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Saturday, 24 May 2014 14:47

Theoretical Orientation to Therapy Featured

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            Theoretical orientation is a prevalent way of defining a therapist, in psychotherapy (Egan, 2007). Individual practicing therapists have a theoretical method or approach to which they adhere while helping clients. Although it is fundamental that therapists have to have knowledge of a variety of theoretical approaches, aligning to a specific theory that compliments the counselor’s personal style and expertise, and makes them feel comfortable enables them to have a good base from which to work with clients effectively (Okun, 2007). Similarly, having knowledge of a variety of theoretical approaches enables the counselor to work with counselors who conform to different approaches, with ease.


In accordance to my personal style, knowledge, and strengths, I believe that solution-focused and family systems theories are methods with which I feel comfortable practicing.  In this paper, the purpose is to demonstrate my personal orientation to theory and the connection between these approaches and my personal strengths, in relation to my prospective work with families and children. I also discuss the likely interventions that I will implement, in accordance with the solution-focused and family systems theory. Finally, a current therapeutic situation will be discussed, in relation to the theoretical approach.


 The Family Systems Theory

            The practical application of the family systems theory has a variety of definite advantages (Egan, 2007). It is a common believe among therapists that the family of origin has an influence on an individual beginning from childhood to adulthood. The family systems approach emphasizes the need for a therapist to appreciate the influence of the current family structure on an individual. The most significant advantage of the family systems theory is the inclusion and recognition of the different entities within the family that influences the individual’s thought processes, behavior or character, coping strategies, and the capacity for social interaction with individuals, in the outside world. This attribute of the family systems theory is fundamental for therapists, especially those who work with young persons who are at an early stage of coming to terms with a domestic violence relationship.


            The clinic at which I am involved in clinical practicum has a focus on a client-centered approach. However, I have opportunities to practice psychoeducation, focusing on their family of origin and how it impacts their decisions as adults, as well as identifying their ideas of a healthy relationship and situations in which they are most comfortable. This is the initial step from which we proceed to the examination of how the relationship between the client and people around them influences the client’s children. In a majority of cases where the client can recognize their connection to the family of origin and its impact on the health of their adult relationships and choices, the client gets the motivation to disengage themselves and their children from an abusive relationship.


Therefore, considering the ages of children, it may be necessary to have sessions that involve the family of the client, in the process of therapy. However, it is important to recognize that involving the client’s family may cause problems that may not have been present in the implementation individual therapies.  For instance, the ages of children and size of the family can become obstacles in making an application of the family systems theory.  This is because the therapist has to move from dealing with an individual history and viewpoint to incorporating diverse views. In addition to the firsthand opportunity of watching the interaction between the individual and family, the therapist has a role to ensure that every member of the family is accorded an equal measure of fair treatment while also ensuring that all individual members enjoys confidentially and that their story is expressed and heard.


The risk is that the counselor may be triangulated into the family. Therefore, counselors must take precautions and ensure that they do not form alliances or take sides with individual members of the family. This can be a challenge especially when the individual member of the family was engaged in therapy with a single member of the family.It is also vital for a counselor to feel comfortable with the family while ensuring they are sensitive to the individual needs of the family members. Sensitivity to individual needs may vary with the size of the family and the age of the targeted client.  The age range of clients in the clinic where I am attached is wide. Clients have a range of age 20 to age 60. Therefore, I get a chance to interact with clients’ children, ranging from age five to age 20, on average. Lastly, I am engaged with many family members, and, so, sometimes it can be an overwhelming task to take note of the individual communication style, point of view, and alliances between members of the family involved, in the therapeutic process.


 Personal Style, Theoretical Orientation, and Initial Interview Strategy

            Since an early age, I have learned to be a straightforward person. I always do things in a systematic way that conforms to logic. For example, when faced with scenarios that involve choices, I always choice the shortest course of action. I know and believe that the past has a bearing in what we do in our current and future lives. I also understand that none can change their past. Therefore, it is not wise to spend a lot of the counseling time reliving the past. In this regard, I believe that all persons have the ability to change their current status provided they get a proper motivation to change. The implication of this belief is that I embrace the solution-based therapy as an adjunct approach to the family systems foundation of my personal theoretical orientation to therapy, in helping clients. 


