Child and Family Therapy
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Section One
Q1.
- Assessing family violence
In today’s societies, there has been a rise in the number of family violence cases. Most cases occur in families of people struggling with alcohol abuser disorder, and who feel that there is no end in sight. The occur related problems occur too fast and in re-occurrence as most people do not seem to get any better, especially if they lack the personal motivation to control the behavior. In this context, it is not an uncommon situation to find alcoholic parents who find it hard to control their addiction and avoid getting into problems with the family.
As a therapist, it is important to note that since 2005, there has been a whole-of-system approach used to assess family violence. The approach has always achieved success as it includes an innovation into the justice system that incorporates the family violence specialist and the mainstream victim. From experience, I have learned that family violence results from particular behavior that controls the family members and results to fear and a fundamental of the need for safety at home. In most cases, the actions are dominative such that family relationships worsen. Family violence extends beyond physical abuse and involves psychological abuse of the victim. In this case, I understand that the husband is taking advantage of the power imbalance at home to cause subtle victimization of the families.
The effect of violence on women and children is often profound. In the assessment of the current situation in the family, I would begin by building the strengths of the Aboriginal factors within the family. The Aboriginal factors include social, cultural, spiritual, and emotional wellbeing (Kilcullen et al., (2018). I will need to understand and respect the much that the family has achieved together before learning about the cause of the violence. According to the Family Violence Protection Act 2008, Milne & Neil (2018), I would begin by understanding the character of the husband that has resulted in the violence. It defines the behavior of the person towards the family members, such as:
- Emotionally or sexually abusive.
- Physically abusive.
- Economically abusive.
The examples of family violence that constitute family violence must fall within the following examples:
- Threatening or causing personal injuries to family members.
- Intentionally damaging the family member’s property.
- Depriving the family members of their liberty unlawfully.
There are many entry points that I can use in assessing family violence, including:
- Direct contact with perpetrators and the husband for violence services like case management, peer support, Aboriginal healing services, and behavioral change programs.
- Mainstream services with the husband regarding counseling on alcohol abuse.
- Correctional and legal services aimed at making the husband aware of the possible implications of the behaviors.
Below is the violence assessment plan I will use in understanding and intervening in the current condition of the family.
Fig: Assessment plan: Source McCulloch et al. (2016
- Treatment Plan
According to Barish (2018), Parent Management Training (PMT) and Cognitive Behavioral Therapy (CBT) are the two treatment modalities commonly used as the trans-diagnostic approach to irritability, anger, and aggression. They target the possibility of emotional deficits and social problem solving associated with the husband’s aggressive behaviors. The treatment starts with a detailed assessment of the number of episodes that happen every week, and the intensity of anger outburst to the family members. Based on the structural interview with the victims of the aggression about the behavioral patterns of the husband, a tailored therapeutic intervention can get arranged. The treatment plan would aim to rectify the social problem solving, development of social skills, and emotional regulation.
Module 1: Identify the triggers to the anger and develop preventive strategies. In this case, the husband requires adopting reappraisal and relaxation training whenever they are under the influence of alcohol.
Module 2: The husband recalls a time when they aggressively engaged the members of the family and try to find ways through which they would have avoided the enactment. Such would develop the skill of preventing potentially anger-provoking situations.
Module 3: Develop a menu of therapeutic techniques that the husband can revisit whenever he is alone. The menu is devised to enable the husband to practice the skills of engaging other family members.
Module 4: Train the husband to accept the wife’s support in identifying patterns of aversive family interactions and rewarding them with nonaggressive attention.
Module 5: Training on effective commands to avoid developing nonessential behavioral constructs.
Module 6: Treatment fidelity checklist where the husband can record their adherence to the above-stated treatment modules. It enhances the ability to offer treatment reliably.
The treatment plan includes relational therapy since aggressive behavior may result from loneliness and depression. Thus, the treatment modules focus on preventing relational aggression and improving family relationships while intends to eliminate the alcohol disorder get underway.
Q 6.
Salma and her mother are facing conduct and emotional disorders, respectively.
According to Tornal & Martinez (2017), family relationships include both objective and subjective caregiving. Objective burden entails the child’s problems that arise from financial strains and lack of ample time with the parents or guardians. For instance, Salma complained that her mother only cared about her job and not even a single moment for her children. On the contrary, subjective caregiving entails the direct occurrence of the caregiver’s feeling eg, guild, sigma, embarrassment, or anger. Thus, the subjective burden can be regarded as the disruption in the caregiver’s life to the extent that they start living a stressful life.
Parents and children with emotional and behavioral disorders often experience huge challenges regarding the relationship between the two. Such comprises financial burden when the child feels that they are not provided the much they would want. Such instances lead to conflicts and high irritability that affects normal family life. On the other hand, a parent with an emotional disorder like has been shown in the case will lack personal freedom in the attempt to overprotect the family. They often get sad or are engulfed in emotions that affect their social life and even lead to the disruption of their working patterns.
A child with behavioral disorder tends to require more attention from the parents or guardian. Most of these behaviors occur due to the lack of upright care since their childhood. As such, a child is required to be trained on the appropriate manners since their childhood. They should be taught to respect their parents and everyone in general. The substantial parental burden resulting from the care of children with behavioral disorders has been reported in many families. Using the Child and Adolescent Burden Assessment (CABA), it is evident that children will often face behavioral disorders during their adolescence (Johnston et al., 2020). Most parents experience the pressure of keeping up with the behaviors of the child. If they, on the other hand, have an emotional disorder, they will experience stigma that they may affect their normal life unless intervened by a therapist.
