SOCW 6121 Wk 1

 

Week 1: Family Theories

Understanding family systems and the complex interactions among the members is extremely valuable to a clinical social worker. Throughout clinical practice, the social worker works with families in some capacity. Family theories help guide the social worker in practice. Many family theories exist from which to choose, and most of them complement one another. This week, you are introduced to major contributors to the field of family theory. You will evaluate family theories, and you will apply concepts and models to social work practice.

Note: In this course, students in your peer group will create videos and/or PowerPoint presentations, and you will be asked to review them. The goal is to make these materials accessible to everyone, regardless of disability or language of origin. If you are unable to access these materials, it is your responsibility to request appropriate accommodations from the Office of Disability Services at your University within the first week of the course start date.

Learning Objectives

Students will:

• Apply family theory concepts/models to social work practice

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Walden University. (n.d.). MSW interactive home page [Multimedia]. Retrieved from https://class.waldenu.edu
Plummer, S.-B., Makris, S., & Brocksen, S. (Eds.). (2013). Sessions case histories. Baltimore, MD: Laureate International Universities Publishing.
“The Petrakis Family” (pp. 20–22)
Banmen, J. (2002). The Satir model: Yesterday and today. Contemporary Family Therapy, 24(1), 7–22.
Brown, J. (1999). Bowen family systems theory and practice: Illustration and critique. Australian and New Zealand Journal of Family Therapy, 20(2), 94–103. Retrieved from http://www.thefsi.com.au/wp-content/uploads/2014/01/Bowen-Family-Systems-Theory-and-Practice_Illustration-and-Critique
Vetere, A. (2001). Structural family therapy. Child & Adolescent Mental Health, 6(3), 133–139.
Bowen Center for the Study of the Family: Georgetown Family Center. (n.d.). Retrieved from http://www.thebowencenter.org
Document: Group Wiki Project Guidelines (PDF)
Document: Wiki Instructions (PDF)

Required Media

Laureate Education. (Producer). (2013e). Petrakis (Episode 6) [Video file]. In Sessions. Baltimore, MD: Producer. Retrieved from https://class.waldenu.edu
Note: The approximate length of this media piece is 2 minutes.
 Assignment 1

• Describe your experience in working with groups and families, whether as a participant, leader, and/or observer (e.g., agency committee, interdisciplinary team, book club, church group).
• Describe what you are hoping to gain from this course.
• If you are comfortable doing so, relate a fun fact about yourself, such as hobbies, personal interests, or experiences.

 

Discussion 2: Family Theory

Murray Bowen is one of the most respected family theorists in the field of family therapy. Bowen views the family unit as complex and believes it is important to understand the interactions among the members in order to solve problems. Satir and Minuchin also advanced family therapy with their concepts and models. As a clinical social worker, using these models (along with having an ecological perspective) can be very effective in helping clients.

For this Discussion, review the “Petrakis Family” case history and video session.

By Day 4

Post (using two concepts of Bowen’s family theory) a discussion and analysis of the events that occurred after Alec moved in with his grandmother up until Helen went to the hospital.

If you used the concepts of structural family therapy, how would your analysis of the situation be different?

Which family theory did you find to be most helpful in your analysis?

Finally, indicate whether Satir’s or Minuchin’s model is the more strength-based model. Why?

By Day 6

Respond to two colleagues who chose a different Bowenian concept in analyzing the events, and offer an alternative viewpoint.

• Response 1

 Chastidy Boutin RE: Discussion 2 – Week 1

COLLAPSE

Post (using two concepts of Bowen’s family theory) a discussion and analysis of the events that occurred after Alec moved in with his grandmother up until Helen went to the hospital.
Bowen’s family theory is an identifiable by eight concepts with a focus in behaviors that develop in a family system (Brown, J. 1999). The purpose of the Bowen Family Theory is to reduce or eliminate anxiety and the symptoms surrounding its presence. The two concepts that will be analyzed for the Petrakis Family case is ‘Emotional Fushion and Differentiation of Self’ and ‘Nuclear Family Emotional System – Symptoms in a Spouse’.

