University of Texas at Arlington Discussion – Description
Please read the below and answer the questions at the end. If you have any questions please ask.
Discussion assignment # 4
The Ruiz family sought therapy from the agency where you are employed as an experiential-trained family therapist. The family consists of: Maria Ruiz, mother ( age 37) Salvadore ( “Sal”) Ruiz, father ( age 43), Lisa, daughter ( age 16), and Hector, son ( age 12) . Mr. & Mrs. Ruiz have been married for 17 years. They have been separated for the past 4 months. The separation was initiated by Mr. Ruiz who was diagnosed 4 months ago with ALS (amyotrophic lateral sclerosis) ( also known as Lou Gehrig’s disease) Mr. R. informed his wife and children that he did not want to “burden” them as the ALS progressed. He told his wife that in order to save she and the children from the pain of watching his physical decline, he had decided to separate from her and to file for divorce. Mr. R. assured her that he will continue to provide financial support to the family and expressed relief that he has a life insurance policy that, upon his death will allow Mrs. R. and the children to maintain their current standard of living.
Mrs. R. has begged her husband to return to the family. She has attempted to reassure him that she and their children want to care for him as he faces the uncertainty of his diagnosis . She stressed that being apart from him will cause more stress and worry than if the whole family can be together during his illness. Mrs. R. also reminded her husband that they both have numerous extended family members who live nearby and have offered to provide help and support in any way needed.
Since receiving the ALS diagnosis, Mr. Ruiz has kept regular contact with Father Lucio, a priest with the Catholic church that the Ruiz family has attended for many years. Father Lucio has strongly encouraged Mr. R. to reconcile with his wife and to return to living with the family. Father Lucio recommended that, before making a final decision about whether or not to file for divorce, that Mr. Ruiz attend couple and family therapy. Reluctantly, Mr. R. agreed.
When given the diagnosis, Mr. R. responded by researching medical information about ALS including the typical course of the illness, average life expectancy, and experimental treatments to delay symptoms. According to his wife, when he discussed his diagnosis with his family, Mr. R. factually described this information and neither expressed nor displayed any emotional reactions. During the initial intake with your agency, Mrs. Ruiz noted that such a “logical and factual” response has been her husband’s typical reaction to any crisis the family has faced, throughout their marriage. Mrs. R. added,
“ I am just the opposite. I feel everything so deeply and I express my feelings, regardless of the situation. I have always believed that I should show my children that having feelings and expressing them is normal and healthy”. Mrs. Ruiz continued, “I love my husband but we disagree about this part of our parenting approach. Sal believes that our children should be “tough and strong” and “keep their feelings to themselves” so they can face life’s challenges. Throughout the years, this has been the main area of conflict between us. When the children were younger, Sal would scold them if they cried about something. I remember one time when Hector was just 5 years old and he fell off of his bike. He scraped his arm and hand and was bleeding. My husband told Hector to “take it like a man” and “stop crying like a baby”. I think in order to make up for Hector’s parenting approach, I’ve gone overboard in trying to be nurturing and protective of my kids. My daughter Lisa complains that I’m always worrying and asking her if anything is wrong, if she’s ok, and if she needs anything. I’ll admit that I do that almost constantly. I just worry that if I don’t, my kids won’t tell me if something is wrong.”
You meet individually with each of the Ruiz children in order to better understand their perspective about their father’s illness and to determine how each child feels about attending therapy. During the session with Lisa, she describes the following: “When our dad first told us that he’s sick, I was really scared. I wanted to hug him and tell him everything is going to be ok, but he seemed to just want to give us the facts. He’s never been very affectionate so I knew he didn’t want a hug. After he told us about the ALS, he just said “I will come and talk to you if there is anything else I think you need to know. I have to leave for work now”. My mom and brothers and I just sat silently after he left. We were so shocked and had so many questions for my dad, but we knew that unless he brought up the subject in the future, we shouldn’t ask him anything about his illness. I guess I shouldn’t be surprised that he dealt with the situation as he did. He’s always been kind of ‘cold’ and distant. I love him, but I don’t think I really know him. My mom isn’t like that at all. She’s always emotional. Sometimes it’s just too much. I remember a situation that happened about 9 months ago with a girl, “Tess” at school whom I thought was a good friend. The girl was spreading a rumor around school that I liked her boyfriend and was trying to break them up. I was really mad and hurt because I thought she trusted me and knew I would never do something like that. Well, I mentioned it to my mom and she started to cry, saying “ I can’t believe Tess hurt you like that! She should be ashamed for spreading a rumor about my baby! Are you going to be ok Lisa? Do you want me to call Tess’s mother? Do you want to talk about your feelings? Do you feel like crying? Its good to get your feelings out. “I tried to reassure my mom that I had handled the situation with Tess, but every day for 2 weeks, she asked me about it and if I wanted to talk about my feelings! Now I hardly ever tell my mom about anything significant in my life that I think might set her off into one of her ‘emotional episodes’!!”