Emotional disorders are less persistent that behavioral or conduct disorders. Although there are lower cases of parental burdens occurring due to emotional disorders where parents face anxiety and depressive feelings due to sympathy on their children’s behaviors, it is normal that children may face difficulties whenever they feel that their needs are not met. Just like Salma, they tend to blame the parents for the conditions. The current study shows that emotional and conduct disorders occur due to the socioeconomic relationships between the child and the parent and often leads to active conduct disorders and deprived circumstances (Fairchild et al., 2019). Both emotional and conduct disorders require care from a mental perspective. The intervention for such cases requires a deep understanding of the needs of the child and the extent of care that the parents give. In most cases, parents give the best they can, but the children, out of peer pressure, tend to undervalue the amount of effort that their parents exert for their wellbeing leading to the parental strain. As such, as a therapist, it is important to begin by understanding and supporting the care programmer that the parents have offered.
Since parental strain has a detrimental effect on parental health, it is important to begin by assessing the level of worry that has engulfed the mother to the extent of missing work (Lebowitz, 2019). The mental health of the mother may have been affected, and it is crucially important to begin by planning an intervention for her mental conditions. Living in such conditions may cause depression, which may affect their health life for good. Since the perception of sigma and burden are already real to the mother, it is important to consider treatment plans to restore their high-level embarrassment and guilt or any other psychological difficulties they may be facing. Such would enable the mother to control their sensitivity and their mental health at every time. As a practitioner, I understand that the feeling may impair the therapeutic conditions of both the Salma and her mother. Thus, the assessment of the case requires mental understanding, which would impact any other intervention aimed at alleviating the child’s behavior and restoring normality in the mother.
The mother’s conditions can be restored through continued practical support to improve their mental conditions. Such would remove them from the danger of facing mental problems. Subsequently, Salma would get respite care aimed at enhancing the social network relationship with her mother. The intervention aims at training her to understand the kind of parental support that her mother gives, which would impact the parental-child relationship. It instills the behavioral strategies that Salma should adopt at all times to minimize or prevent the behaviors. As it has been established in the above literature, parental emotional disorder and the child’s conduct disorder occurs as a result of distress which results in a range of mental problems. Thus, the interventions need to focus on reducing the stress between Salam and the mother. If Salma can get accept the effectiveness of the mother’s parenting at multiple levels, it would enhance the quality of family relationships and eliminate the feeling that the mother has no time for her children. Moreover, it is important to start by understanding and address the extent of the adverse effect that the feelings of stigma and embarrassment have caused to the quality of life.
More specifically, my therapeutic intervention will adopt a broad assessment framework to recognize the parents’ perceived burden from Salma’s conduct and the primary or secondary mental health issues that it may cause to Salma. Secondly, the intervention will seek to alleviate practical family support to eliminate the underlying burden in parental care through family support and perception that integrated a general family-systematic behavioral strategy. According to Dobson & Dobson (2018), Cognitive-behavioral therapy is often used to change the child’s thinking and improve their anger management, negative thinking, impulse control, and moral reasoning skills. As a family therapy, I aim to improve family interactions and communications. Many children with conduct disorder lack self-esteem, irritability, and tend to develop frequent tempers. They will never appreciate others and will often develop remorse after hurting the feelings of others.
The intervention must begin by conducting medical and psychiatric histories to find signs that nay is causing the conduct disorder in Salma. There may be other underlying issues like depression and Attention Deficit Hyperactivity Disorder (ADHD) that may lead to Salma’s behaviors. The intervention is based on the severity of the problem and the extent of understanding of the problems. It is worth noting that both the mother’s and child’s ability to participate in the specific therapies must be ensured. Although there may be no specific medication to restore the behavioral cues in the child, intensive psychotherapy produces the same results as the perpetrator learns to control their anger, and appropriately express their feelings. In the end, Salma’s thinking will get reshaped coupled with a parental management therapy that trains the mother to impact the child’s behavior at all times positively.
References
Barish, K. (2018). How to be a better child therapist: An integrative model for therapeutic change. WW Norton & Company.
Dobson, D., & Dobson, K. S. (2018). Evidence-based practice of cognitive-behavioral therapy. Guilford Publications.
Fairchild, G., Hawes, D. J., Frick, P. J., Copeland, W. E., Odgers, C. L., Franke, B., … & De Brito, S. A. (2019). Conduct disorder. Nature Reviews Disease Primers, 5(1), 1-25.
Johnston, O. G., Derella, O. J., Gold, M. A., & Burke, J. D. (2020, April). Preliminary Validation of the Parental Help-Seeking Stage of Change Measure for Child Behavior Problems. In the Child & Youth Care Forum (Vol. 49, No. 2, pp. 223-246). Springer US.
Kilcullen, M., Swinbourne, A., & Cadet‐James, Y. (2018). Aboriginal and Torres Strait Islander health and wellbeing: Social, emotional wellbeing, and strengths‐based psychology. Clinical Psychologist, 22(1), 16-26.
Lebowitz, E. R. (2019). Addressing Parental Accommodation when Treating Anxiety in Children. Oxford University Press.
McCulloch, J., Maher, J., Fitz-Gibbon, K., Segrave, M., & Roffee, J. (2016). Review of the family violence risk assessment and risk management framework (CRAF). Monash University.
Milne, L., & Neil, R. (2018). Domestic violence and the role of early childhood educators: Understanding court orders and supporting children. Educating Young Children: Learning and Teaching in the Early Childhood Years, 24(3), 18.
Tornal, J. M. P., & Martínez, A. D. (2017). Relationship between subjective and objective burden in family caregivers of Alzheimer patients. European Journal of Health Research:(EJHR), 3(1), 41-51.