Intervening for Stepfamily Success E-Book
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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
This welcome resource provides concrete examples of how to apply multiple family systems theories and treatment planning to common stepfamily issues. A single stepfamily case study is examined through the lenses of the Adlerian, transgenerational, prescriptive play therapy, structural, cognitive behavior, solution-focused, and narrative models to provide an understanding of the benefits of each approach and how to determine the best fit for a stepfamily's presenting issues. In addition, each chapter examines ethical concerns specific to counseling stepfamilies, issues of diversity, and current research on stepfamily assessment and therapeutic outcomes.
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Seitenzahl: 269
Veröffentlichungsjahr: 2019
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Table of Contents
Cover
Preface
One Stepfamily Case Study, Multiple Approaches Illustrated
Target Audience
About the Editor
About the Contributors
Acknowledgments
PART I: Introducing the Case Study
Chapter 1: What We Know About Stepfamilies
Case Study
Stepfamily Demographic Data
Clinical Approach of This Book
Addressing Cultural Diversity
Conclusion
References
PART II: Specific Family Counseling Models Applied to the Case Study
Chapter 2: Adlerian Family Therapy
Rationale for Choosing Adlerian Theory
The Stages of Adlerian Family Therapy
Facilitating Insight With Adlerian Family Therapy
Adlerian Interventions for Developing Insight in Clients
Therapeutic Strategies
Effectiveness of the Adlerian Approach: Indicators and Counterindicators
Diversity and Cultural Considerations for Adlerian Counselors
Advice for Students or Clinicians Using Adlerian Therapy With Stepfamily Clients
References
Chapter 3: Transgenerational Family Counseling
Rationale for Choosing Transgenerational Family Counseling
Two Theoretical Constructs to Facilitate Client Insight
Three Intervention Strategies
Therapeutic Strategies to Facilitate Change
Effectiveness of Transgenerational Family Counseling: Indicators and Counterindicators
Factors of Client Diversity That Influence Intervention Choices
Factors That Influence Clinical Services Delivery
Advice for Students or Clinicians Using Transgenerational Therapy With Stepfamily Clients
References
Chapter 4: Prescriptive Play Therapy
Rationale for Choosing Play Therapy
Two Theoretical Constructs That Facilitate Client Insights
Three Useful Intervention Strategies
Three Therapeutic Strategies
Effectiveness of Play Therapy: Indicators and Counterindicators
Factors of Client Diversity That Influence Clinical Service Delivery
Advice for Students or Clinicians Using Play Therapy With Stepfamily Clients
References
Chapter 5: Structural Family Therapy
Rationale for Choosing Structural Family Therapy
Theoretical Constructs Used to Facilitate Client Insight
Intervention Strategies
Therapeutic Strategies That Facilitate Change
Effectiveness of Structural Family Therapy: Indicators and Counterindicators
Client Diversity in Structural Family Therapy
Advice for Students and Clinicians Using Structural Family Therapy With Stepfamily Clients
References
Chapter 6: Cognitive Behavioral Model
Rationale for Choosing a Cognitive Behavioral Model
Working With the Case Study Stepfamily
Theoretical Constructs Used to Facilitate Client Insights
Intervention Strategies
Strategies Used to Implement Treatment Goals
Effectiveness of Cognitive Behavioral Treatment: Indicators and Counterindicators
Client Diversity Factors That Influence Treatment Interventions
Advice for Students and Clinicians Using a Cognitive Behavioral Approach With Stepfamily Clients
References
Chapter 7: Solution-Focused Brief Therapy
Rationale for Choosing Solution-Focused Brief Therapy
Two Theoretical Constructs to Facilitate Client Insight
Intervention Strategies
Therapeutic Strategies to Facilitate Change
Scaling Questions (and Follow-Up Questions)
Effectiveness of SFBT: Indicators and Counterindicators
Factors of Client Diversity That Influence Clinical Service Delivery
