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Case Treatment Strategy Plan
The Williams family is a traditional, nuclear family with several pressing issues, which includes marital conflict, family issues pertaining to both of their sons, along with financial difficulties. The eldest son was diagnosed with Asperger’s Syndrome several years ago, which his awkwardness has caused social alienation the past 4-5 years. The youngest son doesn’t have much engagement with his family. Academically, he has been declining over the past two year. The case is conceptualized, the provided services by the author’s counseling agency is given. Collaboration with community partners whose services will be given as well is provided.
The Williams family is a traditional nuclear family, with two sons. 18-year-old Jacob has been diagnosed with Asperger’s Syndrome and 15-year-old Leo. The parents, Jeff and Sandy have been married for 21 years. Jeff owns a used car business and Sandy has been employed as a teacher’s aide at an elementary school for 10 years.
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The Williams family presents with several issues that require multiple interventions. Slow business at the car lot has caused financial pressure on the family along with Jeff’s lack of financial managements and spending habits. Along with the financial difficulties the family experiences, Jeff drinks excessively. He drinks daily and this habit has caused great tension between him and Sandy. More problems are created for the family as they wrestle with the challenges of Jacob’s Asperger’s Syndrome, which includes his inability to function socially, feelings of depression and sadness. The problems that are occurring as a result of Jacob’s diagnosis has left the family isolated from family, friends, and feelings of abandonment by the school system. In addition, Jeff and Sandy are at odds with one another based on how they each respond to Jacob’s behavior. Lastly, the youngest son, Leo is disengaged and withdrawn from the family and having trouble at school. His grades have dropped significantly over the last two years.
The Williams’ family presenting issues are:
1. Jeff’s drinking problem.
2. Financial difficulties and challenges due to lack of financial management and poor spending habits.
3. Jacob’s behavior as a result of his Asperger’s Syndrome.
4. Sandy and Jeff’s conflict due to their responses to Jacob’s behavior.
5. Leo’s disconnection to the family and his decline in his academic performance.
For a better understanding of the issues the Williams family have been dealing with, Bronfenbrenner’s Ecological Theory will be applied to their situation and circumstances. Ashiabi & O’Neal (2015) breaks down Bronfenbrenner’s Ecological Theory in the following context, “In its earliest inception, Urie Bronfenbrenner’s ecological model gave prominence of place to the environment and divided an individual’s environment into nested and interrelated systems: the microsystem, mesosystem, macrosystem, and exosystem. The microsystem is the immediate environment in which the child lives. This includes any immediate relationships or organizations the child interacts with. The mesosystem describes interrelationships between different microsystems. For example, parental involvement in children’s schooling can have a positive influence on children’s academic competence through children’s valuing of academics. The exosystem level has indirect effect on an individual’s developmental outcome and is the setting in which the individual does not actively participate. Examples of the exosystem include the parents’ workplace. Events happening at the workplace can affect children through how parents interact with their children. Bronfenbrenner’s final level is the macrosystem. It involves the society, and includes cultural values and describes the economic conditions under which families live along with material resources, and opportunity structures. The interrelations among these nested environments allow for examination of how patterns of interactions within these systems influence each other and affect individuals’ developmental outcomes”. Utilizing an ecological perspective with the Williams family, intervention strategies will require execution at multiple systemic levels. According to Scott & Wolfe (2015), maintaining an ecological perspective allows interventionists to comprehend the many ways in which various community components are interrelated and impacted by one another. This involves starting from the point of the individual system and gradually moving outward to a nested framework which encompasses the microsystem, mesosystem, exosystem, macrosystem and chronosystem that influences how the systems interacts (Scott & Wolfe, 2015).
The Williams Family
Abundant Life Counseling Agency
Abundant Life Counseling Agency is owned and operated by Devara D. Brock, a Licensed Professional Counselor and certified Life Coach. The agency’s location is in Columbia, Missouri and specializes in individual, family and group therapy. The agency employs two other Licensed Professional Counselors, a Licensed Clinical Social Worker, a Provisional Licensed Professional Counselor and an administrative assistant.
