Final Exercise in Family Therapy

Final Exercise in Family Therapy

Dr. Scott Sparrow

UTPA EPSY

In the following transcript, I have presented an imaginary family, and have conducted counseling with the family. I have also attached a blank answer page for your use.

There are 25 core concepts that are numbered in the body of the transcript. They are worth 8 points apiece, for a total possible score of 200 points toward your final tally. Write the name of the core concept that best captures the intervention being used by the therapist. And then tell me why it’s useful in the context of the session.

Please note that there are other core concepts embedded in the transcript and not numbered. If you want extra points, circle the words that represent a core concept, and number it. Use 26-35 on the Answer Sheet to include extra core concepts. You can claim up to 5 extra core concepts @ 8 points apiece.

Scenario

Linda Zamora calls you requesting an appointment for her daughter, Maricela, who has been “causing problems” at home. Maricela is 15, and has recently become “obsessed” with boys. Her normally above-average grades have fallen to Cs, and she has begun wearing short dresses, and makeup. Just last week, she had her nose pierced without asking, and her father (Joe) went “bananas.” It was then that Joe agreed that they needed to get Maricela counseling. Linda tells you that she and her husband haven’t been communicating very well for some time, and blames the problem on Maricela’s behavior. She tells you that she has a four-year-old son Tommy who hasn’t been getting enough of her time because of all of this. Linda and Joe have been married for 16 years, and used to be much closer than there are now. Joe is a football coach, works evenings during the fall semester, and “can’t keep his mind off sports.” Linda is

a high school Spanish teacher. You suggest to Linda that it would be better if she could bring everyone in for the first appointment, and Linda agrees to do so.

First Appointment

1) Hi, I’m Dr. Sparrow. Hi Linda (shaking her hand). And Joe? (shaking his hand) it’s good to meet you. Come on in.

You can have the sofa and these two chairs. And I always sit here. Wow, that’s a big bubble you’ve blown! (to Tommy) You must be Tommy. (Tommy nods) And it didn’t even get stuck on your nose. How do you do that? My bubbles always get stuck. -- #1

Tommy giggles and says, “I dunno.”

Dr. S. -- Hello, I’m Dr. Sparrow. You must be Maricela.

Maricela -- Yes, that’s me…

(transcript skips to...)

Dr. S. -- Okay (turning to the parents). I spoke with you on the phone, Linda, but we didn’t have much time. I’d like to hear from each of you about what you think the problem is. -- #2

Dr. S. -- (Looking at the parents) Which one of you would like to tell me what brings you to counseling? (Dr. S.then purposely looks at his notebook instead of looking at either parent.) -- #3

(Joe and Linda look at each other. Joe says, “You tell him...”)

Linda -- Okay. Well, we’ve been having some trouble with Maricela. She used to be so nice and cooperative, but now it’s like we don’t matter anymore. She gets these clothes from her friends (referring to Maricela’s short skirt) and she got her nose pierced without telling us. I think it’s all pretty natural, but Joe and I disagree about that.

Dr. S. -- Thanks, Linda. Joe, what do you think the problem is?

Joe -- I agree with Linda, except that I am much more worried about her behavior. I think it’s way over the top -- the nose ring, not telling us, the boys. I think that Linda doesn’t tell me everything, either. I get really upset when I feel that they are keeping things from me.

Dr. S. -- Okay. Maricela, what do you think the problem is?

Maricela -- They are the problem! They don’t know what it’s like to be a teenager. I’m normal, just like my friends. They think I’m stupid, and they never believe anything I tell them. Especially Dad. He gets all jacked up over the smallest things. He's always on my case.

Dr. S. -- You say "always," but I'd like to think back and tell me if there was ever a time when you and your dad were getting along better? -- #4

Maricela -- When I was 3 months old and could only say "goo goo," probably. (She laughs at her own joke.) Seriously, well, yeh, there was one time when we got along pretty good.

Dr. S. -- So what was happening when you got along? I mean what were you doing differently then?

Maricela -- Probably it was because we were playing music together. I play the flute, and dad plays the guitar, and last year we practiced at home for a Christmas performance at church. That was a lot of fun, but then it was over.

Dr. S. -- You mean you stopped playing music together?

Maricela -- (looking down and looking sad) Yeh, we stopped.

Joe -- That was a good time, wasn't it, Maricela? (She nods without looking at him.)

Linda -- Dr. Sparrow, it seems to me that Joe is much too harsh toward Maricela, and he really needs to listen to her more.

Dr. S. -- Linda go ahead and talk to Joe about that. --#5

Linda -- Joe, you just need to take some time and listen to what Maricela wants. I don't think she's any wilder than any other normal teenager.

