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APA Psychotherapy Training Videos are intended solely for educational purposes for mental health professionals. Viewers are expected to treat confidential material found herein according to strict professional guidelines. Unauthorized viewing is prohibited.
In Individual Therapy From a Family Systems Perspective, Dr. Florence W. Kaslow demonstrates her integrative approach to therapy. This approach combines techniques from relational–contextual, Bowenian, structural, and cognitive–behavioral therapies, among others, and focuses on the individual within the family context. In this session, Dr. Kaslow focuses on interpersonal conflicts and stresses between the client and members of his family as well as on the client's own internal conflicts. The case concerns a son involved in a family business and some of the issues frequently encountered in such situations when the interpersonal problems within the family are not resolved and spill over into the family business arena. Dr. Kaslow proposes possible resolution strategies to help the son individually and within the business context for the benefit of everyone. This video features a client portrayed by an actor on the basis of actual case material. Precipitating Events The client, Alan, made an appointment with Dr. Kaslow after he saw his internist for "stress headaches." About 6 weeks ago, Alan went to his internist for a physical exam because he was having what he labeled "debilitating stress headaches," including dizziness, visual impairment, and an ashen pallor. His physician indicated that he was "a walking time-bomb of stress and tension" and that he needed to change his work and lifestyle. Although his internist found nothing physically wrong with Alan, he recommended that he exercise and consult with a psychologist for the stress. His physician recommended Dr. Kaslow. Alan agreed that he probably did need to talk to someone. He was experiencing a lot of stress at work and at home. He frequently felt like he was going to explode. And, he had started having "blow-ups" with his daughter at work. She had entered into the family business 4 years earlier (after getting her MBA from Harvard). There was always a lot of stress at work, but about 2 months before, Alan had "lost it" with his daughter in front of important potential business associates. Alan's company was considering an expansion of their real estate investments. Their real estate holdings were modest but secure and provided steady income. Alan's daughter, Julie, had been working in the business as a deputy vice president for several months. Julie had learned the ropes, working with both junior and senior accountants to learn "from the ground up." Since her latest promotion, Julie had wanted to diversify their real estate holdings. She put together a package to buy and develop some commercial property in an "up-and-coming" area and renovate it to contain dwellings, business space, galleries, and shops. Julie presented her package to the CEO (her father) and the Board of Directors. Her fiancee, Chris, a real estate broker, was present at the meeting. In the middle of his daughter's presentation, Alan developed a splitting headache and asked the Board of Directors to adjourn. When he got his daughter alone, he started "ranting and raving." "The deal is shoddy! We don't know where this money comes from. Too much is at risk here. We know nothing about developing such property, about zoning, about any of it! You and Chris want to control this business too fast, too soon!" According to Alan, he went on and on, and soon staff were politely closing doors and avoiding the hall near the executive office. Once Alan controlled himself, he felt "embarrassed, overwhelmed, and kinda scared." "Am I flipping out?" he wondered. Alan recalled two other times that he associated stress with physical pain. 6 Months Ago When Alan expressed his concern to Julie and his wife Joyce before the party, they went "ballistic." Julie was greatly offended and suggested that she should "maybe look for a position in another firm." Alan thought that maybe it was a mistake to be "handing over the firm to his daughter." He and Julie did not speak for weeks. For Alan, the whole incident was accompanied by extreme agitation and blinding headaches. About 15 Years Ago It seemed as though Alan didn't sleep for a year, and he had continual stomach problems. His doctor prescribed tranquilizers. But he still felt overwhelmed by the uncertainty and the change. Preceding Sessions Session 1: In this first session, Alan told his "story." He described his understanding of what had happened; he explained how he had thought about his problems and what goals he had for therapy. Alan established that his primary goal for therapy was to reduce his level of stress. Alan and Dr. Kaslow explored what Alan had already done to relieve stress that had not worked. Dr. Kaslow provided the educative concept of "symptom bearer," explaining to the patient that he is the symptom bearer for the larger system, in that his pain is also born by the other members of the system in some way, but he has been designated the "sick" or distressed one. Dr. Kaslow oriented Alan to family systems therapy. She explained that in this approach one considers the self (individual), the system (or family), and society (as represented in business and work, in Alan's case), and that they would be exploring Alan's problems from these multiple foci: personal-based, family-based, and business-based. She further explained that treatment occurs on all levels of the "system." Session 2: In this second session, Alan further discussed other high anxiety times in his life, explaining what he had done in the past. Dr. Kaslow began to mention further strategies for stress reduction including an exercise program, vacation plans, and possible medications. Dr. Kaslow and Alan began to identify some emerging themes in Alan's problems, primarily issues of loss and grief:
They also discussed a series of interventions both at the business and with other family members:
Session 3: To be viewed. Return to Individual Therapy From a Family Systems Perspective |
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