Advice for Students and Clinicians Using SFBT With Stepfamily Clients
References
Chapter 8: Narrative Family Therapy
Narrative Theory
Rationale for Choosing Narrative Family Therapy
Theoretical Constructs of Narrative Family Therapy
Intervention Strategies
Therapeutic Strategies
Effectiveness of Narrative Family Therapy: Indicators and Counterindicators
Factors of Client Diversity That Influence Clinical Service Delivery
Advice for Students and Clinicians Using Narrative Family Therapy With Stepfamily Clients
References
PART III: Professional Issues
Chapter 9: Ethical Considerations for Counseling Stepfamilies
Stepfamily Trends and Correlates
Competence and Training
Informed Consent
Assessment and Diagnosis
Confidentiality
Countertransference and Supervision
Conclusion
References
Chapter 10: Blended Families of Color, Gay and Lesbian Blended Families, and Blended Worldviews
Stepfamily Instability: The Influence of Macro-Microstructures
Working With Blended Families of Color, Gay and Lesbian Blended Families, and Intercultural/Intracultural Families
The Intercultural Model of Invisible Stepfamilies of Color
Processes That Influence Development of a Healthy Family Unit
References
Chapter 11: Concluding Thoughts
Index
Technical Support
List of Illustrations
Chapter 10
Figure 10.1 Intercultural Model of Invisible Stepfamilies of Color
Guide
Cover
Table of Contents
Begin Reading
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edited by
Joshua M. Gold
Intervening for Stepfamily Success
One Case, Multiple Perspectives
6101 Stevenson Avenue, Suite 600Alexandria, VA 22304www.counseling.org
Copyright © 2019 by the American Counseling Association. All rights reserved. Printed in the United States of America. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher.
American Counseling Association6101 Stevenson Avenue, Suite 600Alexandria, VA 22304
Associate Publisher Carolyn C. Baker
Digital and Print Development Editor Nancy Driver
Senior Production Manager Bonny E. Gaston
Copy Editor Kay Mikel
Cover and text design by Bonny E. Gaston
Libarary of Congress Cataloging-in-Publication Data
Names: Gold, Joshua M. (Joshua Mark), author.Title: Intervening for stepfamily success : one case, multiple perspectives / Joshua Gold.Description: Alexandria, VA : American Counseling Association, [2019] | Includes bibliographical references and index.Identifiers: LCCN 2018047567 | ISBN 9781556203732 (pbk. : alk. paper)Subjects: LCSH: Stepfamilies. | Family counseling.Classification: LCC HQ759.92 .G645 2019 | DDC 306.874/7—dc23 LC record available at https://lccn.loc.gov/2018047567
Preface
This book was developed as a clinical primer to provide the reader with concrete examples of how to apply multiple family systems theories and techniques to stepfamily concerns using a single case study approach. Given the ongoing escalation in the numbers of stepfamilies, and the probability that clinicians, regardless of the setting of counseling practice, will experience growing numbers of stepfamily concerns in their clinical caseloads, the availability of multiple approaches to support stepfamily success will be a welcome resource. This is a practitioner book. It assumes the reader has basic knowledge of theory-based treatment planning, systems thinking, and family theory. The chapters build on those foundations by illustrating how clinicians from different modalities might address the issues facing our case study stepfamily.
Chapter 1 introduces the case study that is used in subsequent chapters to illustrate each theoretical approach. This chapter explains the advantages of using a single case study across diverse models. Chapters 2 through 8 apply specific models to this single case. Chapters 9 and 10 discuss ethics and diversity issues specific to counseling stepfamilies. Chapter 11 provides some concluding comments.
One Stepfamily Case Study, Multiple Approaches Illustrated
The repeated use of the same stepfamily to illustrate differing models provides a window into how each model could be of help and how to ascertain the best fit for the counselor and the presenting stepfamily and issue.
