Case Study Week 4 Case StudyAngie

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Week 4 Case Study

Angie Gage

Mid-America Christian University

Marital and Family Treatment Techniques

Dr. Salmon

September 5, 2021

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Psychodynamic Family Therapy Conceptualization

For use with individual, couple, or family clients

Date: September 5, 2021 Clinician: Angie Gage Client/Case #: Jim and

Sue

Introduction to Client & Significant Others

Identify significant persons in client’s relational/family life who will be mentioned in case

conceptualization:

Adults/Parents: Select identifier/abbreviation for use in rest of case conceptualization

: Age: 30 Occupation: Laborer Other:

: Age: 28 Occupation: Homemaker Other: Some formal education

toward dental hygiene

Children/Adult Children: Select identifier/abbreviation for use in rest of case

conceptualization

: Age: 5 Grade: unknown Other: Shelly, daughter

Others: Identify all:

Presenting Concerns

Describe each significant person’s description of the problem, focusing on

OBSERVABLE behaviors:

: Jim describes the problem as a lack of sexual compatibility, a lack of shared interests,

and a lack of participation by Sue in therapy.

: Sue describes Jim as an overcritical partner which lead to her sexual disinterest.

In session, Jim’s presence was forceful, demanding, and critical of Sue. Sue presented

with a tentative and withdrawn demeanor, and only spoken when she was directly

engaged.

Additional: Both partners expressed a desire to maintain sobriety through counseling.

Broader System: Description of problem from extended family, referring party, school,

legal system, etc.:

: Extended Family: Jim’s extended family is reported as having substance and alcohol

use history. Jim describes his family of origin as ‘dysfunctional’ and himself an ‘addict’.

Sue’s family is her adoptive family, her biological family of origin information is

unknown.

Sue describes a family upbringing with substance use issues. Sue also reveals that she

is the only adopted child in her family and is the youngest of six children.

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Sue describes being sexually abused by a family member in her youth for which she

has never sought treatment.

Background Information

Trauma/Abuse History (recent and past): Sue was sexually abused by an older

brother in grade school, who is also the person that exposed her to drug use.

Substance Use/Abuse (current and past; self, family of origin, significant others): Jim

admits to past substance use. Sobriety has been maintained for two and a half years.

Sue also admits to substance use issues and has been sober for two and a half years.

Precipitating Events (recent life changes, first symptoms, stressors, etc.): Jim and Sue

decided to make a lifestyle change and abstain from drugs and alcohol. During this time

their sexual interests began to diverge, and they became aware that they had little

similar interests.

Related Historical Background (earlier incidents, family history, related issues, prior

treatment, etc.): Jim has the perspective that he has worked harder in therapy and

that Sue has not participated adequately.

Defenses

Describe internal conflicts and defenses commonly used by client, significant other,

and/or key family members:

Splitting: Jim could have issues with splitting in his views of Sue and seeing her actions

as all bad.

Projection/Projective Identification: Jim may be projecting feelings of inadequacy

towards Sue.

Repression/Suppression: Sue may be repressing her anxiety by pulling away from

Jim.

Minimizing: Evaluate how Shelly may be minimizing actions and interactions between

her two parents.

Displacement: Jim’s feelings of inadequacy/ lack of control are displaced on Sue as

criticism.

Other internal conflicts and defenses: Explore how Shelly interacts with her parents

and the dynamics of any defenses.

Attachment Patterns

Describe when (if at all), client(s) feel securely connected in their current attached

relationship(s):

: Regularity of secure attachment: Irregular. Relationships/conditions for secure

attachment: Jim feels secure when Sue is reciprocal of his physical expressions of

love. Jim feels security through physical presence and expression.

: Regularity of secure attachment: Irregular. Relationships/conditions for secure

attachment: Sue feels secure when she is able to please those around her. When

Sue feels validated and useful, she feels secure enough to participate physically and

emotionally in the relationship.

Additional: Evaluate patterns of attachment with each individual and Shelly.

Describe typical attachment behavior when person does not feel secure in relationships.

: Anxious Avoidant Anxious/Avoidant. Frequency: Occurring at a frequency which

causes distress to the relationship. Describe: When Jim becomes anxious, he

increases his cynical criticism and unrealistic expectations.

: Anxious Avoidant Anxious/Avoidant. Frequency: Occurring when Jim approaches

Sue in a sexual manner. Describe: When Sue becomes anxious, she becomes

increasingly avoidant of the issue or person.

Additional: Evaluate patterns of anxiousness/avoidance with Shelly and her

parental interactions.

Self-Object Relations Patterns, Parental Introjects, and Transference

Describe self-object relation patterns and parental introjects for client, significant other,

and/or key family members, especially patterns those related to managing anxiety,

criticism, conflict, vulnerability, intimacy, etc.: