For this discussion, you will practice analyzing a case and using the DSM to develop a differential diagnosis, and then selecting a family systems theory as the framework for establishing treatment goals.
Read Joanne and Reggie’s Case Study below, based on Shaw and Ingoldsby’s “Children of Divorce” (1999). In your initial post:
Briefly analyze the micro (intra-individual and closest relationships and contexts) and macro (broader context) perspectives of how individual, family, community, societal, and cultural factors are affecting Reggie, Joanne’s son.
Use the DSM to develop a tentative diagnosis for Reggie, Joanne’s son.
Identify one of the three family systems approaches examined in this unit that you can apply to the case. Explain why you think it is appropriate for this case.
Develop one long-term and two short-term treatment goals, based on the family systems theory you chose, with accompanying interventions.
Explain your rationale for selecting each goal, and describe how the interventions you selected will help create change toward the goal.
Use APA style to cite and reference at least two sources from this Unit’s assigned readings. Your post should be between 250–500 words.
Joanne and Reggie
Joanne, a 32-year-old African American female, contacted your clinic regarding the problematic behavior of her 10-year-old son, Reggie. At the time of the phone intake, Joanne mentioned that she had separated from her 35-year-old husband, Jim, about 9 months prior. Reggie’s behavior began deteriorating a few months prior to the separation. Joanne noted that her other child, Aleisha, age 8, has shown few behavior problems since the separation, although Aleisha occasionally speaks of missing her father.
According to Joanne, Reggie currently demonstrates behavior problems at home and at school. At home, Reggie has become noncompliant and defiant toward his mother. He refuses to complete daily chores and consistently challenges Joanne’s authority to make family decisions. Reggie has also developed a negative attitude toward Aleisha, regularly starting fights and acting aggressively toward her. Over the past 6 months, Reggie’s grades have fallen from As and Bs to Cs and Ds. He has been suspended from school twice for fighting with other children during recess.
Reggie began exhibiting behavioral problems at home and school shortly before the parental separation. Previously, although he had an occasional temper tantrum at home, he completed chores regularly, rarely questioned his mother’s authority, and never fought at school.
During the phone intake, Joanne described her relationship with her ex-husband Jim as “horrible,” commenting that the divorce has become “messier and messier” during the past year. She said the marriage dissolved because Jim had engaged in several extramarital affairs. He is now living with Sylvia, age 24, who he began seeing before the separation. Joanne stated that she is still extremely angry with Jim about his affairs and the dissolution of their marriage. She said that she only talks to Jim “when it is absolutely necessary.” When asked if Reggie’s father would be interested in helping with Reggie’s problems, she responded, “probably not,” and said that she would prefer as little contact as possible with her ex-husband.
When asked how often the two children were seeing their father, she commented that his visitation was “irregular at best.” During the first few months after the initial separation, Jim had seen the children at least once every two weeks. However, during the past four to five months, his contact has become sporadic. In the past two months, he has only seen Reggie and Aleisha once. Jim has also been negligent in making child support payments. Jim’s mother and sister, as well as his large extended family, continue to be involved in Reggie’s life.
The initial intake session included Joanne and the two children. During the intake, Joanne was adamant about her son’s and ex-husband’s misbehavior. Though Alicia spoke only when spoken to, Reggie articulately defended his own behavior as well as his father’s. Reggie also defended his challenges to Joanne’s competency to make decisions for the family, and complained that his mother had become extremely inconsistent in establishing and enforcing rules the past year. When Reggie was asked about his behavior at school, he was less forthcoming, stating only that he would “be okay if people just left me alone.” When asked to describe his relationship with his father, Reggie said it was good, and that he would like to see his father more often.