Family is the most basic and fundamental unit of the society. The strength of the family units determines the overall welfare of the society. Social progress and the stability of the family units are inextricably intertwined. The health of the family determines the general welfare of the society. Rules and regulations have been promulgated in different jurisdictions to protect the family from unqualified medical practice. In relation to this, mental health practice for a long time had been encroached by quacks and untrained medical practitioners. For the last twenty give years, therapy has been confined to individual and family therapy counseling (Slavney, 2010). This paper will delve deep into the intricacies of family and individual therapy practice. The paper will highlight the distinctions that encompass the individual and family practice in consideration to the connection they have on the needs of dealing with a particular individual undergoing a specific psychological case that needs attention from both a family practitioner and an individual practitioner.
Kristen, a 31-year old Caucasian female, was dismissed from her nurse-duties given the circumstances that she has been involved with lately. While the patient denies being unreliable at work, she does not deny that she has been experiencing substance dependence problems since three years past. Admitting to instances of depression, anxiety, [possible] ADHD, relationship strain with family, significant debt issues and a physical problem on a herniated disk, she mentions how alcohol, opiate and sedative dependence provide a distinct escape for her away from the realities of her life. As a result, she was involved in DWI cases twice during the year 1997 and another in 2008. Although she did not have suicidal nor homicidal attempts, she mentions how she sometimes feel hopeless.
Having to live with a dysfunctional extended family at home and to rear a family of her own in the basement of their house, Kristen is understood to be in a lot of pressure. Fixing issues with her family is out of the question as they are deemed to be non-supportive of her situation. Her connection with her fiancé Kevin could still be fixed but only if he would be willing to undergo psychological assistance as well.
The Family Practitioner
Family practitioner handles issues associated with the family unit. The clients that require the services of family practitioners those are in a sexual relationship. The majority of them are in an intimate relationship. The professional bodies require a family therapist in the USA. At the core of those skills, a university degree is required for the practitioner. Unlike in the European countries such as Germany and Spain, rules that govern the conduct of the therapist are a little bit lenient compared to Europe. The deficiency in legal proclamations is covered with the commercialization of the practice (Harley). Successful hypnotherapist and systematic coaches have edged the majority of the quacks and inexperienced medical practitioners out of the market, in addition, the regulation by the professional bodies have set the bar to an unreachable standard for the untutored therapist.
A family practitioner is expressly required to have specialized knowledge on the human nature and social interactions. The knowledge is covered in the psycho-education studies that are offered in the accredited universities. A family therapist observes the relational patterns and assumes the role of a mediator and a problem solver. The observations are carried out in 20 to 50 sessions that the family members have with a therapist. Freudian therapist concentrated on the cognitive of the client to solve the complex social labyrinths. A psychological exploration into the childhood trauma was related to the immediate problem. Psychodynamics and intergenerational therapist do not dwell on the circle or linear causation to ease the tension in family relationships (Nicholls). Family therapists are relational in nature. They are interested in the characteristic of the people in the group. Experimental family therapist, however, are interested in the individuals, in the system of social interactions. To solve the conflicts in the family setting, the therapist focus in the on the specific instances in the conflict, family therapist are concerned with the solving and the maintenance of the problem rather than solving a singular trajectory of social dissonance. The cause and effect analysis has infinitesimal clinical utility, family members argue that the method strengthens the fabric of conflict while advancing the argument of that one party is to bear the burden of the blame. To evade this psychoanalytical quagmire, family therapist and gestalt scientist have adopted the circular method of handling conflict. Cognitive behavioral therapy has been the most prominent method of treatment in the 20 the century. In 2004, the French government conducted a research and came up with the INSERM method. The meta-analysis method has been instrumental incurring alcohol dependency, hyper maniac schizophrenia and bipolar disorder.
Family therapists are supposed to be well equipped with effective communication strategies. Specialized communication affects the market viability of the therapist in the market. Good communication skills affect outcome of the psychoanalysis sessions and consequently the financial standing of the therapist. Specialized knowledge on communication strategies enable a family therapist to dig past the fabricated innuendos commonly associated with the psychoanalysis sessions and discovers the core of the family conflict. Interpersonal skills are as paramount as the communication skills in the field of psychodynamics and gestalt science (Nicholls).
