U09a1 Demonstrating a Systemic Approach -Cindy...

The Berkman Family Cindy Ransom

COUN 5275 Utilizing Systemic Approaches: Infancy through Adolescence

U09a1 Demonstrating a Systemic Approach

Email: [email protected] Instructor: Blaine Everson

RUNNING HEAD: THE BERKMAN FAMILY – SYSTEMIC APPROACH 2

Table of Contents

Abstract……………………………………………………………………………………3

Presentation of Family Case………………………………………………………………4

Developmental Issues for Consideration…………………………….……………………5

Developmental Risk Factors for Adolescents……………………………………………..7

Risk Assessment…………………………………………………………………………..8

Parent Considerations……..………………………………………………......................10

Family Life Cycle and the Impact of Divorce…………………………………………...11

Berkman Family Genogram………………………………………….……………….….13

Reflection on the Family Genogram……………………………………………...……...14

Family Challenges and Strengths………………………………………………………...15

Solution Focused Therapy Approach…………………………….………………………17

Family Relationships and Interpersonal Exchanges………………………..…………....18

Assessment Findings...………..………………………………………………………….19

DSM-5 Relational Diagnosis………………….……………………………………........19

Treatment Goals and Interventions……..…………………………………………..........21

Ethical and Legal Considerations………………………………………….…………….23

Author’s Reflection………………………………………………………………………25

References………………………………………………………………………………..28


Abstract

For the topic of this paper the author has chosen to examine the characters in the

film The Squid and the Whale written and directed by Noah Baumbach. The paper will

explore specific developmental issues and familial counseling considerations in order to

assess the family for therapy. A family genogram will be observed along with risk

assessments and possible ethical considerations in working with minors. The author will

present some of the family strengths and weaknesses and apply the Solution Focused

Brief Therapy approach. DSM-5 diagnosis options will be considered and their reasons

explained as well as a look into possible treatment goals and interventions for the family.

Finally, a brief reflection on how her personal background could affect working with this

particular family.


For this assignment the author has chosen the film The Squid and the Whale written

and directed by Noah Baumbach. The film was selected because this author has an

interest in working specifically with adolescents and their families. Divorce is a growing

and prevalent issue in the country with more than half of all marriages resulting in it

(APA, 2014). Family counselors are faced with the issues these changes bring frequently

in their work. Each family situation, however, is unique and therefore must be tailored to

each of the client and family needs.

Presentation of Family Case

The Squid and the Whale is a movie centered around the Berkman family and

takes place in the 1980’s. In the movie, Bernard and Joan are both highly educated

writers and the parents who are divorcing. Bernard is opinionated and condescending,

constantly putting down Joan or anyone who he thinks is not of intellectual superiority.

Joan is a writer who is beginning to receive acclaim for her work. The tension between

her and Bernard were elevated as she began to show small signs of success in her career.

The strain of Bernard’s continued domineering attitude also resulted in her having an

affair. Walt is their 16-year-old son who idolizes his father and mimics many of his

characteristics, especially towards belittling his mother. Frank is the youngest at 12 years

old and shows intense emotional distress upon learning that his parents were divorcing.

He is a very sensitive boy who begins to act out by experimenting with drinking and

masturbating at school.

There are several developmental issues that a counselor must take into

consideration when working with this family. The first is to look at both the boys’ ages

and stages of development. Second, the counselor must look into the ages and stages of


development for the parents and where they are in their life cycle. Finally, one must

consider the family life cycle stage and the impact divorce has on the family unit.

Developmental Issues For Consideration

At the ages of 12 and 16, both Frank and Walt would be considered in the stage of

early adolescence. “This stage is characterized by rapid physical changes, significant

cognitive and emotional maturation, newly energized sexual interests, and a heightened

sensitivity to peer relations” (Newman & Newman, 2012, p.336). Both boys are facing

different challenges that are influenced by the changes they are experiencing physically

and mentally. It is important for the counselor to examine the issues for both boys in four

domains; physical, cognitive, social and emotional.

Physical Issues

An important consideration that a counselor must take into account for both Frank

and Walt is that they are simultaneously experiencing different stages of puberty.