Joe -- That may be true, but I don't see why we have to accept what she's doing just because her friends do the same thing. I think we need to hold her to a higher standard than that.

(Tommy, who has been playing with the basket of toys, gets up, and comes over to Linda while she’s talking to Joe.)

T -- Mommy, can I have a drink.

Linda -- Tommy, you just had one. You need to wait…

T -- But Mommy, I’m thirsty.

Linda -- Dr. Sparrow, do you have some …

T -- Juice, Mommy!

Linda -- ...some juice for Tommy?

Maricela -- Tommy, sit down! You don’t need anything.

Dr. S. -- Linda, I noticed that as soon as you and Joe started talking, you shifted your attention away from Joe to take care of Tommy request. -- #6

Dr. S. -- And then Maricela tried her best to help you take charge of the situation. #7

(continues) But you're the parent. Do you think you can handle the interruption without depending on her to rescue you?-- #8

Linda -- I guess so. Maricela, let me deal with Tommy.

Maricela -- That would be the day.

Linda -- (Tommy starts pulling at Linda's sleeve again). "Wait, Tommy, and I’ll get something when we finish. (Tommy keeps pulling)

Joe -- Tommy, go sit down. (Tommy goes back to the basket and begins to play with a dinosaur.)

Linda -- Joe, he was just playing. It was all right.

Joe -- It’s not all right with me. He needs to obey you. I mean...we can never have a conversation without being interrupted! I get home and you always want to talk -- lately about Maricela -- but we don’t get very far before Tommy needs something, and then you give in.

Dr. S. -- Is that the way it usually goes? (looking at Linda -- she nods) So, what do you usually do when Tommy interrupts? (looking at Linda) -- #9

Linda -- I usually try to find out what he needs, and take care of him. He’s only four, and can’t do for himself.

Dr. S. -- Joe, what do you usually do when Tommy interrupts your conversations with Linda? --#10

Joe -- I just let her take care of what he wants. I know how she is, so I just find something to do. Linda can’t say no to the kids. I used to try to get her to be tougher back when Maricela was younger, but I gave up after a while.

Linda -- You sure give up fast! When I get back from tending to Tommy’s needs, you’re always watching TV or on the phone. I can never get your attention! Football is all that matters, until it’s basketball season...!

Joe -- Not always…

Linda -- Always!

Dr. S. -- So, when you two start talking, Tommy often needs something, and once you’ve taken care of it, Linda, you two never get back to what you and Joe were talking about. -- #11

Linda -- I never thought I did, but I guess I let it happen.

Dr. S. -- And, Joe, you’ve learned to take care of yourself by turning to sports -- you’re very self sufficient #12 –

but you end up deserting Linda after she deserts you. Sports has become an excuse not to defend your relationship from interruptions-- #13

Joe -- I guess so, but I really get upset when she walks away.

Dr. S. -- Go ahead and talk to her about that. -- #14

Joe -- She never listens to me when I try to tell her how I feel about that. It's pretty hopeless.

Linda -- You don’t try very hard, Joe!

Dr. S. -- It’s important that you don’t give up saying what’s true for you, Joe. You can do it. Go ahead and tell her. #15

Joe -- (turning to Linda) You know that it really bothers me when you walk away from me. I feel...angry, sad...like you’re saying, “To heck with you, you’re not important.” (Leans over with his head down)

Linda -- Thanks (Linda reaches out and touches his hand, and smiles sympathetically.)

Dr. S. -- Linda, I get a sense that you’re always ready to take care of your kids. But it never seems to be your turn -- or Joe’s and your turn. -

I’m wondering what keeps you from putting you and Joe first sometimes? I’m wondering if there’s something from your past that accounts for this pattern? Does anything come to mind? -- #16

Linda -- I guess I try so hard because my mother didn’t take care of us very well. In fact, she neglected us very badly. My father left when I was three, and Mom drank a lot at night. I was locked in my room so long one time after she passed out … (tearing up)...that I felt that she had died and that no one would ever find me. It was the next day before anyone came. It was pretty horrible what we had to do just to survive. I just don’t want to be like her!

Dr. S. -- What kind of relationship do you have with her now?

Linda -- Oh, she’s changed, but we’ve never talked much about what happened.

Dr. S. -- So, when you’re dealing with your own kids, you remember what it’s like to be deserted, and try to keep them from ever feeling the way you did.

Linda -- (She nods) I guess I take it way too far. I mean, he can play by himself or watch TV when I’m busy, but I just always say yes when he seems to need me. He doesn’t need me to do that all the time.

Maricela --You were that way with me, too, Mom; but I’m taking care of myself now.

Linda -- I appreciate that, mijita. But I don't want you to grow up too fast.