With the first concept, Emotional Fusion and Differentiation of Self, the actions of the choices of an individual are arranged or changed to better create a level of balance within the family system (Brown, J., 1999). Helen expressed her concerns to Alec about the frustrations she was currently having with the situation involving Magda’s care. Alec suggested that he would be able to take over some of the care of Magda, releasing his mother of stress, and begin living in the home with his grandmother. According to the interpretation of the theory’s context, fushion can be expressed in a way that is similar to Alec’s reaction to his mother’s emotional stress outburst. Fushion is often shown as a feeling of intense responsibility got another’s reaction. Alec felt as though his mother’s distress was an issue that was displayed onto him due to the fact Helen was taking responsibility for so many chores for Magda.
 

   Concept 2 is ‘Nuclear Family Emotional System’. The emotion dysfunction of the family is apparent more within this concept. In the category of ‘Symptoms of a Spouse’, a spouse’s functioning can be pushed into roles that are held to far more responsibility than the other party. The spouse who takes on more responsibility is said to experience symptoms more likely than the opposing due to the feeling of needing to have a solution to the issues present (citation). Helen takes on many roles in the family and has been identified as the role of Magda’s primary caretaker. Magda took on the primary role of caring for Magda as it was felt that the children were too busy to contribute to the help of anything in the household. Magda’s health began as a small role, which then took on a bigger one and Helen maintained her role as her caregiver. Ultimately, she decided to allow Alec to help care for Magda as well, but the stress of the situation ended Helen up in the hospital.

             If you used the concepts of structural family therapy, how would your analysis of the situation be different?

The Structural Family Theory is composed of a systemic view of the structural or organizational functioning of a family system. The understanding of the structural family theory is a composed interpretation of detailing current levels of family interaction (Vetere, A., 2001). The structure additionally not secludedly observes the level of functioning in one level of the family, but in the subsystems as well to include measures such as boundaries and thus forth. When using this theory for the case of The Petrakis Family, the social worker would create a visual chart of the family to include elements of the members, responsibilities, and relationships. This method helps to create an understanding of the family’s interaction and potentially problematic issues and where interventions could be included for support. The Structural Family Theory would differ because it is identifying individual family members more along with a generalization of problems and find interventions. I would take the information from this theory and be able to clearly identify each person in the family’s role in care for Magda and well as other household responsibilities they carry. This could clearly help to indicate the heavy stress load that Helen carries for all of her family members.

Which family theory did you find to be most helpful in your analysis?

I found the Structural Family Theory to be more helpful as it is a visual representation of the family and the included subsystems identified in the hierarchy. This theory additionally helps to provide an interpretation of the fact of responsibility for individual members. According to Vetere, A., (2001), those who use the structural dynamic explore the structure of the family such as subsystems, boundaries, functions, relationships, and social support (Vetere, A., 2001). With the identification of the family functioning, the social worker can identify areas that are strong and those that need reconstruction. 

Finally, indicate whether Satir’s or Minuchin’s model is the more strength-based model. Why?

When observing both models, it is interpreted that Minuchin’s Model is more Strengths-based due to the formation of the approach of the theory. The Structural Family Theory has focus on reducing symptoms, identification of self issues and the differentiation of the person from their family of origin. The focus on helping the individual helps to encourage growth on specific details of strength. The Structural Family Theory finds the behaviors of individuals are a function of the relationships conducted with others. The main goal is to help encourage growth to encourage a stronger family system (Vetere, A., 2001).

Response 2

 Jamie Mahaffey RE: Discussion 2 – Week 1COLLAPSE

Post (using two concepts of Bowen’s family theory) a discussion and analysis of the events that occurred after Alec moved in with his grandmother up until Helen went to the hospital.