The Individual Practitioner
The practice of individual therapists is a completely different from the family practice. Individual practitioners deal with one individual at a time. Individual practitioners share a similar knowledge base with the family practitioners. There is, however, a stark difference in the operation of both professions. Individual practitioners are closely monitored by human rights organizations and patient protection agencies for the abuse of the right of privacy. The application of the outlawed psychological methods such as unauthorized hypnosis is heavily penalized by the criminal justice systems.
Individual family therapist usually involves spoken language while handling adult clients. Carrying out psychotherapy on children and teenagers involve dramatization. Modern individual therapists involve the use of narratives, songs and music to help youngsters to overcome the traumas and psychoanalytical problems (Bockinan). Different approaches are employed in response to the clinically diagnosable symptoms. The approach is usually specific in nature and tailored to fit a particular psychological problem. The codes of ethical practice outlined by psychological organizations regulate the dissemination of the information the client provided during the therapy sessions. The information is usually sensitive hence the need for client confidentiality.
Individual practitioners in the application of psychotherapy to their patients is seen in the context of the invitation to interpersonal exchange to helps the client triumph over life’s hurdles. The methods and approaches employed by the psychotherapists and counselors determine the success of the therapeutic frame created to connect with the patient. As opposed to family based practitioners, individual practitioners aim at providing the client with opportunities for self-awareness and capacity building. The desired outcomes involve a change in behavior which subsequently, corresponds to a change in the thought processes. The conflict is between the individual and himself. An individual practitioner has a duty to the client to ensure that their mental health is balanced.
Approaches of Psychological Interventions
Countertransference is a common phenomenon that has plagued many psychotherapists and counselors. It refers to the emotional connection the counselor makes with the client. The projection of an object in the past by client evokes the human emotions of the therapist. Psychotherapist seeks to dominate the countertransference for an effective guidance and counseling sessions. The potency of countertransference has been acknowledged in the mainstream psychoanalytic debates and related psychodynamic circles. Prominent Psychotherapists such as the Sigmund Freud and Carl Jung described the psychological phenomena as the unconscious reaction to the client’s life situations about the experiences the psychotherapist has been through in his or her life. It is the unconscious content of the therapist that betrays the human nature of recognizing a shared identity with the other human beings. Countertransference means that both the patient and the therapist play a role in each other’s life. An individual therapist will react strongly to counter-transference compared to a family based therapist. The reaction from the therapist may result from the close association with the client. The psychological content of the therapist will determine the nature of the reaction (Harley). Repressed emotions also play a critical role in reaction counter-transference. Family practitioners have minimal reaction to countertransference. Family based counseling is usually a group based and the reaction is distributed among the members of the group. The overall reaction is minimal. Individual therapist faces a grave danger of body based counter interference.
During the first interview with the family practitioner couples state their commitment to solving their conflict. They acknowledge the need to have their conflict solved. The solution becomes a core factor to the therapeutic sessions. The therapist outlines the timetable for the counseling sessions. The therapist can choose to interview the couple jointly or he or she can also choose to interview the couple separately. Different approaches will be applied according to the nature of the counseling. The guidance and counseling involves a marital conflict; the therapist will involve the circular approach to eliminating the possibility of one of the parties shouldering all the blame. Family traumas related to accidents, death of a family member or a horrific experience involves the whole family. The practitioner meets the family jointly for the therapeutic sessions. Counseling and psychotherapy must be tailored to meet the needs of children. The esteem of the children is usually affected by the harsh circumstances of the social environment. Therapy sessions help to sew the torn fabric of the society. It ensures that members of the society are mentally healthy. Therapy can help a delinquent overcome criminal tendencies especially if the youngster has overridden his or her cognitive resistance to crime.
