Case Study Outline: Read The Following Case Study And Comple ✓ Solved

Case Study Outline: Read the following case study and comple

Case Study Outline: Read the following case study and complete the Case Study Outline addressing the items below. Case Study Outline items: 1. Background information and socio-cultural considerations. 2. Assessment (methods must be consistent with Structural or Experiential family therapy theory: Minuchin, Whitaker, Satir). 3. Treatment plan with 3 treatment goals that follow logical problem solving. 4. Interventions consistent with chosen theory, including collateral stakeholders as needed. 5. Discuss future research that may be needed. Include developmental, clinical, and sociocultural issues. Be concise (2–3 pages). Week 5 Case Study: Structural/Experiential (Minuchin/Whitaker, Satir) Blended Family Case Study- Tanya Tanya, is a 16 year old African American adolescent, was admitted to a psychiatric emergency services late one evening for attempting suicide by taking an overdose of medication. Tanya was groggy, unresponsive, and unable to report what she had ingested. Her 18 year old boyfriend, Marlon, had rushed her to the hospital after finding her semiconscious on the floor of her family’s living room. Marlon was able to supply some information about Tanya’s background and recent history to the admitting nurse. Shortly after the recent death of her mother, Tanya had moved from the rural South to an urban industrial city in the San Francisco Bay area. She had moved in with her Father, Elijah and his second wife, Karen, and two younger half– sisters, Kemora, aged 8, and Keyante, age 10. Marlon reported that Tanya had been very unhappy with the transition from a small southern town where she had a close network of friends and relatives to a large metropolitan area where everything was strange and unfamiliar to her. She had transferred to a local high school but had been put back a grade because she was unable to do the work in the 11th grade. Tanya complained that the other students made fun of her accent, her clothes, and her classroom behaviors, she hated to go to school. She also missed her church choir, her part-time job, and all of her friends. Furthermore, Tanya had also complained that her stepmother expected her to babysit with her younger half-sisters and made her clean and cook after school, so she couldn’t work anywhere else. Her father seemed distant and preoccupied with financial problems, and she felt very isolated and lonely. In recent weeks, Tanya had complained to her boyfriend about headaches, stomachaches and insomnia. She had gone to the family doctor, who had prescribed some tranquilizer pills for her, but they only made her feel worse. According to the boyfriend, Tanya sometimes seemed very angry, got in to screaming matches with her stepmother, was very irritable with him and frequently stated that her life was a mess. Her boyfriend was worried that Tanya may have accidentally taken too many of the tranquilizers after her father had said he couldn’t afford to send Tanya to visit her hometown relatives during her spring vacation. During the 48 hours following her admittance to the hospital, Tanya’s condition stabilized, and she confirmed much of this information in the psychiatric evaluation that was conducted before she was released from the hospital.

Paper For Above Instructions

Background and Socio-cultural Considerations

Tanya is a 16-year-old African American adolescent who recently experienced multiple major stressors: the death of her biological mother, an inter-regional relocation from a rural Southern community to an urban Bay Area city, school demotion, social ostracism, increased household responsibilities in a blended family, and financial stressors in the household. These intersecting influences place Tanya at heightened risk for depressive symptoms and suicidal behavior (APA, 2013; WHO, 2014). Cultural displacement, loss of church/community supports, and identity stress (accent, dress, peer rejection) are critical sociocultural factors. Race, socioeconomic status, and the blended family structure (father with new spouse and younger half-siblings) shape power dynamics, role expectations, boundaries, and available supports (Carter & McGoldrick, 1999; Walsh, 2016).

Assessment (consistent with Structural and Experiential models)

Assessment should be both individual and systemic, using tools and observation strategies rooted in Structural (Minuchin) and Experiential (Whitaker, Satir) family therapy. Recommended methods:

• Genogram and family structure mapping to define subsystems, boundaries, hierarchies, and alignments (Minuchin, 1974; Carter & McGoldrick, 1999).
• Observational enactments in a session (or in a safe, hospital-based family meeting) to see real-time interactional patterns, alliance formations (e.g., Tanya–Marlon, Tanya–father, Tanya–stepmother), and boundary permeability (Goldenberg & Goldenberg, 2013).
• Emotion-focused experiential assessment: use of sculpting, family metaphors, and evocative exercises to surface unexpressed affect, grief, and unmet needs (Satir, 1967; Napier & Whitaker, 1978).
• Standardized symptom measures for adolescent depression/suicide risk (e.g., PHQ-A; Columbia-Suicide Severity Rating Scale) and collateral history (medical records, school reports) to quantify clinical risk (APA, 2013; CDC, 2021).
• Risk and safety assessment emphasizing current suicidal intent, means, protective factors (e.g., relationship to boyfriend, religious identity), and access to medications/other means (WHO, 2014).

Treatment Plan and Three Specific Goals

Treatment model: Integrative Structural-Experiential family therapy, prioritizing immediate safety and then systemic restructuring and emotional expression (Minuchin; Whitaker; Satir).

1. Goal 1 — Ensure Safety and Stabilization: Within 72 hours establish a concrete safety plan, remove or secure means (medication), and coordinate outpatient or intensive outpatient follow-up. Rationale: immediate mitigation of suicide risk is essential before deeper family work (WHO, 2014).
2. Goal 2 — Reorganize Family Boundaries and Hierarchies: Over 8–12 sessions, reduce diffuse role overload on Tanya by clarifying parent–child and stepparent/subsystem boundaries, redistribute caregiving chores, and re-establish parental leadership by Elijah. Rationale: structural stressors (role overload, inappropriate delegation) contribute to Tanya’s distress and must be corrected to restore adaptive functioning (Minuchin, 1974).
3. Goal 3 — Facilitate Emotional Expression and Grief Processing: Over 8–12 sessions, create experiential interventions to process maternal loss, migration grief, anger toward stepmother, and adolescent identity concerns, increasing family emotional attunement and support. Rationale: Experiential techniques target blocked affect and can build empathic connections and resilience (Satir, 1967; Whitaker, 1978).

Interventions (consistent with theory and including stakeholders)

Initial interventions:

• Crisis management and safety planning with Tanya, father (Elijah), and Marlon present as appropriate. Secure medications and create a 24/7 emergency plan (WHO, 2014).
• Family joining and enactment (Structural): Therapist actively joins family system, maps alliances, and elicits a live enactment of a typical stress episode (e.g., demand to babysit). The therapist then restructures by redirecting communication, temporarily realigning subsystems to establish appropriate parental authority and relieve Tanya’s caregiving load (Minuchin, 1974; Goldenberg & Goldenberg, 2013).
• Experiential emotional work (Whitaker/Satir): Use sculpting or role reversal with Karen and Elijah to express Tanya’s hurt and loss, promote empathic response, and externalize grief. Whitaker-style provocative interventions may help mobilize latent emotional expression; Satir techniques can improve communication and self-esteem (Satir, 1967; Napier & Whitaker, 1978).
• Collateral engagement: involve school counselor to address bullying and academic supports, church/community leaders to restore social supports (if Tanya consents), and involve Marlon in safety planning while assessing developmental appropriateness of boyfriend involvement (Walsh, 2016).
• Skill-building: teach parents monitoring, limit-setting, problem-solving, and warmth-expressing behaviors. Introduce family rituals to restore connection (Carter & McGoldrick, 1999).
• Coordinate medical/psychiatric care for symptomatic management, and consider brief pharmacologic consultation if clinically indicated (APA, 2013).

Developmental, Clinical, and Sociocultural Issues

Developmentally, Tanya is mid-adolescence with normative drives toward autonomy, identity formation, and peer belonging. The relocation and maternal loss interrupted normative developmental tasks, compounding risk for depressive disorders and suicidality (APA, 2013). Clinically, presentation suggests major depressive symptoms with somatic complaints and an acute suicide attempt; comorbid adjustment disorder and complicated grief should be considered. Socioculturally, racial identity, cultural expressions (church, accent), socioeconomic stressors, and possible stigma around mental health shape help-seeking and family responses. Therapists must employ cultural humility and integrate community resources meaningful to Tanya (Walsh, 2016).

Future Research Directions

Research should clarify: (1) outcomes of blended-family structural interventions for adolescent suicidality across diverse cultural groups; (2) efficacy of combined structural-experiential approaches versus single-model treatments for adolescent depression and suicidality; (3) mechanisms by which relocation and cultural displacement increase suicide risk and how community-based restorative interventions (e.g., faith communities, peer mentorship) buffer risk; and (4) implementation research on rapid hospital-to-family-system transition models to reduce reattempts (Minuchin-informed brief interventions combined with experiential grief work).

Summary: A combined Structural-Experiential approach prioritizes safety, reorganizes maladaptive family structure that overloads Tanya, and creates experiential opportunities for grief and emotion processing. Integrating school and community stakeholders, coordinating medical care, and conducting culturally attuned systemic interventions address the immediate risk and underlying systemic contributors to Tanya’s crisis (Minuchin, 1974; Whitaker, 1978; Satir, 1967).

References

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Publishing.
• Carter, B., & McGoldrick, M. (1999). The Expanded Family Life Cycle: Individual, Family, and Social Perspectives (3rd ed.). Allyn & Bacon.
• Centers for Disease Control and Prevention. (2021). Youth Risk Behavior Surveillance — United States, 2019. MMWR Surveillance Summaries.
• Goldenberg, H., & Goldenberg, I. (2013). Family Therapy: An Overview (8th ed.). Brooks/Cole.
• Minuchin, S. (1974). Families and Family Therapy. Harvard University Press.
• Napier, A. Y., & Whitaker, C. A. (1978). The Family Crucible. Harper & Row.
• Satir, V. (1967). Conjoint Family Therapy. Science and Behavior Books.
• Walsh, F. (2016). Strengthening Family Resilience (3rd ed.). Guilford Press.
• World Health Organization. (2014). Preventing suicide: A global imperative. WHO Press.
• Nichols, M. P., & Davis, S. D. (2020). Family Therapy: Concepts and Methods (11th ed.). Pearson.