 I also have beliefs that are related to the solution-focused theory, which incorporate into the practice of therapy. For example, I believe that the client has a significant role to play in the planning of therapy and development of their treatment goals. This belief blends well with the client-oriented approach applied by therapists, in the clinic at which I am completing my clinical practicum. The choices that come from within an individual can have a lasting effect that those from outside sources such as the therapist. Outside sources can have good intentions but may not be accepted easily by the client, as their individual target goals for the therapeutic process. In addition, I acknowledge the potential of self-motivation, in attaining therapeutic goals set by the client. Envisioning positive outcomes is a fundamental step in realizing therapeutic goals (O’Connell, 2012). For this reason, I embrace the application of self-talk. I promote asking the client to envision their life without the problem so that they realize the importance of working towards making the problem disappear and, hence, achieving therapeutic goals. 


Lastly, I believe that making summarizations at the end of individual sessions is important in reinforcing messages. Summarizations reinforce to the individual that the therapist took note of their expressions. In addition, it gives therapists an opportunity to restate the problem in different ways so that the client can have different perspectives of the problem. This enables the client to think of possible solutions that may have not been apparent to them. This is specifically useful for victims of domestic violence, whom I work with, in the clinical setting. At the beginning, the client is usually in a crisis and cannot solve the problem effectively. The recap or summarization enables the client to redefine their problem and think of potential solutions as they now can understand the problem better.


 Diagnostic Assessment, Goals, and Interventions

            In a sample case, a couple came to the clinic for counseling. The wife came complaining that the husband was dealing with their 7-year old son inappropriately. The son, who is in second grade, sometimes refuses to go to school. Sometimes, the couple is able to force him to school, but sometimes they are unable to convince him to go to school, and the boy stays home the entire day. Struggles to make the boy to get dressed and prepare for school marked the beginning of a routine day for the family.


The problem was that the parents differed about the best approach to make the child change his attitude towards school. While the husband preferred to beat the boy and force him to school, the wife preferred a softer approach. Therefore, the difference in approach made couple part ways and the boy remained with the husband, who would force the boy to school every morning. The wife wanted a method to make the husband agree to her soft approach of handling the boy, or get her son out of the custody of his father. I arranged to meet the couple and the boy for counseling, utilizing the family systems approach.


 I like using self-motivation with the clients. In many occasions, clients who come to the clinic are those that have minimal or no control over their lives, children, and homes. Therefore, asking the couple to state their goals resulted in them keeping quiet, without providing any answer. Generally, there are some silent goals that individuals have such as wanting the end of abuse, wanting to feel better, or wanting their children handed back to them. After the start of the discussion about what their situation would be like without the problem, it took a couple of sessions for the couple to begin to conceptualize the specifics of the things that needed to happen such as making their son go to school voluntarily, solve their differences, and other things that needed to happen to enjoy a relief. 


After the identification of client goals, the next step was to create a strategy to move towards these goals. Usually, it is important to start with simple, achievable steps. I normally work backwards from the goal to the strategies. For example, for the couple who wanted to solve their marital problem and find a way to make the child go to school, I assisted the couple to identify strategies that would assist in meeting the goals of therapy. During the discussions, it became apparent that the boy did not like the school because his friend had told him nice things about their school, and so he wanted to change schools. He had not told his parents because he thought that his father would beat as he always did. The parents agreed to a change of school and a non-violent approach to handling their son.


 Challenges, Strengths, and Ethical Implications

            The challenge in utilizing the family systems approach to counseling is that couples may not be in good terms at the time when they come to the clinic for counseling. For example, the wife and husband were living in different homes, making it difficult to arrange for a joint session. The husband was reluctant to agree to be involved. However, after a few failed replies to the invitation for therapy, he finally accepted. The other challenge was that the couple’s child was too young to be considered an independent family member. However, the case was not too complex to warrant questioning the validity of contribution of the young child to the solution arrived at during the counseling process. It is also fundamental to note that the family members agreed to participate voluntarily and agreed on the solution, without any form of coercion or influence from the counselor, in accordance with the law and professional ethics. 