The application of theory-based treatment planning through the clinical lens of various family counseling approaches clarifies how experienced counselors conceptualize the case from their professional orientation. Contributions from practicing family counselors show how differing models do, and do not, work with differing stepfamily concerns in real life. The concluding advice for students and practitioners regarding each model comes not from theoreticians but from practitioners and is a valuable resource for those who seek to develop their family counseling skills.
The presentation and explanation of outcome data enables clinicians to establish best practices relative to their specific model of counseling. Reviewing these studies also provides those who would contribute to the growing professional knowledge with examples of how to design and implement such research.
Each chapter author reflects on the efficacy of the clinical intervention through the lens of the following two questions: (1) What factors of client diversity influence your choice of interventions with your stepfamily clients? and (2) How do these factors influence your clinical service delivery?
Target Audience
This book demonstrates how clinical experts working with different family systems models would approach a single family case study. The text provides new and experienced clinicians with a professional resource guide that no other publication can match. The intended target audience includes all counselors and mental health professionals seeking to provide understanding, legitimization, and facilitation of stepfamily development. This book is intended for clinical development purposes; therefore, its utility transcends specific training programs or settings and is a valued contribution to clinicians’ professional libraries. This is a practical handbook for professionals in their graduate training programs and for counselors, social workers, psychologists, and marriage and family therapists who count stepfamilies among their caseload.
About the Editor
Joshua M. Gold, PhD, is a professor and doctoral program coordinator in the counselor education program at the University of South Carolina. He has published more than 65 peer-reviewed manuscripts, books, and book chapters. He is the author of Stepping In, Stepping Out: Creating Stepfamily Rhythm, as well as several journal articles related to stepfamily functioning and success.
About the Contributors
Luke Barker, MEd, LPC, is a recent graduate of the counseling program at Youngstown State University. He currently works as a community mental health worker in northeast Ohio. He has 4 years of experience working with families in rural areas, and his research interest includes the impact of trauma on the family.
Gloria Bieret, EdD, is an adjunct professor at Buena Vista University. She is an RPT-S and has worked with children and families experiencing family transitions for the past 10 years and is currently in private practice.
Kristin L. Bruns, PhD, is an assistant professor in the counseling program at Youngstown State University and has 10 years of clinical experience. She has worked in college mental health, community mental health, and in a private practice setting.
Michael E. Deitz, MEd, NCC, is a doctoral student in counselor education at Virginia Commonwealth University. He has 2 years of experience working in university counseling centers, where he explored topics of blended families, divorce, and steprelatives. His current research focuses on the wellness of student-athletes and proper counseling techniques for this population.
Samuel Donham, MEd, is a recent graduate of the counseling program at DePaul University. He currently works as a community mental health worker in Chicago.
Kimberly Duris, EdD, is a faculty member in the master’s of arts in clinical mental health counseling program at Lewis University. She has over 15 years of professional work experience in the mental health field, including work with dually diagnosed adolescents, severe to chronically mental ill adults, and clinical supervision for master’s-level interns and master’s degreed professionals seeking licensure.
Kathie T. Erwin, EdD, LMHC, NCC, is an associate professor in the School of Psychology & Counseling at Regent University. She has 25 years of clinical practice experience, has authored seven counseling books, trains psychological first aid teams internationally, and is on the Fulbright Specialist Roster for international teaching and research.
Rebecca George, PhD, LPCS, is a clinical coordinator and faculty member for the clinical mental health counseling program at Webster University. Her research interests include social justice and multicultural supervision, and she has clinical experience working in community mental health and private practice settings to assist underserved youth and adolescents.
Tara M. Hill, PhD, is an associate professor at Wright State University. A professional counselor for 17 years, she has worked in community mental health and private practice, counseling families with diverse structures, including blended families.
Debra Hyatt-Burkhart, PhD, is an associate professor in the Department of Counseling, Psychology & Special Education at Duquesne University. A licensed professional counselor whose practice of 25 years has focused on marriage and family counseling, she has provided in-home family counseling, clinical supervision, and counselor training using a structural family therapy lens.