“Puberty encompasses a group of interrelated neurological and endocrinological changes

that influence bran development, changes in sexual maturation cycles and levels of

hormone production, and physical growth” (p.337). The boys’ bodies and minds are

changing and they are trying to make sense of these new emotions and concerns. Frank

begins to be concerned with his physical appearance and which features he has inherited

from both parents. He also begins experimenting with bizarre masturbation behaviors.

Walt is at the beginning stages of experimenting sexually with a partner.

Cognitive Issues

It is important to understand that during adolescence the brain experiences what

has come to be known as a “pruning” phase. “Investigations into the changes occurring

during adolescence explore how this natural and extensive process of pruning may lead to


reorganizations in the adolescent’s brain that help to explain some of the behavioral and

emotional experiences of this time “ (Siegel & Hartzell, 2014, p.122). The neurons that

are encouraged and used frequently become strengthened during this time period, while

those that are unused are weakened. Both Walt and Frank are going through a stage of

neural reorganization that encourages inquisitive exploration about their lives and

choices.

Both of the boys are starting to exhibit intellectual questioning regarding their

lives and circumstances. Frank displays this by questioning his father’s viewpoints on

philistines. He attempts to begin a debate with his father’s perspective and considers

himself a philistine because he is not interested in intellectual things, such as books.

Walt attempts to appear intellectual in class. Instead of stating opinions of his own he

asks his father for his opinion and simply regurgitates his intellectual musings as his own.

He uses this strategy in order to impress a girl in his class, who eventually becomes his

girlfriend, named Sophie. This form of plagiarism escalates as he performs a song in his

school by Pink Floyd, but claims that he was the composer. He claims to have taken

ownership of creating the song because he believes that he “could have written it” so the

fact that he didn’t was simply a technicality.

Social Issues

The psychosocial crisis for this stage of development is group identity verses

alienation. Young people at this stage look to peers and groups in which they can relate

or belong to in order to feel more secure of their place in the world. As siblings, Frank

and Walt find many opportunities to discuss their emotions with each other regarding

their new household situation. Frank has a close friend whom he confides in the news of

his parents divorcing, while Walt turns to his group of guy friends whom also have


experience with divorced parents. Walt also continues to explore a sexual relationship

with Sophie, who is also a virgin. Newman and Newman (2012) wrote, “Adolescents

begin to think of of themselves as sexual, develop scripts and schemes for how to act

sexually with others, and begin to formulate ideas about the kinds of people they find

sexually attractive” (p.345). Under the guidance of his father, he finds himself discussing

the kind of women he should find attractive and exploring different sexual acts with

Sophie.

Emotional Issues

Adolescence is known as a highly emotional time for both sexes, mostly in part to

the combination of the psychological and physical changes that they are experiencing.

Frank displays emotional unhappiness when he hears that his parents are divorcing and

needs to be consoled, while Walt remains more stoic, unemotional and matter of fact

regarding the situation. Frank begins acting out and displaying negative behaviors as an

expression of this unhappiness. He begins to drink alcohol, use extensive profanity, and is

caught masturbating in school and spreading his semen on random objects. Walt chooses

to deflect his anger of the divorce towards his mother, blaming her affair for breaking up

their family. Additionally, although he has a sexual relationship with Sophie, Walt

continues to keep himself emotionally unavailable in case something or someone better

comes along.

Developmental Risk Factors for Adolescents

Due to the sensitive stage of development they are in, the Berkman boys are in

particular risk. Physically Walt is experiencing adolescence and his body is going

through hormonal changes filled with emotions that he may have difficulty


understanding. Socially, Walt is beginning to explore the social controls towards

beginning a sexual relationship with his girlfriend. According to Newman and Newman

(2012), ‘these controls are a product of parental socialization and practices, school

achievement and educational aspirations, and the attitudes and sexual experiences of

friends” (p.347). Bernard constantly imposes his past adolescent experiences on Walt in

order to influence the way he makes decisions. This leaves Walt in an emotional paradox

where he wants to establish his own independence but also wants to appease his father,

leaving him confused on how to make his own decisions.