The most important thing in utilizing the solution-focused therapy is to define the problem and identify specific goals for the therapeutic process (Zankas, 2008). However, the achievement of these things requires the client to take certain steps first, depending on the problem. For example, the client may need to contact their family and talk to them about their situation. They could also identify opportunities for a sustainable job. After the client and the therapist identify the end goals, they should begin to work together to actualize those goals. The strength of the family systems approach to therapy is that is based on the principle that the whole is important than the sum of its parts (Egan, 2007). Through the involvement of the entire family, individual members of the family perceive the sense that every individual member of the family is important to the process of identifying the solution to the problem.


This is important in ensuring that the individual members of the family buy into the solution agreed upon by the members as assisted by the therapist. The other advantage is that the clients are the ones who identify a preferred solution to their problem. In the sample case, the resulting solutions were developed based on the consideration of the effect on the child.  The therapy was successful in creating a solution for the couple, in that they not only agreed to transfer the son to his preferred school, but also agreed to reunite and live together as a family. The counseling process created a platform where every member of the family had time to talk and be heard fairly. This allowed them to listen to each other without anyone among them dominating the discussions as they would happen in a non-counseling setting.


Perhaps, solution-focused therapy acting as an adjunct method to the family systems also contributed immensely to the creation of an accurate solution. The systems theory perceives psychological problems of an individual as arising from the individual’s current environment and inter-generational family system (Zankas, 2008). From an ethical point of view, the therapist should respect and guard confidences of every individual client. The information obtained from every family member should be treated as if the individual were in a session for an individual therapy. The therapist should refuse to discuss with individual members separately because doing so will foster the development of unproductive alliances among the members of the family. 


In relation to my experience, my initial affective response was that the couple’s case was a case of misunderstanding. Several cases that involve parents differing over their children’s behavior include some aspect of variation among the parents, with respect to responding to the behaviors of the children. From their discussions and expression of emotions, I realized that the couple had been lacking an appropriate platform to talk and listen to each other. It became apparent that the husband had been having his way because of his violent nature, without considering the views of his wife. However, when he got the chance to listen to her and think about his actions, he realized that he had boiled things over, in their marriage. Of course, there are a few things that I would have done differently, with respect to the application of the family systems therapy.


For instance, the schedule of the counseling sessions was spread across a two-week period. Perhaps, well spaced sessions may provide to the clients adequate time to think about themselves, and whether they are ready to commit to certain decisions. Short period may rush the clients to making conclusions without sufficient thought. The clinic to which I am attached emphasizes client-focused approach to therapy. Therefore, this theory is a perfect fit because it encourages therapists to compliment clients. The focus is on identifying the things that work best for the client. I begin from there to help the client pursue their goals as identified. It is important to begin by acknowledging the significance of the fact the client took the first step to honor the appointment to come for counseling. Recognizing and acknowledging the client’s awareness of the state of their life and their willingness to seek help and take action are a motivation to the client. From there, I can help the client set strategies and timelines for the attainment of the therapy goals.


 Conclusion

            I believe that the best method to assist clients is for a therapist to adopt a personal theoretical approach while having a basic knowledge of various theories. It is also fundamental to realize that therapists who are flexible and willing to borrow from other theoretical approaches accord their clients the benefits associated with utilizing multiple opinions and different theoretical approaches. In accordance with my personality profile and interests, I believe that the solution-focused approach to therapy is the best foundation for interventions, particularly utilizing it as an adjunct to the family systems theory. The clinic to which I am attached has a client strategy that suits the application of these theories. Therefore, I can apply goals and strategies related to these theories within my choice of the clinic.


References

Egan, G. (2007). The Skilled Helper: A Problem-Solving Management Approach to Helping (8th Ed.). Belmont, CA: Brooks/Cole

O’Connell, B. (2012). Solution-Focused Therapy. Thousand Oaks, CA: Sage

Okun, B. (2007). Effective Helping: Interviewing and Counseling Techniques (7th Ed.). Pacific Grove, CA: Brooks/Coke

Zankas, S. (2008). Ethical Issues in Couples and Family Therapy. Retrieved November12, 2013, from https://umdrive.memphis.edu


 

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