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VARGAS CASE STUDY 2
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
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
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
VARGAS CASE STUDY 3
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
Structural family therapy involves joining the family to understand the invisible rules that
control their behavior, understanding the relationships between various family members and
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
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
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
VARGAS CASE STUDY 4
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
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.
VARGAS CASE STUDY 5
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
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
Part II
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
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
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
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.
VARGAS CASE STUDY 8
References
Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of
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
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