Using the concepts Nuclear Family Emotional Process (impairment of child and marital conflict) and Multigenerational Transmission Process from Bowen’s family theory we can analyze the events with the Petrakis family (Brown, 1999). Alec is the oldest child of Helen and Jon and there was likely a focus on him from both his parents but likely primarily Hellen which created an impairment of the child when considering the Nuclear Family Emotional Process (Brown, 1999). This is likely why Alec struggled to fulfill his parent’s expectations and struggled with drug use. Alec was also more likely than his siblings to feel the marital tensions between Helen and Jon due to the care of his grandmother Magda which is why he offered to help his mother in caring for his grandmother. The Multigenerational Transmission Process helps in the concept of the Petrakis family when we consider the role that Magda likely played in John’s life when he was a child (Brown, 1999). Magda likely also cared for all members of her family and supported more traditional roles that the mother is expected to take care of their family in domestic ways such as cooking and cleaning. This explains why John becomes dissatisfied with Helen when her caring for his mother infringes on her ability to make dinner and clean for him and the children. Helen also follows this and views her self-worth in her ability to care for the family which also comes from the concept of the Multigenerational Transmission Process.

If you used the concepts of structural family therapy, how would your analysis of the situation be different?

If I were to consider the concepts of structural family therapy instead, I am not sure that my analysis would vary so greatly from Bowen’s family theory because both incorporate the complexity of a family and how the members interact with each other. However, one difference when considering structural family therapy would be also including the other systems the family members operate in including work, school, friends, etc. and those systems effects on individual family members along with how that affects their role withing the family (Vetere, 2001). Bowen’s family theory seems more focused on the family members relationships and how they are affected by each other as opposed to how outside forces affect them. For example, Alec’s issues may stem from more than his parent’s attentions but also from his friends and people he is around outside of his family.

Which family theory did you find to be most helpful in your analysis?

I feel that both models are equally helpful in the analysis of the Petrakis family. The Bowen family theory takes a deep dive into the roles people have within their family considering parent’s childhood and their parent’s childhoods and how it affects people’s interactions within their marriages and with their own children and parenting styles. The concepts of structural family therapy include other systems that need to also be considered when we view relationships within a family and how they are impacted.

Finally, indicate whether Satir’s or Minuchin’s model is the more strength-based model. Why?

It seems that Satir’s model is more strength-based than Minuchin’ structural family therapy as it seems to inspire clients to be more self-aware and gives them the power to change their situation (Banmen, 2002). While structural family therapy helps in the analysis of the family systems and how they might affect one another, it does not fully explore the individuality that Satir does in the consideration of the Iceberg model and empowering the client to create and promote change in their life.

References

Banmen, J. (2002). The Satir model: Yesterday and today. Contemporary Family Therapy, 24(1), 7–22.

Brown, J. (1999). Bowen family systems theory and practice: Illustration and critique. Australian and New Zealand Journal of Family Therapy, 20(2), 94–103. Retrieved from http://www.thefsi.com.au/wp-content/uploads/2014/01/Bowen-Family-Systems-Theory-and-Practice_Illustration-and-Critique

Vetere, A. (2001). Structural family therapy. Child & Adolescent Mental Health, 6(3), 133–139.

The Petrakis Family

Helen Petrakis is a 52-year-old heterosexual married female of Greek descent who says that she feels overwhelmed and “blue.” She came to our agency at the suggestion of a close friend who thought Helen would benefit from having a person who could listen. Although she is uncomfortable talking about her life with a stranger, Helen said that she decided to come for therapy because she worries about burdening friends with her troubles. Helen and I have met four times, twice per month, for individual therapy in 50-minute sessions.

Helen consistently appears well-groomed. She speaks clearly and in moderate tones and seems to have linear thought progression; her memory seems intact. She claims no history of drug or alcohol abuse, and she does not identify a history of trauma. Helen says that other than chronic back pain from an old injury, which she manages with acetaminophen as needed, she is in good health.