Frank is a few years younger than Walt and also is confused about the physical

urges that overcome his body. He is exploring this through masturbation and has a lack of

group identity, which has pushed him into isolation. The masturbation itself is not

unusual behavior but his wanting to spread the semen on random objects throughout the

school is cause for some concern towards his mental health. “Adolescents who show

strong signs of mental health and adaptive coping strategies have positive communication

and trusting relationships with parents or other close family members as well as strong

feelings of trust and security among friends” (Newman & Newman, 2012, p.371). Due to

the difficult circumstances that Frank is facing at home, he is left with no consistent

support systems with which he could rely. Ultimately he struggles socially and

emotionally.

Risk Assessment

In the case of the Berkman family, the counselor assessing risk must take several

things into consideration regarding the entire families stages of development. The boys


are in a very sensitive stage of development. Adolescence can be a very confusing time

because there are so many things happening cognitively and physically during

maturation. At this stage of development egocentrism is a common occurrence. Newman

and Newman (2012) wrote,

“Early adolescent egocentrism has two characteristics that may affect

adolescent’s social interactions as well as their problem solving: (1)

preoccupation with their own thoughts, and (2) a belief that others are also

preoccupied with their thoughts. Thoughts about the possible and the

probable, the near and distant future, and the logical extension of

contemporary events to future consequences all flood their minds ”

(p.359).

Both Walt and Frank are exhibiting curiosity about the world around them and their

future in it. While Walt remains preoccupied with the direction his sexual relationship

should go and how that will affect him in the future, Frank is in a mode of self-discovery

questioning whom he resembles, what his interests are and what these things mean for

him. Walt and Frank are met with the challenge of making sense of the world around

them while trying to also understand the physical changes they are experiencing.

Specifically, Franks’ experimenting with alcohol must be explored and addressed.

Two possibilities for his turning to alcohol are to minimize the feelings of stress and, in

addition to the masturbation, sensation seeking. During adolescence, puberty heightens

the awareness of body sensations and alcohol may accentuate these feelings (Newman &

Newman, 2012, p.380). Many struggling youth attempt to use alcohol to suppress their

feelings of helplessness, minimize inhibition and experience these heightened bodily


sensations. The high levels of family conflict have left Frank feeling vulnerable and

stressed and his alcohol intake is a risk factor that he, along with the entire family, needs

to confront. If left unaddressed it could have very detrimental and negative consequences

in his future, especially if it becomes habitual.

Another risk that may be considered is the possibility of Frank

experiencing adolescent depression. Adolescents are met with several challenges in a

variety of areas. They experience social, familial, personal, physical and psychological

stressors and it can be incredibly overwhelming to young individuals. “Males are thought

to distract themselves from depression by doing something enjoyable, thinking of other

things, or ignoring their problems, instead of ruminating. Though being active and

controlling one’s moods can be very healthy for many males, this behavior can become

problematic when ignoring moods results in other symptoms, like aggressiveness,

substance abuse, or disruptive behavior” (Pruitt, 2007). Frank’s youth has left him ill

equipped with the proper coping mechanisms to address the feelings that he is

experiencing.

Parent Considerations

Bernard and Joan are both in the developmental stage known as Middle

adulthood. Bernard is a narcissistic, pretentious and overbearing man whom believes that

many people are “beneath” him both physically and intellectually. He attempts to treat his

sons as peers, although not at all at his scholarly level of comprehension. He goads them

into competing against him in order to consistently prove that he is superior to them and

show little care or concern to their emotional states or well-being. Joan is a determined

but softer-spoken individual who is emotionally devoid of affection from her husband.


She cares for her children very much and is concerned about their behaviors, emotional

well-being and seeks comfort in being appreciated by her lovers.

Bernard and Joan have a very contentious bond that leads to their divorce. With

the addition of their combative relationship and parental responsibilities they also have

career challenges they are facing as well. “As people move through middle adulthood,

the management of heir occupational career becomes a task of central importance to their

sense of personal effectiveness, identity, and social integration” (Newman & Newman,

2012, p.485). Bernard is introduced as very succesful published writer whose career has

begun to take a nosedive as he no longer has representation for his next literary project.

Joan has a writing career that is just beginning to succeed and this has become an issue of

great tension between her and Bernard. Joan’s success has challenged Bernards belief of

being superior to all. Bernard struggles with finding a publisher and getting his student to

have intercourse with him. This along with Joan’s affair with a man whom was not

academic, in any way, has left Bernard feeling quite vulnerable and questioning his

current state.

