Different systemic issues in a counselling case study Essay

The purpose of this essay is to consider different systemic issues in a counselling case study. The focus of systemic approaches is not on the individual, but on their wider social context, they include their family, current relationship, work, religion and even wider society (Vossler, pg.192) Systemic approaches were mainly influenced by general systems theory and cybernetics. General systems theory looks to identify things that are common to systems in nature and technology. Cybernetics is looks at the structure of systems and how they function. (Vossler, pg.192-193)

My case study will be on Andy. I will look at different ways of working with Andy in order to help him with his problems. I will consider if one to one counselling or family therapy would suit him better. I will discuss issues that I feel need addressing for example Andy’s role within his family and how his childhood may be contributing this. I will discuss issues around Andy’s relationships with his wife and children and look at how these relationships affect his current role with his family. I will look at different methods and techniques that may potentially help Andy and his family. I will address Andy’s issue of not feeling part of his family as a man, and the reasons for this. I will finish this essay by summing up what this essay has covered and a short self reflection.

Andy is a 46 year old, white supermarket worker who was born and raised in Liverpool. Andy is the middle child. He has one older sister and one younger sister. He was raise by his parents up until the age of 10, at which time both Andy and his sisters were placed in care. Andy’s relationship with his parents was very bad. They were neglectful and physically abusive to all three children. Andy’s relationship with both his sisters is pretty good, they are in regular contact.

Andy sought counselling after becoming depressed and not being able to find his place within his relationship with his wife and children. Andy has been with his wife for 8 years and married for 6. He has 3 children aged 15, 7 and 2. His oldest child is from a previous relationship and lives with his ex partner.

In the beginning of their relationship both Andy and his wife Mandy were taking drugs. When Amanda fell pregnant she gave up drugs completely. Over the next few years Andy’s habit increasingly became worst. Amanda stuck by Andy but often gave him ultimatums about stopping drugs. Finally when Andy’s youngest child was born he decided it was time to stop taking drugs. Andy attended rehab and has now been clean for almost two years. His problem is that he feels like he is struggling to fit in within the family environment. He doesn’t feel like a husband or father, more like an outsider. Andy now feels very low and sad that he has let his family down for a long period of time. He has a lot of guilt regarding ruining many family occasions, for example Christmases where he would be gone all day. Andy wants to be a good father and husband but often feels depressed when he tries but gets nowhere. When Andy is feeling down he considers taking drugs again as he feels this blocks out the pain he feels. The reason he was on drugs was to block out the pain from his childhood. Andy feels that his wife treats him as if she is his nurse or his mother.

Andy’s distress is that he feels as though he doesn’t fit into his family. Adaptation is needed for Andy to gain the role he desires. He was a drug addict before and replied on Mandy to pay the bills, look after the children etc. He is now free of drugs and wants a more active role in his family. He wants to feel like the man of the house instead of another child. The whole family need to adapt for this change to take place. Mandy needs to take a step back and allow Andy to help more with the children and the running of the house. Andy needs to change as an individual and become more confident and dominant within his family to establish his role. The children also need to adapt to their Dad’s new role and accept that he’s going to be around a lot more and taking a more permanent role in their lives.

The question of what’s stopping Andy from being in the role he wants is a complex one. Some may argue that it’s entirely Andy’s fault, other may think its how Mandy is acting that’s preventing him from fulfilling the role he desires. From a systemic view point, it’s the whole family system that is stopping him and needs to adapt to the change in order for Andy to feel he accepted within his family. (Vossler, pg.192)

A typical conflict between Andy and Mandy occurs when they are at home. Excerpt 14 of the D240 DVD states that therapy can take place in any setting and generally where the issue arises. Therefore it would be a good idea to have some therapy in the family home. After the session, the counsellor can help the clients reflect better ways in which to deal with the situation. It generally happens when Andy tries to get involved and take a more active role. Mandy immediately tells him to stop and that she will do it, whether it’s tidying up or going to the shop. This makes Andy feel useless and like a child. Andy tells Mandy how he feels but she dismisses it which in turn makes Andy angry. They then argue over a number of things. This could be described as Circular causality (Vossler, pg.193)

The impact the depression has on Andy is for him to feel very low and think back to his childhood and the mistakes he’s made as an adult. It gets so bad sometimes that Andy thinks drugs would block all the hurt and change his low mood. Andy’s depression also has an impact on Mandy, when Andy is feeling depressed, Mandy feels she can help but also fears Andy will start drugs again. She wants to look after him.