Helen has worked full time at a hospital in the billing department since graduating from high school. Her husband, John (60), works full time managing a grocery store and earns the larger portion of the family income. She and John live with their three adult children in a 4-bedroom house. Helen voices a great deal of pride in the children. Alec, 27, is currently unemployed, which Helen attributes to the poor economy. Dmitra, 23, whom Helen describes as smart, beautiful, and hardworking, works as a sales consultant for a local department store. Athina, 18, is an honors student at a local college and earns spending money as a hostess in a family friend’s restaurant; Helen describes her as adorable and reliable.

In our first session, I explained to Helen that I was an advanced year intern completing my second field placement at the agency. I told her I worked closely with my field supervisor to provide the best care possible. She said that was fine, congratulated me on advancing my career, and then began talking. I listened for the reasons Helen came to speak with me.

I asked Helen about her community, which, she explained, centered on the activities of the Greek Orthodox Church. She and John were married in that church and attend services weekly. She expects that her children will also eventually wed there. Her children, she explained, are religious but do not regularly go to church because they are very busy. She believes that the children are too busy to be expected to help around the house. Helen shops, cooks, and cleans for the family, and John sees to yard care and maintains the family’s cars. When I asked whether the children contributed to the finances of the home, Helen looked shocked and said that John would find it deeply insulting to take money from his children. As Helen described her life, I surmised that the Petrakis family holds strong family bonds within a large and supportive community.

Helen is responsible for the care of John’s 81-year-old widowed mother, Magda, who lives in an apartment 30 minutes away. Until recently, Magda was self-sufficient, coming for weekly family dinners and driving herself shopping and to church. But 6 months ago, she fell and broke her hip and was also recently diagnosed with early signs of dementia. Through their church, Helen and John hired a reliable and trusted woman to check in on Magda a couple of days each week. Helen goes to see Magda on the other days, sometimes twice in one day, depending on Magda’s needs. She buys her food, cleans her home, pays her bills, and keeps track of her medications. Helen says she would like to have the helper come in more often, but she cannot afford it. The money to pay for help is coming out of the couple’s vacations savings. Caring for Magda makes Helen feel as if she is failing as a wife and mother because she no longer has time to spend with her husband and children.

Helen sounded angry as she described the amount of time she gave toward Magda’s care. She has stopped going shopping and out to eat with friends because she can no longer find the time. Lately, John has expressed displeasure with meals at home, as Helen has been cooking less often and brings home takeout. She sounded defeated when she described an incident in which her son, Alec, expressed disappointment in her because she could not provide him with clean laundry. When she cried in response, he offered to help care for his grandmother. Alec proposed moving in with Magda.

Helen wondered if asking Alec to stay with his grandmother might be good for all of them. John and Alec had been arguing lately, and Alec and his grandmother had always been very fond of each other. Helen thought she could offer Alec the money she gave Magda’s helper.

I responded that I thought Helen and Alec were using creative problem solving and utilizing their resources well in crafting a plan. I said that Helen seemed to find good solutions within her family and culture. Helen appeared concerned as I said this, and I surmised that she was reluctant to impose on her son because she and her husband seemed to value providing for their children’s needs rather than expecting them to contribute resources. Helen ended the session agreeing to consider the solution we discussed to ease the stress of caring for Magda.

The Petrakis Family

Magda Petrakis: mother of John Petrakis, 81

John Petrakis: father, 60

Helen Petrakis: mother, 52

Alec Petrakis: son, 27

Dmitra Petrakis: daughter, 23

Athina Petrakis: daughter, 18

In our second session, Helen said that her son again mentioned that he saw how overwhelmed she was and wanted to help care for Magda. While Helen was not sure this was the best idea, she saw how it might be helpful for a short time. Nonetheless, her instincts were still telling her that this could be a bad plan. Helen worried about changing the arrangements as they were and seemed reluctant to step away from her integral role in Magda’s care, despite the pain it was causing her. In this session, I helped Helen begin to explore her feelings and assumptions about her role as a caretaker in the family. Helen did not seem able to identify her expectations of herself as a caretaker. She did, however, resolve her ambivalence about Alec’s offer to care for Magda. By the end of the session, Helen agreed to have Alec live with his grandmother.