Breanna Jones, MEd, is a school counselor at Fees College Preparatory Middle School. Her experience includes working with blended families and diverse populations in a high school in urban Chicago, Illinois, and a middle school in Tempe, Arizona.
Diane Clark O’Brien, PhD, is a faculty member and program coordinator for Webster University. She has previously published chapters for books and is a frequent presenter at national, regional, and local professional conferences, covering such topics as grief issues, aging, trauma, and clinical supervision.
Antonio Porter, MEd, is a recent graduate of the counseling program at DePaul University, and he has worked in higher education for 4 years.
Darrick Tovar-Murray, PhD, is an associate professor in the counselor program at DePaul University. He has taught counseling and couples and family counseling for 13 years and has worked in a variety of community settings for 10 years.
Naomi J. Wheeler, PhD, LMHC, NCC, is an assistant professor in the counselor education program at Virginia Commonwealth University. She has extensive clinical and administrative experience with couples and families that includes work at a university-based community counseling clinic and research center.
Dallas Wright is a graduate student in the counseling department at DePaul University. His clinical experience includes facilitating adolescent and young adult therapy groups, and his research interests include reentry experiences in urban communities and the psycho-emotional impact of incarceration.
Acknowledgments
I must acknowledge the outpouring of interest from clinicians when I posted a request for authors on CESNET for this, my first edited book. The value of this book is directly tied to the academic strength and clinical expertise of its contributors. I appreciate their willingness to offer their individual expertise and to adhere to the organizational and administrative protocols for this project.
I gratefully acknowledge the thoughtful feedback provided by the reviewers who cared enough about the quality of the work and the value of its topic to offer their perspective for my consideration. I also honor the support and guidance provided by Nancy Driver, Carolyn Baker, and the professionals at ACA who helped me hone the thesis of this book and supported its enactment. Their consistent patience and input were critical to its evolution as I worked to strengthen the content while allowing the authors’ voices to emerge. This book has truly been a team effort. My name appears on the cover, but I could not have accomplished this feat without the notable contributions of the individuals mentioned here.
PART IIntroducing the Case Study
Chapter 1What We Know About Stepfamilies
Joshua M. Gold
The presence and prevalence of stepfamilies as a social institution continues to grow (Gold, 2016). Today, there is nothing unique about combined families; the numbers have risen dramatically in the past 45 years (Gosselin & David, 2007; Jones, 2003; Lewis & Kreider, 2015). The scholarly and clinical study of this complex family unit has uncovered distinctive characteristics of stepfamilies.
This book illustrates stepfamily dynamics in a unique way. The authors of each chapter in Part II present a specific theoretical approach for working with a single family unit. The case study family is the same family for all chapters, and it is described in the following section. The case study description is a composite of several stepfamilies and is not based on any one particular stepfamily unit.
Case Study
Marvin is in Grade 4, and his in-class behavior has recently come to your attention. He has become argumentative with the teacher, refuses to complete his work, and teases other children. When confronted by the teacher, Marvin explodes into tears and accuses her of not caring about him. In the latest episode, when the teacher tried to comfort him, Marvin struck her several times with his fists, causing observable bruising on her arms. When confronted by the principal, Marvin remains obstinate and defies his authority even in the face of corporal punishment or suspension. The school wants to refer Marvin for testing for attention-deficit disorder, hoping that this diagnosis will lead to a prescription of Ritalin.
You are Marvin’s counselor, and you decide to explore Marvin’s behavioral change as a function of family change. You have not met Marvin’s parents or family, but Marvin’s recent behavior leads you to ask them to provide some family information. You learn that Marvin’s father (Ted) and stepmother (Mary) have been married for 1 year. Ted (age 35) was married to Linda for 11 years, and they had two children: Marvin, age 9, and Vanessa, age 10. Ted tells you that his first marriage was dissolved when Linda decided that she didn’t want more children and wanted to return to college. Ted felt that children need a mother at home. Eventually, Linda moved out of the family home, moved in with a friend, and returned to university. Ted reports no feelings of attachment to Linda and says that the divorce has worked out fine.