Summary of Case Treatment
- The knowledge base
Taking from the discussion noted herein, it could be analyzed that the information shared by Kristen about herself and her surrounding environment play a great role on how matters would turn out especially when it comes to determining the possibilities of improving her personal situation. Looking through her case, there are specific points to consider:
- Kristen needs to regain personal control over herself first
- Developing a better lifestyle is key to a more developed course of determining her capacity to survive her current situation and create a new realm for development for herself and later on for her own family
- Dealing with her fiancé is likely becoming one of the primary sources of her anxieties and depression especially given the fact that she already has a child to raise
- Job environment could be a good escape [a change of situation] but since it is lost, she should be able to regain stability to regain her work and a possibility to improve on her performance
Considering the situation Kristen is under, she should be given the chance to see a better light of what is happening, and that is the fact that she could still accomplish something out of her misery. She needs to know that she could still fix matters but that could only happen if she would be willing to quit her substance dependence issues.
- The use of self
A focus on herself; this is a distinct process that needs to be given attention to. Relatively, Kristen should first learn to value herself and know that without such value for her own being, she would not be able to accomplish her responsibilities to her child. She needs to know that she could combat the situation only if she is in sound mind and can make sound decisions for herself.
Realizing that she is undergoing self-destruction could help her find a better way of dealing with matters especially relating to her issues of substance abuse. Giving her better options of releasing stress and anxiety would be the best choice at this point. She needs to be guided and taught that masking matters through wasting herself would not solve but specifically worsen the situation.
The perception towards individuality and personal conviction is considered a strong foundation toward intervening in cases like the one being dealt with by Kristen. Her involvement with a dysfunctional family should be used as the reason as to how she should focus on herself and not the people nor the situations surrounding her at present.
- Skills needed for engaging and assessing
The practitioner who would handle this case should have strong individual-case skills. Knowing how one functions and understanding how such functions could be altered due to environmental disturbances would help in determining the most progressive manner of developing one’s being and becoming more effective in helping the individual find a way to improve herself and emerge from the situation she has been subjected to.
Kristen needs a practitioner who is willing to extend herself towards becoming a primary tool in setting a good schedule that would be able to help ease out stress and sources of anxiety. The practitioner should be able to establish a good working schedule for her and Kristen that would determine a better course of life-adjustments that the patient could depend upon. Assessing her situation and the progress of her case from time to time is a vital point of development in this case.
- Differences in what is brought up in the counter-transference
Counter-transference could actually provide the practitioner to make a mirror-like reflection that would help her find a way to feel what Kristen feels and become involved [in a professional manner] with the desire of improving matters for her patient. Kristen needs a solid foundation, someone she knows has a more structured way of dealing with matters, someone she could depend to have a more objective vision of her situation apart from the dysfunctional individuals surrounding her. Being that kind of person on the part of the practitioner attending to her would best define the path of the psychological assistance and treatment she needs to regain control of her life, her family’s welfare and her work as well.
- What are the first interview demands of the family therapist in knowledge base versus work with individuals?
The family therapist needs to know more about the family and their willingness to work with the issue while on the other hand, the ones working with individuals need not much delve on the thinking of other individuals but the one in the case alone. In the case of Kristen, an individual therapist is needed. Given that Kristen is living with a dysfunctional family, she is the one that needs to be focused upon and helped accordingly to make her stand on her feet again. If in the process of development, Kevin, her fiancé, agrees to undergo treatment as well, then this is when a family therapist could enter the case.
Although families may be the primary source of strength and confidence of individuals, their dysfunctional behavior could also be the cause of individual failure among the members making up each unit. In the case considered in this discussion, it could be realized how much such fact could affect the being of a person. The need to deal with individual desires of regaining control of one’s life is then an important aspect of treating patients with dysfunctional backgrounds. Helping them take a personal stand and be willing to rise to the occasion and develop themselves into becoming better individuals is the key towards breaking the chain of dysfunctional behavior.
Bockinan, N. (2009). Personality-guided Therapy for Depression. New York: American Psychological Association.
Harley, J. (1987). Problem Solving Therapy. New York: Wiley.
Nicholls, M. (2013). Family Therapy, Concepts and Methods. New York: Allyn and Bacon.
Slavney, P. (2010). Psychotherapy: An Introduction for Psychiatry Residents and Other Mental Health Trainees. New York: JHU Press.