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A stay-at-home mother

2 pages per Case Study.

1. Use the following case study to thoroughly address the following (from a systems perspective):

A. Presenting problem (3 pts.),
B. Patterns of interaction gleaned from the case study (3 pts.),
C. Overall treatment approach/theoretical orientation (3 pts.),
D. Goal of therapy (3 pts.),
E. Intervention strategies and estimated length of treatment (3 pts.),
F. Potential ethical issues (3 pts.), and
G. Challenges you might have in working with the couple (3 pts).
H. Finally, imagine first that the couple is European American; then imagine that the couple is Latino or African America. Does this change your conceptualization? Why or why not? (3 pts.)

A stay-at-home mother has been treated for panic and anxiety with no results. Marianne�s panic attacks start early in the day, last all day, and are often accompanied by intestinal cramps and diarrhea. She broods about dying and is overwhelmed by fear. She is unable to care for the house or children so her mother-in-law and mother take turns stepping in.

Marianne�s husband Marc is asked to attend couple therapy with Marianne. The couple is attractive and charming; they�ve known each other since childhood and there is a great deal of love between them. You�ve asked how Marc has attempted to help Marianne and he describes that he has done everything in his power to help her: he�s listened to her, talked to her, reassured her, and taken care of her in every way he could think of.


2. Read the following case study

Case Study 2:
Tony and Pat come to your office and explain that they�ve been happily coupled for 20 years. They are childfree and enjoy doing many things together like biking, cooking, and socializing with friends. They consider themselves best friends. When asked what brings them to therapy, they look at each other in silence, expecting the other to speak.

�Is it something to do with sex?� you ask.
�Kind of,� says Tony.
�Does it have to do with enjoying sex?� you ask Pat.
�Sort of,� Pat answers.
The conversation goes on like this for a while. �What about infidelity?� you ask. �Are one or both of you having an affair?� Tony immediately says yes at the same time Pat says no. Turning to Tony, Pat says, �I never had an affair.�
�But you had sex,� Tony responds angrily.

At this point in the case study, what are your assumptions about this couple relative to gender and race? (5 pts.)

What issues do the authors in Gurman, Lebow and Snyder (2015) alert you to where potential therapist biases are concerned? (10 pts.)

�We never had intercourse, and I never spoke to the person,� says Pat.

After some more confusing discussion, as Tony begins to cry, Pat finally explains that he�d paid a dominatrix to beat him and that the sessions had ended in masturbation. After a few of these sessions, Pat had told Tony about his newfound sexual preference. They were, after all, best friends, and he didn�t want to hide anything from Tony. Tony was considerably upset, but once the initial shock had worn off, Tony tried to help Pat by playing the role of dominatrix. Tony�s heart wasn�t in it, however, and Pat didn�t like Tony doing it. As they tell the story, Pat looks remorseful and Tony seems deeply hurt.

What specific biases and assumptions do you bring to this case relative to the presenting problem? (5 pts.)

Assume the couple is heterosexual, what intervention strategies might you use in your work with the couple? Now imagine that Tony and Pat are a gay male couple. Does your approach with the couple change? Would it change if they were a lesbian couple? Why or why not? (5 pts.)


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