It’s important to consider the dominant setting of Andy’s childhood and how it relates to his role within his family life with Mandy. Mandy is also acting in a dominant role which could make Andy feel similar to how he felt as a child. Mandy is in control of everything in the house, the bills, the rules, the routine. Andy may feel how he did as a child because of this. From Mandy’s point of view she is helping him by doing everything and taking charge.

Andy is a man and therefore perceives that he should be the dominant one in the relationship, he feels that he should be providing for his family. Mandy on the other hand sees Andy as somebody in need, somebody who needs her help, more of a child rather than a man or partner. Andy said he feels as though Mandy treats him like a child or as if she is his nurse. This appears to take away from his masculinity, instead of feeling strong and in control, he feels weak and like a child.

Being the only male child may also have affected Andy. It’s a social expectation that males should protect and look after females. Andy had no way of protecting his sisters but feels as though he should’ve been able to.

One of the first aims of working systemically with a client is to look how they became stuck in their cycle of behaviour. (Vossler, pg.205) Andy is stuck because he is unable to gain the role in his family that he wants.

If I were a counsellor working with Andy I would explore several issues around his childhood and how they relate to his relationship with his wife and children. He feels guilty and as though he has let his family down, this is a similar feeling to how he says he felt that his parents let him down by abusing him and his sisters and giving them a bad childhood. I would look at what’s causing him to feel like a child within his relationship with Mandy. I think it’s important to explore the guilt he feels towards his children and try to help him move on from this. I’d consider the conflicts that Andy and Mandy have and the reasons for them and how they can be described in circular causality. Consider the effect of Andy feeling down and depressed on the relationship and how it affects Mandy, Andy and the children.

I would explore Andy’s relationship with drugs and the reasons he has considered taking them again, how this used to impact his family relationship and what has changed. Also how Andy thinks it would change the dynamics of his relationship now. Does he think Mandy would be happier as she has someone to nurse or look after like a child?

There are several aspects to the therapeutic relationship. If I were a counsellor working with Andy, I would show certain qualities towards him. They include empathy, being able to put myself in the client’s shoes and see things from his point of view. This is important so you can see where the client is coming from and how they feel. I would accept him unconditionally without judging him. I’d be genuine and myself with the client whilst remaining professional. Other counselling skills are also important like reflecting, paraphrasing, the use of silence and open questions. These qualities are used in the hope that the client will feel listened too, accepted. The use of these qualities makes for a good relationship with the client.

Andy may benefit from both one to one therapy and family counselling. It’s important for Andy to explore his childhood and how this has affected his life since leaving home. I think Andy’s children are too young to benefit from family counselling, however, Andy and Mandy would benefit from counselling together so that they can help understand each other’s feelings and help adapt the change that has happened and establish their roles within their relationship.

Recursive interaction pattern (Vossler, pg.195) would be important when working with Andy’s family. I would ask each person how they perceive the situation. If each member of Andy’s family explained how they see the dynamics of the family and Andy’s role within it, it may help the other members to understand all points of view and how they are feeling. Andy then may understand why Mandy wants to look after him and her fears of him doing too much and returning to drugs. Mandy may see that Andy desperately wants to fulfil his natural role in the family. Constructivist thinking is that no two people perceive things the same, (Vossler, pg.195-196) therefore discussing how each person feels can help the other understand.

This essay had looked at a variety of issues that Andy has and how they may be looked at and dealt with from a systemic view point. I looked at Andy’s relationship with his wife and children as well as the relationship with his parents and sisters. I think Andy’s problems mainly stem from his neglectful childhood. Another problem with Andy’s situation was that his wife Mandy was having trouble adapting to their situation. Andy is no longer in need of her help as a nurse or mother figure and she has found it hard to accept him having a new role in the family. I find that systemic therapy could help Andy and his family immensely.

I really enjoyed this assignment, its been my favourite out of the 3 on D240. I found it really interesting to look at how the systemic approach would deal with fear and sadness. The part I found challenging was to stick to the word limit.

Bibliography

Vossler, A, 2010. D240 Understanding counselling and psychotherapy, Chapter 9 Systemic approaches. The Open University, Milton Keynes.

Dvd D240 understanding fear and sadness exert check if audio or dvd. Excerpt 14 systemic counselling.