Abundant Life Counseling Agency will meet with the Williams family weekly. The essential services that will be provided will include individual, family and marital counseling. The therapist is certified in Cognitive Behavioral Therapy, Person Centered Therapy, Solution Focused Therapy, Motivational Interviewing, and Emotion Focused Couples Therapy. The therapist with also be utilizing an integrated approach to counseling while working with the Williams family. Carl Rogers’ person centered therapy has made measurable contributions to the fields of counseling and psychotherapy (James & Gilliland, 2003). Rogers’ views of the human potential and the role of the therapist as being a listener that is supportive, accepting, and caring became a welcomed alternative to Freudian psychoanalysis and directive behaviorism (Rogers & Kinget, 1962; Raskin, 1948; Seligman, 2001). Solution-focused (SF) therapy began in the 1980s with the research and writings of Steve de Shazer, Insoo Kim Berg, and their colleagues. SF therapists work to increase their clients’ awareness (Norum, 2000). Rather than enhancing complete self-awareness, SF therapists selectively focus on their clients’ strengths and on what is working in their lives. Services not available by Abundant Life Counseling Agency will be provided by local agencies within the community.
Alcohol Abuse. The beginning step in working with the Williams family would be to address the head of the household, which is Jeff and his presenting issue, which is alcohol abuse. Upon coming home from work, each day Jeff drinks until he goes to bed. He remembers nothing the next morning. This has caused conflict between him and his wife Sandy. Utilizing the motivational interviewing technique, the major approach being the transtheoretical model of change. The model of change was developed to help therapists to first understand how problematic a person perceives their use of alcohol to be. Miller & Rollnick (2013), realized that in order for any form of treatment for alcohol use disorder to be applicable, the therapist would need to be able to work with the person at that person’s level of understanding. When working with Jeff, he would be informed of the stages of change according to the Motivational Interviewing paradigm. Jeff will then choose which stage he most identifies with and begin at that stage. The therapist would then partner with Jeff to move forward and assist him with changing his behavior.
Jeff and Sandy’s Marital Issues
Financial Difficulties and Challenges. Due to the downturn in the economy, Jeff’s used car business has caused financial difficulties, stress and anxiety for the Williams family. The therapist would work with both Jeff and Sandy regarding their income, spending habits, and budgeting practices. The therapist would remind the couple of the Word of God that they are not alone in the struggle, hoping that it will encourage their hearts. “Keep your lives free from the love of money and be content with what you have, because God has said, “Never will I leave you; never will I forsake you” (Hebrews 13:5, NIV).
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Community Resources. Columbia, Missouri is a small town with a plethora of resources. A local bank in the community, Central Bank of Boone County created a program for the community members called Prosper U. Their mission statement reads, “Prosper U empowers people to achieve financial success through educational programs, workshops and one-on-one financial and credit coaching. Whether you’re a small business just getting started, a couple ready to buy a home, or just confused about building a monthly budget; Prosper U can help”.
Prosper U has its own location for classes, workshops and individual counseling/coaching on 720 East Broadway Columbia, MO 65201. The individual’s contact information is Sarah Moreau, phone number 573-874-8465 and email address [email protected] Services provided are free of charge and open to the public.
Parenting Difficulties. Raising teenagers is a battle within itself, adding a child with a disorder is even more challenging. Sandy took the initiative to seek out treatment for her and her family. In conjunction with the services received from the Thompson Center, the therapist would offer Parent Management Training (PMT) to Jeff and Sandy. This form of therapy encourages parents to become actively involved in strengthening the functioning of the family. PMT focuses on the whole family and has proven to be long lasting (Sofronoff & Farbotko, 2002).
The therapist would put both Jeff and Sandy in remembrance of the Word of God, “Finally, all of you, be like-minded, be sympathetic, love one another, be compassionate and humble” (1 Peter 3:8, NIV). Parents can get so bogged down, frustrated, angry and sometimes get out of character and just need a kind reminder.
Asperger’s syndrome is characterized by difficulties in social interaction and by restricted and stereotyped interests and activities. Asperger’s syndrome is different in that there is no general delay in language or cognitive development (APA, 2000). Asperger’s syndrome is distinguished by a pattern of symptoms rather than a single symptom. This disorder affects hundreds of children globally, Jacob is one of those children diagnosed with Asperger’s Syndrome.