Family Life Cycle and the Impact of Divorce

Divorce has such an incredible impact on the entire family system. McGoldrick,

Carter, and Garcia-Preto (2011) wrote, “We can see divorce as an interruption that puts

the family on a new trajectory – an additional family life cycle stage – in which the

physical and emotional losses and changes of divorce are put into effect and absorbed by

the three generational system” (p.318). This “interruption” is very prevalent in the

Berkman family as all parties, but mostly the boys are affected by the separation. In an

article by Hartman, Magalhães, and Mandich, (2011) they do a scoping review of studies

centered on the effects of parental divorce and marital separation on adolescents. In it


they discusss several themes prevalent in all of the studies. Several of these affected

themes can be seen in the Berkman family such as deviant behavior, views on their own

romantic or sexual relationships, and the parent-adolescent relationship.

Deviant behavior can be the use of “illicit drugs, alcohol, and cigarettes, as well

as other behaviors considered unacceptable by society” (Hartman, Magalhães, &

Mandich, 2011). Frank begins drinking soon after his parent’s divorce, while Walt

blatantly plagiarizes a Pink Floyd song and performs it at his school talent show,

claiming it as an original.

Adolescent personal views on romantic and sexual relationships are also shifted

post divorce. Some studies have shown more permissive attitudes regarding sexual

behavior in divorced families (Hartman, Magalhães, & Mandich, 2011). This is similar to

how Bernard encourages Walt to sleep with Sophie to just “try it out”. Bernard’s

opinions regarding women and dating become incredibly important for Walt to consider

and he adopts the notion that “something better” will come along but Sophie will do for

now. This is very indicative of how Bernard views women as expendable, including Joan.

He had been married three times and one “did not count”, the other two were “difficult”.

He attempts to pass this mentality on to his son Walt.

The parent and adolescent relationship in the Berkman family has an incredible

number of nuances and considerations for the counselor to examine. Hartman,

Magalhães, and Mandich (2011) found that divorce has been shown to decrease the

quality of family functioning, increase mindsets of children feeling caught in the middle,

and display negative affects resulting from parents disclosure of sensitive topics to their

children. The negative effects of disclosure can be seen in the Berkman family when


Bernard tells Walt about Joan’s affair. Walt immediately disconnects with his mother and

refuses to stay with her. He begins to push her away and refuses to have any contact with

her. He refuses any form of friendly interaction with her despite her best efforts. It is not

until Walt is forced to discuss his relationship with his mother in therapy that he even

realizes that they indeed had a close connection while his father as absent.

The Berkman Family Genogram


Reflection on the Family Genogram

The genogram is a great assessment tool for counselors to begin to see patterns

within families. Genograms provide a “map” of how the family members relate to one

another. It can also be beneficial to the family to see some of these patterns, which they

may not have previously been made aware of. For example, the Berkmans' are exhibiting

triangulating relationships. Walt and Bernard against Joan, while Joan and Frank are

against Bernard. According to McGoldrick, Gerson, and Petry (2008), “The genogram

allows the clinician to detect intense relationships in a family and, given the family’s

structure and position in the life cycle, to hypothesize about the important relationships

and boundary patterns of that family” (p.168). There are a few things of note that can be

observed by the Berkman Family Genogram.

There are several lines of hostile relationships between ex-spouses as well as

children with their parents. Bernard and Joan appear to have a united front when in the

presence of both children, however, individually they are experiencing a great deal of

resentment towards one another. Joan resents the way Bernard talks down to her and is

emotionally unavailable or attentive to her needs. Bernard is hurt by Joan’s affair but his

pride and constant endeavor to appear intelligent does not allow him to show his

emotions regarding this event. Instead, he chooses to focus his anger on Joan by belittling

her in front of the children and composing himself with an air of superiority over

everyone around him, including his children.

Walt begins to display a hostile relationship with his mother after he learns about

her affair from Bernard. As a result, he spends more time with his father and continues to

emulate his behavior and adopt his chauvinist perspective on women. Frank begins to

challenge his father’s perspectives. For example, during a ping pong game Bernard


describes Ivan as a Philistine, someone who is not interested in books or other intellectual

things. Despite his father’s objection, Frank contests that he also considers himself a

philistine. He also begins to show signs of disrespect with foul language towards his dad.

