Running head: VARGAS CASE STUDY 1

Vargas Family Case Study

Students Name

Institutional Affiliation
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Vargas Family Case Study

Part I

The Vargas family faces increased tensions partly due to their son, Frank who frequently

gets in trouble for his inattentiveness and hyperactivity. His father, Bob believes that Frank is

simply too smart for his grade hence his inattentiveness, but his mother, Elizabeth, suspects Frank

might have ADHD. Elizabeth and Bob now face marital discord because Frank keeps getting

reprimanded by his teachers, an issue that Bob downplays thus stressing his wife further. Heidi on

the other hand continually represses her desires to keep her mother happy. While she regularly

receives gold stars and has more achievements than her brother, she feels left out on her fathers

attention preferring to sit close to her mother. Moreover, both children blame each other for the

arguments between their parents.

Initial treatment goals

Initially, the treatment goals were to help Frank with his inattentiveness and impulsivity

issues. He cannot sit still, does not listen, is forgetful, and is always getting hurt which has resulted

in numerous altercations with teachers at his school. His impulsivity leads him to blurt out answers

in class, have trouble waiting his turn, and to lose things. While Elizabeth believes that he might

have ADHD, Bob downplays the issues as boys being boys and claims Frank is too smart for his

class which shows the diffusion of parenting boundaries. Since Bob is a PE teacher, he supports

Franks in his sports and athletic pursuit but fails to engage in his daughters life. Another goal is to

reduce and eliminate the marital discord caused by Franks activities. Reducing the dissonance

requires first getting both partners to express their deep emotions and issues which allow the

physician to start resolving the problems.

Week 1:

The counselor conducts Structural Family Therapy based on Bowens Family Systems

Theory. Bowens systems theory posits that individuals remain inseparable from their relationship

networks. Additionally, as Bowen hypothesizes, all people have faced challenges in their families of
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origin, and an awareness of these biases could help to normalize human behavior. Bob exhibits

signs of cross-generational coalitions with his parents as he cites their authority as his basis for

minimizing Franks actions.

Structural family therapy involves joining the family to understand the invisible rules that

control their behavior, understanding the relationships between various family members and

disrupting dysfunctional relationships. By applying structural therapy, the counselor then

determines that the childrens problem stems from the diffuse boundaries between their parents and

between the parents and children. Frank keeps interrupting to share stories despite reprimands from

his mother while Bob displays no reaction. The counselor applies several interventions including

accommodating differing views from the participants about the cause of Franks impulsivity, and

structural mapping of the family to understand the contentious issues.

Week 2:

Systems theory which affirms the role of the overall family health on that of the individual.

Bowens family therapy, derived from structural family theory, also holds that family members

cannot be understood in isolation because they never function in isolation. The counselor intervenes

through validation of Elizabeths feelings, evocative questions, and empathetic conjectures.

Week 3:

Psychoanalysis Theory involves learning more about eachs family of origin in hopes of gaining a

better understanding of their relationship. Bob has a strong bond with his sister, Katie, his mother,

and adoptive step-father. Therefore, the counselor utilizes attachment theory to determine how to

create a secure base within therapy for the family can provide secure emotional bases for each other.

Bob also seems particularly attached to the idea of his brother in law as a devout Christian. The

counselors interventions include acknowledging the different childhood experiences and how they
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might feature in the current challenges. Moreover, through retrospection, Elizabeth surmises that

her mother never recovered from the death of her first child which strained their relationship.

Week 4:

The therapist utilizes Emotionally Focused Therapy which aims to identify and disrupt negative

interaction patterns. Bob consistently overrides his wifes objections to Franks behavior

disregarding her feelings which increase tensions. Instead of putting Frank to work as he had

promised, he takes him to a fun outing thus perpetuating family games whereby Frank prefers

sitting next to Bob while Heidi stays close to her mother.

Week 5:

The counselor uses emotionally focused therapy to get the family to share their experiences since

the previous session. The approach is based on systemic theory, attachment theory, and person-

centered therapy. Bob acknowledged his error in handling Franks suspension while also expressing

his frustration that he cannot fix Elizabeths problems. The interventions used include identifying

the effects of the problem on the family and the consequences of a family in perpetuating the

problem. Although the Bob tries to resolve Franks issues, Heidi displays increased demands for

attention.

Week 6:

Structural theory shows that a childs perception of right and wrong is through trial and error

mainly depends on their parents reaction. Prior interventions seem to be working as Bob has

bonded with his son but has ignored his daughter. The counselor intervenes through emotionally

focused therapy which reveals that Heidi represses her desires to avoid making her mother sad.

