify each step in the model.
    • Apply the model to your case and, under each step of the model, describe how that step would look if applied to the case.
    • Incorporate multicultural issues presented in the case study within the selected ethical decision-making model.
    • Copy this slide as needed and combine steps on the slides as necessary or appropriate. In the notes section, include supporting narrative details for your bullet points.
      • Please make sure you are applying steps of the ethical decision-making model to your case.
  6. Proposed Resolution slide: Use bullet points to summarize your proposed resolution to the ethical dilemmas in the case. In the notes section, add supporting narrative details for your bullet points.
  7. References slides: Use current APA style and formatting guidelines.

Requirements

  • Written communication: Should be free of errors that detract from the overall message.
  • Format: Use the Ethics Case Study Template linked in Resources. Use current APA style and formatting guidelines as applicable.
  • References: You must cite best practices from at least three scholarly research articles in this assignment. You may cite reputable sources from websites, books, textbooks, and assigned resources as well, but these will not count toward the three required scholarly research references.
  • Length of PowerPoint: A minimum of 12 slides.
  •