Family Challenges and Strengths

The Berkman family has its fair share of challenges and strengths. The major

challenge for the working counselor will be to repair some of these hostile relationships.

A main focus would have to be to help amend the relationship between Bernard and Joan.

Amato and Keith (1991) cited, “Interparental hostility creates an aversive home

environment in which children experience stress, unhappiness, and insecurity (Maccoby

& Martin, 1983). Obviously, such an environment is less than optimal for the

development of children”. By assisting Joan and Bernard to have a friendlier relationship

the children can feel that they have a more secure “base” with which to support one

another.

Bernard’s’ attitude of superiority will also prove challenging for the counselor as

he will more than likely enter into the therapeutic atmosphere with resentment and

negativity. One tool that could possibly be implemented with Bernard is the intent-impact

model. The intent-impact model explores whether or not the impact of the message on the

listener is the same as what the sender intended. In therapy, the intent-impact model can

be used to look for the positive (or neutral) intent behind messages or behaviors that are

perceived as being negative. An individual who feels hurt or fearful (neutral intent) may

express it as anger, which can create a negative impact (Williams & Day, 2007). When

Bernard expresses anger towards Joan it could be considered his expression of hurt for

her betrayal of their marriage through her affair.


Another challenge will be addressing Frank’s masturbation and use of alcohol.

This may require some sessions alone with Frank in order to give him the opportunity to

express himself more freely without the presence of his parents. These are all sensitive

topics and must be approached with great care and empathy by the counselor.

A strength the family exhibits is the care and consideration that the brothers show

for one another. Walt and Frank often confide in one another and consider each other’s

feelings throughout the difficult transition of their parents getting divorced. This

connection and their love for one another can prove to be an incredibly powerful tool of

support for both of them. Another strength is the connection that the children have

towards their specific parents. Walt is able to see some things sympathetically from his

father’s perspective and Frank does the same for his mother.

Although this seems like a dividing point for the family it can be used to

strengthen their bonds. In sessions with the boys, the closeness that they share can allow

them to help the other see a perspective from the distanced parent. Circular questioning

can allow them to adopt different viewpoints while allowing them to explore their

personal feelings about their parents.

Indeed it is important for the counselor to take into consideration both the family

strengths and weaknesses in order to establish a positive outlook for change. “Knowledge

of family strengths will help the therapist understand how families cope with problems

and how they promote growth and development”. (Hanna, 2007, p.91). The Berkman

family has a considereable amount of issues to be discussed but there seems to be a great

amount of care and concern from each of the family members. There is no doubt that

with the proper guidance this family can find their way to being a more healthy and


happier unit. A strengths based therapeutic approach, such as Solution Focused Therapy,

can prove in credibly beneficial to the Berkman family.

Solution Focused Therapy Approach

The counselor working with the Berkman family will be using the Solution

Focused therapy (SFT or SFBT) approach for assessment and diagnosis. “Solution-

Focused therapy is a future-focused, goal oriented therapeutic approach to brief therapy

developed initially by Steve de Shazer and Insoo Kim Berg at the Brief Family Therapy

Center in Milwaukee in the early 1980’s. SFBT emphasizes strengths and resiliencies in

people by focusing on the exceptions to their problems and their conceptualized

solutions” (Corey, 2013). SFBT allows clients and therapists to engage in a collaborative

approach towards resolving their presenting issues. Aspects that make this approach

beneficial in Family counseling are the therapeutic perspective, the role of the counselor,

the theory of change and the interesting intervention techniques that can be applied.

The SFT approach can prove to be very beneficial to the Berkman family because

it is rooted in optimism, capability and hope. The issues that the Berkman family face

results in them becoming incredibly overwhelmed with negativity, destructive responses

and a sense of powerlessness. These clients need assistance in “finding their way” back to

believing in their self-competence and promoting constructive and hopeful outlooks on

their abilities. This focus on positivity empowers clients to concentrate on resolving their

presenting issues more effectively.