Mary is 33 years old. She left her family home at age 17. Her father could not understand her desire to attend university rather than marrying and settling down as her three older sisters had done. Mary related that her boyfriend from high school (Fred) proposed on the eve of their high school graduation and that she “created a scene” by turning him down. She worried that he would not support her career and independent identity. She worked very hard to earn a bachelor’s degree in computer science. In her few visits home, Mary and her parents fight constantly about how her life is turning out. The conflict escalated when her parents discovered that Mary was having an affair with Ted. The last fight ended with Mary vowing never to speak to them again, her mother in tears, and her father defiantly telling her to leave! Throughout her struggle with school and establishing herself in her career, Mary had little time for relationships, promising herself that marriage could wait.
Ted owns a computer service firm that he boasts of “building from nothing.” He is the only child of William and Ethel. Ted’s father is a take-charge kind of man, always in control, and very certain of his decisions. William is the boss not only at work but also at home. Ethel says that she gets the greatest pleasure in seeing to “every need of her two boys.” Ted had several girlfriends in college, but his parents dismissed all of them as “below him.” When he finally met Linda, he considered her his “fantasy woman,” but he had a hard time convincing his parents that she was “good enough” for him. Ted’s father seemed more accepting of Linda, but his mother always harbored a grudge about Linda “stealing her son.” Ethel reminded Ted at the time of his divorce that she had predicted that Linda was no good.
Mary met Ted (her boss) at their workplace about 2 years before his divorce became final. She said that she felt attracted to his strong sense of self and identity. They became novice and mentor, and as Ted’s marriage deteriorated, they became lovers. After Ted’s divorce was final, Mary spent more time with Ted and the children. She felt unsure around them, but Ted reassured her that after the marriage they would all get along fine.
Two months later, after a weekend honeymoon, Mary moved her furniture and two cats into Ted’s house with his furniture, two dogs, and two children. Vanessa seems to spend a lot of time in her room or with her friends, and Vanessa ignores Mary when she speaks to her. Marvin seems to oscillate between defending Mary to Vanessa and telling Mary that “she is not his real mother.” In addition, Mary recently received a call from Ethel telling her that the children don’t love her and suggesting that the children move in with their grandparents. Yesterday, Linda came to pick up the kids for visitation, but Marvin refused to go with her. Linda accused Mary of poisoning the children against her and threatening to reopen the custody hearings.
Mary always dreamed of having children, and Ted had originally agreed. Due to the conflict at home, however, Ted has changed his mind. Mary says that he will not even speak to her about this anymore and that he downplays her conflicts with Vanessa and Marvin. Ted says that she is exaggerating because the children always “mind” him. Equipped with this information, you begin to hypothesize about how to help this family.
Stepfamily Demographic Data
Clinicians working with stepfamilies over the past 10 to 15 years have seen their numbers increase dramatically. Stepfamilies are found throughout all cultures, and the diversity of this family form and its identified struggles are significant. A stepfamily is defined as a household in which there are two adults in a committed couple relationship and at least one of the adults has a child or children from a previous relationship. Those children may be in residence, be jointly parented, or have reached an age of majority and departed the family home. An estimated 9,100 new American stepfamilies are created each week, and 50% of all Americans have a stepfamily connection (Stewart, 2007). For example, four recent U.S. presidents (Obama, Clinton, Reagan, and Ford) were members of stepfamilies. Earlier estimates predicted that the stepfamily constellation would be ranked as the most common family form in the United States by 2020 (Visher & Visher, 2003). However, accurate demographic data on stepfamilies are difficult to discern. Standard reporting systems, such as census figures, tend to underestimate the number of stepfamilies because of a lack of a consensus on the definition of a stepfamily; budgetary constraints; and discontinuing reporting marriage, divorce, and stepfamily trends. Data collection is said to be further confounded by three current family constellations: (a) nonmarital childbearing, resulting in a first marriage in which the current spouse is not the biological parent of the children in the home; (b) cohabiting families with children, resulting in these families not being counted as a “legitimate” family system; and (c) multihousehold families, in which children move between two or more households and may not be acknowledged in formal data in either home (Crosbie-Burnett et al., 2005; Deal, 2011; Lewis & Kreider, 2015; Pew Research Center, 2011). I hope such omissions will be corrected in the future so researchers and clinicians can be provided with more accurate numbers of stepfamilies.