Franks confession creates an emotionally intense atmosphere allowing the Vargas family to open

up.
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Week 7:

One of the assumptions of Strategic Family Therapy is that families tend to perpetuate their own

problems by their own attempts to fix it. Moreover, clients often resist change. This is exhibited in

Lindas behavior who calls the school counselor demanding confidential information. After she

deemed the school counselor less than helpful due to confidentiality laws, she called Geoffs

mother, Katie, to instruct her on exactly how to handle it. The phenomenon extends to Geoffs

father Tim, whose intrusion in their life worsened tensions between the family. Additionally,

according to this theory, the specific needs on one family can bring about drastic changes in another.

Week 8:

The Vargas family has ongoing concerns regarding Geoffs safety, as well as with maintaining

boundaries that have been set. At this point, both partners have already acknowledged their deeper

feelings and the counselor has a historical context of their relationships. Therefore, interventions at

this point involve encouraging the client to think about their future and how to continue positive

growth. The therapist also utilizes attachment theory in getting Bob to express his love for his

family and Elizabeth receives these words with quiet gratitude, providing comfort, being sensitive

to Bobs vulnerability.

Discharge Summary

At the start of the program, the Vargas family sought intervention on their sons impulsivity as it

regularly led to problems at school. But it soon became clear that issues existed between Bob and

Elizabeth. The treatment goals changed to establishing clear parenting boundaries and bases of

emotional support. While the family rules remain ambiguous, Frank continues his impulsive

behavior as he assumes the support of his father and grandparents. At the end of the treatment,

clients seemed responsive to interventions as it had helped them to grow closer as a couple and

express their emotions freely.

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Recommendations:

To maintain the positive development in the Vargas family, I would recommend further Cognitive

Behavioral Therapy in individual session to reform some of the habits in the family. Bob readily

supports Frank in his mischievous endeavors which makes Elizabeth frustrated as she feels her

parenting efforts are not appreciated. Additionally, Experiential Family Therapy would help in

stopping repression of feelings which further increases tension.

Part II

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy is an intervention approach that emphasizes action-based

solutions for clients. Individuals have to relate their behavior to their emotions to understand the

causative factors of a problem and work on resolving it. Sessions utilizing this approach are

individualized as it targets specific issues such as anxiety, depression, addiction, and personality

disorders. CBT aims to combat psychological depression which is often caused by cognitive

assumptions and distortions such as learned helplessness, negative self-monitoring,

overgeneralization, mental filters, among others.

Studies have proven the effectiveness of CBT for children, adolescents, and adults.

Butler et al. (2006) conducted a meta-analysis on the efficacy of CBT for different groups with each

disorder. The studies confirm positive outcomes for generalized anxiety disorder, childhood anxiety

and depressive disorders, and panic disorder. Other conditions such as anger, marital distress, and

somatic disorders had moderately positive outcomes. Furthermore, these studies proved that CBT

was superior to antidepressants used in the treatment of adult depression.

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Emotionally Focused Therapy

Emotionally Focused Therapy is a scientific approach based on the premise that our

emotions play a fundamental role in the formation of individual identities. It assumes that humans

often lack a connection to their feelings as they seek to avoid the unpleasantness from the negative

emotions. The counselor creates an emotionally charged environment where both partners can

express their deepest feelings thus forming a foundation for a base of emotional support. Therapy

usually progresses in three distinct stages; i. Cycle de-escalation, changing interaction patterns and

consolidating new communication styles.

Researchers on EFT have reported a strong trend of positive outcomes for clients. As it

derives from scientific studies of adult attachment, it mainly targets adult individuals, couples, and

families. The counselors base their interventions on the premise that human needs have a direct

relationship to human emotions which gives emotions an adaptive potential which can help change

problematic relationships. Weissman et al. (2012) conducted a study to determine the efficacy of

EFT for veterans diagnosed with PTSD. The pilot study revealed that EFT increased relationship

satisfaction, reduced PTSD, and other symptoms of depression. Moreover, McLean et al. (2013)

reported greater improvement for couples in EFT as compared to couples undergoing standard care

alone.
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References

Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of

cognitive-behavioral therapy: a review of meta-analyses. Clinical psychology review, 26(1),

17-31.

McLean, L. M., Walton, T., Rodin, G., Esplen, M. J., & Jones, J. M. (2013). A couplebased

intervention for patients and caregivers facing endstage cancer: outcomes of a randomized

controlled trial. PsychoOncology, 22(1), 28-38.

Weissman, N., Batten, S. V., Dixon, L. B., Pasillas, R. M., Potts, W., Decker, M., & Brown, C. H.

(2011, August). The effectiveness of emotionally focused couples therapy (EFT) with

veterans with PTSD. In Poster presented at the Veterans Affairs National Annual

Conference: Improving Veterans Mental Health Care for the 21st Century, Baltimore, MD