Family Relationships and Interpersonal Exchanges

In the SFBT approach, the counselor allows the client to become the “expert” and

adopts a “not knowing” stance. The counselor does not assume that they know the

answers or that they are there to educate the client. Instead, it is a collaborative

approach where the client is invited to devise their own solutions based on their

current situation. There is little to no emphasis placed on the clients past

experiences and the primary focus is on the here and now.

This approach can prove incredibly beneficial to the Berkman family who tend to

bring up many of their past issues or occurrences in their lives as a main point of

contention. Bernard constantly brings up Joan’s previous affairs and this is a continuous

topic of contention between them. The couple has an enormous amount of difficulty co-

parenting because they display this animosity towards one another and are unable to

communicate effectively. Working on improving this communication will be an integral

component of family therapy.

The boys also display specific interactional patterns focused on the past that should

be considered. For example, Walt argues with Frank about how their father is “the writer”

even though he has not had a book published in quite some time. He does not view his

mother in her current role as a burgeoning writer, as Frank does. These differing

perspectives result in a polarity where each brother is defending a parent and what their

roles are supposed to be, instead of what they are presently. SFT will allow the Berkman

family to focus on what their situation is today and how to strengthen their relationships

through this transition of divorce.


Assessment Findings

In the initial phase of assessment, the SFT approach works on developing a

working therapeutic relationship that is optimistic and hopeful. The clients and counselor

identify exceptions as well as strengths and resources that allows them to become

motivated for change (Gehart, 2014, p.351). Although it may not be apparent at the

outset, the Berkman Family does have many strengths and resources from which to pull

from. The care and concern that the brother’s have fro one another is an incredible

strength. They also can prove to be incredibly powerful support systems for one another.

Additionally, Joan maintains incredible empathy for the boys difficulty in processing the

divorce and she aspires for the family to maintain a loving relationship. Along with his

brother and mother, Frank also has a good relationship with Ivan whom he admires and

respects.

DSM-5 Relational Diagnosis

The DSM-5 discusses relational problems that the Berkman family qualifies for

diagnosis and reasons for each will be discussed in the following:

V61.20 (Z62.820) Parent-Child Relational Problem,

This code is used when “the parent-child relational problem is associated with

impaired functioning in behavioral, cognitive, or affective domains” (APA, 2014). The

hostile relationships between Walt and his mother as well as Frank and his father make

the family qualified for this particular code.

V61.29 (Z62.898) Child Affected by Parental Relationship Distress


Joan and Bernard have extremely high levels of conflict and disparagement. They

lack the ability to communicate effectively with one another, which ultimately affects

their ability to co-parent. It also creates a polarity between their children where they feel

they need to choose a “side” to defend, in order for each parent to be accompanied and

represented.

V61.03 (Z63.5) Disruption of Family by Separation or Divorce

The Berkman's are going through a divorce which has created an influx of

changes that the entire family must deal with. There are new homes, living and visiting

arrangements, school transportation options, as well as decisions to be made about the

family pet. All of these changes can be incredibly troubling to children and adolescents as

they attempt to make sense of their new environments and relationships with their

parents.

Narcissistic Personality Disorder

Bernard’s’ delusions of grandeur and disconnection to the emotional states of

each of his family members leave him with a possible individual diagnosis of Narcissistic

Personality Disorder. “Typical features of narcissistic personality disorder are variable

and vulnerable self-esteem, with attempts at regulation through attention and approval

seeking, and either overt or covert grandiosity. Characteristic difficulties are apparent in

identity, self-direction, empathy, and/or intimacy, as described below, along with specific

maladaptive traits in the domain of Antagonism”.

Child Neglect

Due to the fact that Frank was left home alone and unsupervised when he was

supposed to be under Bernard’s care the counselor would also consider looking into

Child neglect considerations for the Berkman Family. The APA (2014) states, “Child


neglect is defined as any confirmed or suspected egregious act or omission by a child’s

parent or other caregiver that deprives the child of basic age-appropriate needs and

thereby results, or has reasonable potential to result, in physical or psychological harm to

the child”.