The emergence of stepfamilies in ever-growing numbers challenges family counselors to replace the “nuclear family” norm with more current exemplars of family dynamics relevant to, and stemming from, the stepfamily experience (Felker, Fromme, Arnaut, & Stoll, 2002; Goldenberg & Goldenberg, 2002; Gosselin & David, 2007). Stepfamilies have always formed part of the family constellation in our society; however, the recent increases in divorce and subsequent remarriages has expanded their numbers (Goldenberg & Goldenberg, 2002).
Carter and McGoldrick (2005) stated that “more than 1/2 of Americans today have been, are now or will eventually be in one or more stepfamilies during their lives” (p. 14). The Pew Research Center (2011) and Lewis and Kreider (2015) echoed this statement, claiming that more than 40% of adults have at least one steprela-tive in their family. In earlier times, stepfamilies were usually created after the death of a spouse, whereas today the divorce of one or both partners from previous spouses commonly results in new blended families. The divorce rate in 2002 was 55% for first marriages (Gately, Pike & Murphy, 2006); more recent data that include both legal divorces and long-term separations indicate a 50% rate (Stanley, 2015). A majority of those adults, 65% of women and 70% of men (Portrie & Hill, 2005; Wilkes & Fromme, 2002), will remarry. Remarriage usually occurs relatively soon after the dissolution of the previous relationship, with women remarrying within 3 to 5 years and men remarrying within 1 to 2 years (Gately et al., 2006).
The dynamics of each stepfamily is unique due to the personalities of the individuals and the dynamics of their previous relation- ships. The diverse composition of stepfamilies (biological parent, stepparent, child, stepchild, mutual child plus one, or perhaps two ex-spouses plus extended present and ex-family members) generates multiple levels of tension around the adjustment of all family members to the new and multiple roles and relationships. Conflicts are rooted in insecurity regarding each member’s role and the uncertainty of how to enact these roles while living them at the same time. Similar dynamics apply to those grown children whose parents remarry (Harris, 2014).
Children coming into a combined family most often have endured either a divorce between their natural parents or the death of a parent. Their emotional senses have been brought to new heights. The foundation they once held as stable and solid is gone, and life is no longer routine (Jones, 2003). Stepparents often receive the brunt of these frustrations and fears. This is uncharted water for everyone, because “our culture lacks any established patterns or rituals to help handle the complex relationships of acquired family members” (Carter & McGoldrick, 2005, p. 417). In addition to the stepparent–stepchild relationship, clinicians must remember to attend to the marital relationship, which tends to be overshadowed by the stepparent roles (Halford, Nicholson, & Sanders, 2007), and to the effects of having “my,” “your,” and perhaps “our” children all sharing the same home. An additional issue revolves around the extent to which ex-spouses can collaborate as effective co-parents, resolving whatever acrimony remains from the marriage for the sake of long-term shared child rearing (Mahoney, 2006). The old myths of the stepfamily can drastically interfere with effective clinical understanding and therapeutic assistance for these new family constellations. Clinicians must educate themselves to go beyond stereotypes or comparisons of stepfamilies with nuclear families to truly appreciate the unique strengths and challenges in working with a family system that is predicted to become the dominant family form in the United States in the 21st century (Jones, 2003).
