Overview
1. The following family sees you in your office:
A Puerto Rican family with a 12 year-old boy comes to see you in your clinic complaining that his motivation in school is low and that he is excessively impulsive. He was recently suspended for three days for saying he was going to rape a girl at school. Prior to this, he has been found viewing "extreme" pornography on several occasions. His parents have put security on his computer and phone to prevent access to it, but he has figured out ways to get around this. He has explosive anger when confronted. While he has not been violent toward anyone, he will yell and make threats of violence toward his parents and others. Because he is big for his age, he can be intimidating. In addition, his grades have been failing to barely passing. He has a history of struggling academically since he began school and has been required to spend more time on assignments than other students. However, it became worse when he entered the sixth grade and a permanent substitute teacher was assigned to his class. The parents blame the teacher, who is an ex-police officer and is “rigid” in classroom discipline, for unfairly singling him out. He has several classmates who appear to look up to him. He has a stoic presentation that frustrates the teachers during disciplining but seems to earn him respect from other students. It is a result of the suspension that his parents identify the presenting problem as both his anger and impulsive pornography viewing.
In addition to the identified patient, the family contains the biological parents and a 17-year-old brother. The parents have been to marital counseling and have had a difficult marriage for several years. The father shows a lack of motivation in their relationship and his parenting. While he appears to have strong emotional feelings for his wife, he does little initiation of intimate activities or housework. Despite the wife expressing much anger at this, he does not change. He believes that she is too pushy and negative. A recent fight was described when he took a week off from work. She wanted to spend time together and do things as a family. Instead, he built her a patio so she could enjoy being outside when he was at work. She was upset but he thought when she got use of it, she'd be thankful. She has reacted by pulling further away and is angry that he does not seem to care. The mother stays at home and his father is a truck driver for a local bakery. His hours are early, from 3 am to 11 am. He is very tired when home during the day and mostly sleeps and watches TV. His mother wants “more of a family life” and pushes him to spend more time with their sons. He makes fleeting efforts, but has low energy and rapidly discontinues the effort. The mother has lupus and pulmonary hypertension, and is frequently symptomatic. The other son is not problematic. He is seen as the “good boy” doing his chores and homework without reminding He attends a magnate high school and participates on an academic team. He has a girlfriend and spends a lot of time with her.
The younger son shows no interest in other activities. He is large and, in the past has shown interest in sports. Recently, he had an opportunity to play football, but chose not to without explaining further. His mother believes that this was done to “spite” her so she kept pushing him to do it. This just got him angrier and he threatened violence to get her to stop.
In the home, fights between his mother and Luke occur daily in an effort to get him to study and do his homework “properly.” It is stated that he would play his game system all day if he could. The video games and other screens are frequently taken away from him as a result of his not stopping using them when asked to finish the homework. He sees everything as being taken away from him and when positive reinforcements were suggested he stated, “it wouldn’t matter, they’d also be taken away.”
When asked what he would like out of therapy, the youngest son just shrugs and says, "I am only here because I have to be here". The mother stated she wants the youngest son to listen and be like his brother. The father and older son want to support the mother.
Based on this information, do four of the following (including (e) ie you have to do (e) and 3 others: One Paragraph each question! (25 points each)
1. Discuss this family from a Bowen family systems standpoint. Include discussion of assessment features of this theory, as well as apply the key elements of this theory.
1. Discuss this family from a strategy family standpoint. Apply the key elements of this theory, as well as a description of interventions of this theory.
1. Discuss this family from a structural family standpoint. Apply the key elements of this theory, including doing a structural map and apply enactment.
1. Discuss this family from an experiential family standpoint. Include a discussion of assessment features of this theory and how you would apply interventions from this theory.
1. **must do this one: Apply cognitive behavioral theory to this family. Include what skills you would address, and how classical and operant conditioning may have impacted the presenting problem, as well as how you would use operant conditioning in treatment. What cognitive processes would you address, and how?
1. Adress three considerations from the modern family perspectives. Including, but not limited to, multicultural issues, medical issues, issues of technology, and economic issues.
1. Discuss the family from a solutions theory standpoint. Include a discussion of the assessment features of this theory, as well as interventions you would use from this theory.
1. Discuss the family from a narrative theory standpoint. Include a discussion of the assessment features of this theory, as well as interventions you would use from this theory.