Treatment Goals and Interventions

Treatment Goals

In SFT, the therapist is viewed more as a guide who helps the client determine

their goals. “The clearer client’s goals are the more likely they are achieved so it is

important for therapists and clients to create well-defined goals from the outset of

therapy” (Iveson, 2002). The Berkman family and the counselor would work together to

establish some of the goals that they wish to achieve. Once the goals are established the

clients and counselor can focus on the theory of change. Some goals for the Berkman

family could include establishing friendlier communication between the parents and

including Frank in more family activities to minimize his isolation.

Interventions

Interventions in the SFBT approach are mostly centered around changing

perspective and language. Corey (2013) wrote, “SFBT focuses on finding out what

people are doing that is working and then helping them apply this knowledge to eliminate

problems in the shortest amount of time as possible.” Clients are encouraged to do more

of what is working for them in order to reduce the tension of their situation. For example,

Frank appears to speak more openly about his feelings with his brother. They

communicate via telephone when they are not physically together. This might be a


behavior that could be encouraged to continue by having Walt be more physically present

with Frank. The SFBT approach is completely focused on family strengths and puts them

in a better position to celebrate their successes.

Progressive Narratives

When it comes to language, clients are heartened to address their issues with more

positive words, focusing on their strengths instead of their downfalls. This would be

particularly challenging with Bernard, whose language is very engrossed in negativity,

whether overtly or in nuance. “Therapists prefer ‘progressive narratives’ because it

allows them more range to help their clients elaborate and expand on the positive changes

that they can make” (Becvar & Becvar, 2013). All of this positive feedback results in

higher confidence and an understanding that the clients are in control of their own

actions, perceived roles and lives.

Miracle Question

SFBT therapists use a variety of questions and differing interventions in order to

facilitate this change in their client’s perspective. The most common question used in the

SFBT approach is the “Miracle Question”. “The therapist asks, “If a miracle happened

and the problem you have was solved overnight, how would you know it was solved, and

what would be different?” Clients are then encouraged to enact “what would be different”

in spite of perceived problems” (Corey, 2013). The Miracle question allows clients to

begin establishing the goals of where they ultimately want to be and provides a good

jumping off point of tangible enactments in which they can immediately participate.


By assessing the answers given by the Berkman family, the counselor can have a

better understanding of what some of the behavioral changes can be suggested and then

collaborate with the family on an intervention where they continue to do more of these

behaviors. This could then be suggested as their Formula First Session Task. The activity

or “homework assignment” is focused around strengthening the client’s perspective and

perhaps even encourage adopting a positive association with how they will address their

issues in the future. These interventions can be extremely beneficial in assisting the

Berkmans to reconsider their perceptions on their presenting issues while developing a

more positive outlook on the control they do have in their lives.

Ethical and Legal Issues and Considerations

There are certain ethical codes that should be taken into account when working

this family, beginning with working with multiple family members. According to the

ACA Code of ethics, “When a counselor agrees to provide counseling services to two or

more persons who have a relationship, the counselor clarifies at the outset which person

or persons are clients and the nature of the relationships the counselor will have with each

involved person” (A.7. Multiple Clients). Another important ethical issue with working

with multiple clients revolves around the nature of confidentiality. Disclosing the Limits

of Confidentiality will need to be discussed at the beginning of counseling so that the

family is aware of what will be shared should there be conjoint family sessions. This is

especially important for working with minors where written consent will need to be

acquired in order to provide services.

Confidentiality when working with minors is also a major issue for counselors.


“Confidentiality refers to maintaining privacy and not disclosing information to others

outside the counseling relationship unless there is approval or consent by the client”

(Houser, Wilczenski, & Ham, 2006, p.107). It will be important for the counselor to

immediately inform the family of what the limitations of confidentiality may be in their

sessions. One limitation revolves around distinguishing who the “client” is in treatment.

The American Counseling Association Code of Ethics (2005) states; “In couples and

family counseling, counselors clearly define who is considered “the client” and discuss

expectations and limitations of confidentiality. Counselors seek agreement and document

in writing such agreement among all involved parties having capacity to give consent

concerning each individual’s right to confidentiality and any obligation to preserve the

confidentiality of information known.”

Should the counselor be allowed to meet with the boys individually, there is also

an ethical responsibility to their parents. “Counselors inform parents and legal guardians

about the role of counselors and the confidential nature of the counseling relationship.