In our third session, Helen briskly walked into the room and announced that Alec had moved in with Magda and it was a disaster. Since the move, Helen had had to be at the apartment at least once daily to intervene with emergencies. Magda called Helen at work the day after Alec moved in to ask Helen to pick up a refill of her medications at the pharmacy. Helen asked to speak to Alec, and Magda said he had gone out with two friends the night before and had not come home yet. Helen left work immediately and drove to Magda’s home. Helen angrily told me that she assumed that Magda misplaced the medications, but then she began to cry and said that the medications were not misplaced, they were really gone. When she searched the apartment, Helen noticed that the cash box was empty and that Magda’s checkbook was missing two checks. Helen determined that Magda was robbed, but because she did not want to frighten her, she decided not to report the crime. Instead, Helen phoned the pharmacy and explained that her mother-in-law, suffering from dementia, had accidently destroyed her medication and would need refills. She called Magda’s bank and learned that the checks had been cashed. Helen cooked lunch for her mother-in-law and ate it with her. When a tired and disheveled Alec arrived back in the apartment, Helen quietly told her son about the robbery and reinforced the importance of remaining in the building with Magda at night.

Helen said that the events in Magda’s apartment were repeated 2 days later. By this time in the session Helen was furious. With her face red with rage and her hands shaking, she told me that all this was my fault for suggesting that Alec’s presence in the apartment would benefit the family. Jewelry from Greece, which had been in the family for generations, was now gone. Alec would never be in this trouble if I had not told Helen he should be permitted to live with his grandmother. Helen said she should know better than to talk to a stranger about private matters.

Helen cried, and as I sat and listened to her sobs, I was not sure whether to let her cry, give her a tissue, or interrupt her. As the session was nearing the end, Helen quickly told me that Alec has struggled with maintaining sobriety since he was a teen. He is currently on 2 years’ probation for possession and had recently completed a rehabilitation program. Helen said she now realized Alec was stealing from his grandmother to support his drug habit. She could not possibly tell her husband because he would hurt and humiliate Alec, and she would not consider telling the police. Helen’s solution was to remove the valuables and medications from the apartment and to visit twice a day to bring supplies and medicine and check on Alec and Magda.

After this session, it was unclear how to proceed with Helen. I asked my field instructor for help. I explained that I had offered support for a possible solution to Helen’s difficulties and stress. In rereading the progress notes in Helen’s chart, I realized I had misinterpreted Helen’s reluctance to ask Alec to move in with his grandmother. I felt terrible about pushing Helen into acting outside of her own instincts.

My field instructor reminded me that I had not forced Helen to act as she had and that no one was responsible for the actions of another person. She told me that beginning social workers do make mistakes and that my errors were part of a learning process and were not irreparable. I was reminded that advising Helen, or any client, is ill-advised. My field instructor expressed concern about my ethical and legal obligations to protect Magda. She suggested that I call the county office on aging and adult services to research my duty to report, and to speak to the agency director about my ethical and legal obligations in this case.

In our fourth session, Helen apologized for missing a previous appointment with me. She said she awoke the morning of the appointment with tightness in her chest and a feeling that her heart was racing. John drove Helen to the emergency room at the hospital in which she works. By the time Helen got to the hospital, she could not catch her breath and thought she might pass out. The hospital ran tests but found no conclusive organic reason to explain Helen’s symptoms.

I asked Helen how she felt now. She said that since her visit to the hospital, she continues to experience shortness of breath, usually in the morning when she is getting ready to begin her day. She said she has trouble staying asleep, waking two to four times each night, and she feels tired during the day. Working is hard because she is more forgetful than she has ever been. Her back is giving her trouble, too. Helen said that she feels like her body is one big tired knot.

I suggested that her symptoms could indicate anxiety and she might want to consider seeing a psychiatrist for an evaluation. I told Helen it would make sense, given the pressures in her life, that she felt anxiety. I said that she and I could develop a treatment plan to help her address the anxiety. Helen’s therapy goals include removing Alec from Magda’s apartment and speaking to John about a safe and supported living arrangement for Magda.