The numbers of stepfamilies are increasing, but of more concern is their rate of failure (The Stepfamily Foundation, 2017). The divorce or permanent separation rate for first marriages hovers at about 50%, whereas dissolutions in second marriages increase to 60%+, and these marriages often include blended families (Stanley, 2015). These statistics imply that success in a stepfamily is more challenged than success in a nuclear family. Directed research and practical publications are needed to assist clinicians in understanding the unique dynamics of stepfamilies and to guide thoughtful, practical, empirically validated interventions (Jones, 2003).
Stepfamilies are the fastest growing family structure in the United States, and their numbers alone make this a topic of interest. This growth means that counselors will encounter stepfamily issues regardless of their area of clinical focus. Family counselors have the most direct contact with stepfamilies, but school counselors also need to understand stepfamily dynamics as families form, dissolve, reform, and add new children. Mental health counselors may see individual stepfamily members who are experiencing transition issues, and helping the individual may require an expanded focus on family dynamics. Counselors in multiple clinical venues will benefit from knowing how to intervene more productively with the stepfamily clients they are bound to see. This book provides a snapshot of how differing theoretical models can be applied to a single case study to help this stepfamily function more effectively in their new configuration.
Clinical Approach of This Book
This book is based on three premises: (a) that the reader is familiar with the tenets and practices of theory-based treatment planning and intervention; (b) that the reader has a general knowledge of systems thinking; and (c) that the reader has foundational knowledge in the theories of family counseling.
Family Systems
The interventions described in each chapter are based on the principles of family systems. These precepts assert that issues, and their resolution, arise between individuals rather than within one person. Therefore, the focus of attention cannot be simply the “stepdad” or the “stepchild” but how the entire stepfamily interacts in relation to the issue of concern. In areas of communication, such as discipline or conflict resolution, behavioral counseling modeled in self-help books may suggest amending the interaction styles of the individuals to resolve the issue. This approach is based on the assumption that the key issue rests in the enactment of mutually agreed-upon roles and functions.
Although such a concise perspective may be attractive, family systems are complex, and clients are not generally best served by this limited approach. For example, if a father and son are in conflict about an issue, the preexisting history and relationship of parenting between them may need to be “tweaked” to account for the current issue, and the solution may involve paying attention to the developmental needs of the son. However, there is no doubt or ambiguity surrounding the parent–child relationship. The father has been a parent, in some fashion, since the son’s birth and holds all the rights and responsibilities of a parent. The son, likewise, has experienced only this father and has been reared within the “son” role specific to this family. Moreover, those role definitions and enactments reflect socially and culturally acceptable expressions of being a father and a son, with referents in social institutions such as the extended family, church, and so forth.
Theory-Based Treatment Planning: Rationale and Possibility
A number of family counseling theories are presented in this book that could benefit our case study stepfamily, given the counselor’s understanding and belief in the model and the counselor’s capacity to facilitate client investment in that approach. The question then arises, “Which approach would work best with this presenting issue?” By showing how one case study may be approached using different theoretical perspectives, you can individually weigh the merits and limitations of each approach. When the family system is the client, clinicians need to have a broad understanding of the available models and the strengths and weakness of each to provide the best outcome for their clients.
The applicability of differing models has its foundation in the principles and practice of theory-based treatment planning. Sperry (2016) spoke to its novelty of attention rather than technique or intervention as “the first step in providing competent family therapy” (p. 279). Theory provides the counselor and clients with a blueprint for setting goals and treatment options beyond addressing each identified client issue separately (Gehart & Tuttle, 2003). Theory-specific contracts embrace clients’ lived experiences of their challenges, and the enactment of a co-created story offers new hope and perspective for clients. Clients are more invested in their therapy when they are involved in its development.
The use of a single case across all approaches emphasizes that the case itself—the family members or the presenting issues—does not dictate a specific mode of counseling. Rather, the orientation of counselor, as embraced by the clients, sets the foundation for counseling. If a counselor is unable to generate a theory, or story, that replaces the family’s problem-saturated perspective with an outlook of hope and optimism for more successful stepfamily functioning, a referral should be made.