This diagnosis has left Jacob in a very difficult spot. He’s alienated socially, depressed and sad. The Abundant Life Counseling Agency will refer Jacob and his family to the Thompson Center for Autism and Neurodevelopmental Disorders at the University of Missouri. Their mission is “To improve the lives of individuals and families affected by autism spectrum disorder and neurodevelopmental disorders through world class programs that integrate research, clinical service delivery, education and public policy”.
The Thompson Center was inaugurated in 2005 and is based on the medical home model, Thompson Center diagnostic, assessment and treatment services emphasize family-centered care that is comprehensive, coordinated, compassionate, culturally sensitive, and accessible for all. Our aim is to support families from the point of initial contact through access to needed services in the community, with routine follow-up care over time to ensure the best possible outcome for each child and family. Their center is located on 205 Portland Street Columbia, Missouri 65211, with a contact phone number of 573-884-6052 and email address [email protected] The Thompson Center accepts insurance and works with individuals and families without insurance.
Depression is typically marked by a loss of interest or pleasure in all activities most of the day nearly every day (June & Black, 2011). The therapist would first build rapport with Leo and then administer the Beck Depression Inventory and go over the results together. The therapist would then begin to explore some of Leo’s interests and strengths and begin to set short term goals that are realistic and obtainable. Incorporating this would begin as a confidence booster for Leo. The therapist would begin the journey of Life Coaching with Leo before deciding if a behavioral intervention is needed. Life coaching is partnering with the client and meeting them where they are and purposely work together to begin on an upward and forward journey. The therapist believes that Leo will be successful in coaching.
Additional Supports. Addressing Leo’s issue of declining grades, the therapist would work with the school’s administration team along with counselors and teachers. It’s evident that Leo is fully capable of achieving good and acceptable grades. The therapist would also refer Leo to join Men of Color, Honor, and Ambition (MOCHA) a mentoring program offered by the University of Missouri. The mission is “MOCHA exists to provide personal, academic, cultural, social, professional and leadership development to undergraduate males at MU, UMKC, Missouri S&T and UMSL, in an effort to positively impact academic success, increase retention and develop successful leaders of tomorrow, today”. The program has since extended its reach to local middle and high school young men.
The contact person for the MOCHA mentoring program is Jozef Lukey and can be reached via email at [email protected] The main office is located at 320 Jesse Hall Columbia, Missouri 65211.
Bronfenbrenner’s Ecological Theory was used as the theoretical underpinning when working with the Williams family. Micro and meso level interventions were outlined, along with utilizing a community counseling approach. Both intra and inter agency interventions were incorporated. As time progresses with the Williams family, The Abundant Life Counseling Agency will partner with the Thompson Center, and Jacob and Leo’s high school to host a 5k Walk/Run/Bike to raise awareness for Asperger’s Syndrome, where the proceeds will assist in paying for services at the Thompson Center to a family without insurance.
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: Dsm-Iv-Tr. Washington, DC.
- Ashiabi, G. S., & O’Neal, K. K. (2015). Child Social Development in Context: An Examination of Some Propositions in Bronfenbrenner’s Bioecological Theory. SAGE Open. https://doi.org/10.1177/2158244015590840
- James, R. J., & Gilliland, B. E. (2003). Counseling and psychotherapy (5th ed.). Boston: Pearson Education, Inc.
- June, L.N., & Black, S.D., (2011). Counseling for seemingly impossible problems. a biblical perspective. Grand Rapids, MI: Zondervan.
- Miller, W. & Rollnick, S. (2013). Motivational interviewing: helping people change. Guilford Press, New York.
- Norum, D. (2000). Mindful solutions: A journey of awareness. Journal of Systemic Therapies, 19, 16–19.
- Rogers, C. R., & Kinget, G. M. (1962). Psychotherapy and human relations: theory and practice of nondirective therapy.
- Raskin, N. J. (1948). The development of nondirective therapy. Consulting Psychology, 12, 92–110.
- Scott, V.C., & Wolfe, S.M., (2015). Community psychology: Foundation for practice. Thousand Oaks, CA: Sage Publications.
- Seligman, L. (2001). Systems, strategies, and skills of counseling and psychotherapy. Upper Saddle River, NJ: Prentice Hall.
- Sofronoff, K., & Farbotko, M. (2002). The Effectiveness of Parent Management Training to Increase Self-Efficacy in Parents of Children with Asperger Syndrome. Autism, 6(3), 271–286. https://doi.org/10.1177/1362361302006003005
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