(Tommy starts pulling on his mother's arm again)

Linda -- Tommy, wait! (He keeps pulling.)

Dr. S. -- Linda, I notice that when you tell Tommy to wait, that he keeps pulling on your arm. What do you make of that? -- #17

Linda -- He’s not listening, I guess.

Dr. S. -- Not listening? I think he’s a good listener (#18), but I don't think he believes that you mean what you're saying.

(Continues) I think you're going to have to convince him that you're not a pushover, and that there’s no point in trying to get you to do whatever he wants. -- #19. (Dr. S.looks on while Tommy keeps pulling on his mother.)

Linda -- (Very loudly and firmly) Tommy! Go sit down right now! (Tommy looks surprised, and quickly returns to his toys.)

Dr. S. -- Wow, that worked! He believed you that time! How did you do that? #20

Linda -- I guess I just raised my voice. I don't like to do that, but I guess it's necessary some time.

Dr. S. -- Tommy is a good listener, but you have to make sure he believes you, and you were clearly able to do that simply by being firm and letting him know that there’s no point in complaining. From what I saw, you won't have a problem if you remember what you just did. -- #21. (Everyone nods, including Tommy, who is obviously intrigued)

Dr. S. -- So much hinges on your willingness to set aside time for each other in order to deal with these new developments in your lives. From what I’ve seen tonight, it’s important first of all for you, Linda, to convince Tommy that you mean what you say so that you can have the time you need for each other. We all saw you do it, Linda, and if you can do it here, you can keep doing it. -- #22

Linda -- It’s going to be hard for me to be firm. I need more support from Joe. Don’t you agree with me, Dr. Sparrow

Dr. S.: I’m not the one you need to ask. (#23)

(Continues) Tell Joe what kind of support you need, and see what you two can agree one. -- #23

L: (turning to Joe) Don’t just throw up your arms and walk away, okay?

Joe -- I won’t if you won’t give in every time he interrupts! Before I had to wait forever…

Dr. S. -- You are doing well inagreeing that you both have a part to play in setting aside the quality time you need. Maricela, earlier you tried to help your mom when she was telling Tommy to wait, and it’s clear that you are interested in helping your mom take charge. -- #24 But I’m thinking that there are better ways to help her do that than by butting into their conversations. Joe, What do you think Maricela could do to help out?

Joe -- I guess she could watch him when we need to spend some time together.

Dr. S.: Check that out, okay?

Joe -- Maricela, could you help us with Tommy when we ask you to?

Maricela -- Sure, no problem.

Joe -- That would be great, Maricela. I know that I would ease up on you some if you could help us out a little bit.

Dr. S. -- (looking at the parents) It’s important for you to do your work first, however. It’s not Maricela’s role to tell Tommy “Wait.” That’s up to the parents, right? But once you have told him to wait, and you’re not giving in, then Maricela can help you at that point, okay? Do you all understand what you need to do to make this work? (Everyone nods.)

Dr. S. -- (to Linda) I’d like you and Joe to do something once or maybe twice this week when you get home from work. Set some time aside to talk. When Tommy interrupts, Linda needs to be firm while Joe waits for her to finish, and then Maricela can take care of Tommy while you two talk.

Dr. S.: Also, (looking at Tommy), it’s likely that Tommy will continue interrupting until he’s sure that you mean what you say -- right, Tommy? -

T -- Yep!

Linda -- Shouldn’t we do it more than once or twice?

Dr. S. -- Eventually, but it’s important to remember that a change this big won’t happen overnight. You need to give yourselves some time. Don’t be surprised if you fall back into the old pattern from time to time as you make progress. (#25)

(Continues)In fact, I am pretty sure you will have a few more disputes before everything has been smoothed out.

Linda: You are probably right, but I’d like to think we’ll do better than that.

Dr. S. -- I know you came here to talk mainly about Maricela, and we talked about several different things. Before you can address Maricela’s behavior and desires, it’s important for you--Linda and Joe--to be able to spend time together, discussing your needs.

Dr. S. -- (speaking to Joe) Also, I'm wondering--since you and Maricela have enjoyed making music together--if spending some time playing music this coming week might be a very fine thing for you to do to relieve the tension between you.What do y'all think? (looking at Joe, then Maricela)

Maricela -- I'd be willing.

Joe -- Me, too. How about Sunday afternoon? (She smiles and nods)

Dr. S. -- You all did some very fine work here today, and it's important to reflect on just what you did that worked so well. Also, I think that the activities that you have decided to do at home will help your family get closer and trust each other. When we get back together, we’ll see how much of that original problem still exists.

Would the same time be okay next week? Okay, I’ll see you all then.