Counselors are sensitive to the cultural diversity of families and respect the inherent

rights and responsibilities of parents/guardians over the welfare of their children/charges

according to law. Counselors work to establish, as appropriate, collaborative relationships

with parents/guardians to best serve clients” (ACA, B.5.b.) The limits of the counseling

relationship must be very clearly explained in order for all the parties involved to

understand what things will and will not be shared. Written consent forms can provide

clarity with what the expectations will be from the clients and the counselor as they

continue their therapeutic relationship.

Another consideration is to make sure that the counselor obtains the proper


documentation and permission to work with the minors, Walt and Frank. Although there

will be family sessions, the counselor may wish to work individually with one or both of

the boys. According to the American Counseling Association Code of Ethics (2005),

“When counseling minor clients or adult clients who lack the capacity to give voluntary

consent to release confidential information, counselors seek permission from an

appropriate third party to disclose information. In such instances, counselors inform

clients consistent with their level of understanding and take culturally appropriate

measures to safe-guard client confidentiality” (B.5.c.). Whenever a counselor works with

a minor it is important for them to thoroughly explain the confidentiality expectations and

to obtain the proper documentation allowing permission for participation.

Author’s Reflection

The Berkman family requires an empathetic, understanding and above all, patient

counselor. Upon reviewing the case and considerations for the Berkman family, the

author reflects upon her cultural upbringing, personal experiences and values and how

they affect her assessment and ideas on working with this family. Raised in a somewhat

traditional Latino household, the author recognizes that she has had an experience where

the male of the family is recognized as the “head” of the household and should be

respected. As she grew older she began to have a better understanding of how this

dynamic poses many challenges to her acculturation into Western society. She

acknowledges feeling empathy towards Joan’s inability to feel heard by a domineering

male and the struggle she faces attempting to balance her roles as a woman.

From personal experience, the author watched as her mother struggled with

balancing a more traditional role of mother/wife with being an independent working


woman. It seemed that her mother played two roles: Accomplished business woman at

work and devoted mother and wife at home who cooks and cleans, caring for her husband

and children. The author was raised watching the struggle her mother experienced with

balancing these many roles and began to appreciate the intricacies of both societal and

cultural expectations of women were at an early age. This is something that must be

considered in order to ensure that she does to show too much sympathy and ultimately

come to Joan’s aid or defense when unnecessary.

The author is able to take from her personal experience the importance of

communication for this divorced but still co-parenting couple. Currently she and her

husband have created an open communication approach and these are qualities that can

be encouraged for Bernard and Joan in order to help improve their relationship post

divorce. By creating a better relationship they will be better able to co-parent and provide

their children with a healthier environment. Married to a Caucasian man and despite

having established a very egalitarian approach to their childrearing practices, the author

still finds herself balancing the roles of being a mother, wife, friend and sibling and can

relate to Joan who struggles with her many roles. These are commonalities that can also

help to build rapport and connection between the counselor and Joan.

The author can also relate to Bernard as she has had numerous honest

conversations with her husband in which he describes the pressures of being a “man” and

a “provider” in today’s society. In essence, she can use her experiences to look at the

“coin” from both sides. The author ultimately plans to commit to giving both parties

equal time to express their concerns and finish their thoughts in the counseling sessions.

Setting this as a general rule of counseling will allow her to avoid favoring one client

over another and helping them to both feel heard.


The assessment of the Berkman family has allowed the author to explore a family

dynamic in more depth and detail. By looking at each family member’s perspective the

author was able to better understand the complex and unique views of each of her clients.

She hopes to use this awareness in her future counseling career by allowing each client to

express their perspective and helping the family to listen to one another’s thoughts and

feelings. Finally, the author truly values the importance of healthy relationships in any

form, especially when children are involved. It is this passion that ultimately led her to

pursue Marriage and Family therapy as her career. This belief in the power of positive

psychology can truly be beneficial to the Berkman family, as well as any other clients this

author may be faced with in the future.


References

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2014, from Counseling.org: http://www.counseling.org/Resources/aca-code-of-

ethics.pdf

American Psychiatric Association. (2014). Alternative DSM-5 Model for Personality

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