Marriage And Family Therapy

1

Week 5 Case Study

Angie Gage

Mid-America Christian University

Marital and Family Treatment Techniques

Dr. Salmon

September 12, 2021

2

Cognitive-Behavioral Family Therapy Case Conceptualization

For use with individual, couple, or family clients

Date: September 12, 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: Explore extended family relations.

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tentative and withdrawn demeanor, and only spoken when she was directly engaged.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.

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.

Analysis of Interactional Patterns

Primary Pathologizing Interpersonal Pattern (PIPs; A  B)

Basic pattern: Pursue-withdraw Mutual negative escalation Withdraw/withdraw Other:

Jim pursues Sue, Sue distances herself. Jim criticizes Sue, Sue defends her position of isolation

and withdraws. Jim’s negative treatment of Sue escalates and Sue resists by withholding

emotional connection and intimacy.

Describe each person’s observable behavior at the start of tension: Jim’s expectations of Sue

are not met to his standards, as this occurs, he becomes more critical and less accepting. Sue

feels that she is not pleasing Jim and feels inferior.

Describe each person’s observable behavior during conflict/symptom escalation: As Sue adds

distance, Jim’s negative interactions with Sue increase, and conflict become more frequent.