Lisa expresses to you that she is willing to participate in family therapy, noting “ our family can use all the help we can get!”
When you meet with Hector ( age 12), you notice immediately that he makes little eye contact and moves restlessly in his chair throughout the session. He appears hesitant to answer questions and typically responds by answering “ yes”, “no” or “ I don’t know”. ( when asked what he thinks about/ feels about his dad being sick, he shrugged his shoulders but did not respond verbally). The only time during the session that you observed Hector’s affect brighten is when you said the following:
“ Hector, sometimes when a family is going through something that they didn’t expect would happen, it can help everyone in the family to have someone to talk to about it. That is what I do; I help families talk about things that might be hard to talk about. I let them know about ways they can support each other and together we come up with ideas that can help them get through a difficult situation. I would like to do that for your family. Would you be willing to meet with me and the rest of your family so that we can work together?”
Hector immediately looked up, smiled slightly, made eye contact and nodded his head affirmatively.
Answer the following: ( *** Your initial postmust include a minimum of one reference to one of the course texts. You must cite the portionof the text exactly (must cite specific page(s) and quotes from the text)
What do you believe is happening currently, with each member of the Ruiz family and the family as a whole, given the crisis they are facing?
What is “present” but not “manifest”? (describe family dynamics not acknowledged by the family, underlying, long-standing issues that have not been addressed, unspoken “messages” between family members)
Given the long-standing “patterns” of interaction between family members, propose 2 realistic goals that could be beneficial to the family as they face the crisis of Sal’s diagnosis.
4) Based on Virginia Satir’s model of communication styles, which “style” (see powerpoint) best describes “Sal”? Provide one specific example from the scenario
5) Provide a description of how you, as the therapist would use the technique “Family Sculpture” (see powerpoint) with the Ruiz family with you serving as the “sculptor”. You will “sculpt” your view of the family in the present, as the family faces the uncertainty of the future related to Sal’s illness. Your sculpture should reflect family members’ communication styles and relationship patterns (closeness/ distance, enmeshed, disconnected etc.) Describe specifically how each family member will be positioned ( next to whom? how close/ far apart, etc.) as well as positioning of other body parts example: arms crossed, finger pointing at a family member, head turned away, looking down, looking away, hands covering eyes, etc.) Be sure to describe the symbolism for each position and/or gesture.
Example: To symbolize the estranged relationship between Nancy and her mother, I positioned them approx. 5 feet apart, with the mother facing away from Nancy. Nancy has one arm outstretched towards her mother. The other arm is positioned over her chest with that hand resting on her heart. This reflects her longing for closeness and affection from her mother. She has revealed in therapy that throughout her life her mother has criticized and belittled her. I positioned Nancy’s mother with her index finger touching her head and a puzzled look on her face. This represents the mother’s apparent unawareness of her emotional disconnection from her daughter.
6) “Simulated Family” technique” is a form of reverse role play
Purpose: to “simulate” a dysfunctional interaction and to help family members experience for themselves how others experience them as a result of their interactions
Family members are asked to take on the role of another family member (or their perception of that family member’s interactions with others)
Example: Nancy and her mother
Nancy ( as her mother ): “ I’ve never been an affectionate person so you shouldn’t be surprised that I don’t like hugging you or discussing emotional topics. I wish that I could develop a closer relationship with you but its easier to keep my guard up. I really want what is best for you. I just don’t know if I can ever be the mother you want me to be”.
Mother ( as Nancy): “ I’ve always wanted you to show me that you love me. I know you’ve given me what I need throughout my life as far as a home, food, clothing and education, but that wasn’t enough. I needed your attention so much that I used to get in trouble in high school just so you would have to spend time with me. Even though you were yelling at me for getting in trouble, I at least had your complete attention”.
*** Create a “Simulated Family” role play for the Ruiz family ( written as dialogue as in the example above)
Your role play must reflect your assessment of the following areas of needed family change:
* unspoken thoughts, feelings, and perceptions about Sal’s diagnosis
* likely needs/wants of family members that are either unspoken and/ or unacknowledged
* hopes of each family member for the future as the family faces the uncertainty of Sal’s illness
Your role play must include dialogue between:
* Maria ( as Sal) and Sal ( as Maria)
* Sal ( as Lisa) and Lisa ( as Sal)
]* Sal ( as Hector) and Hector ( as Sal)
* Maria ( as Lisa) and Lisa ( as Maria)
* Maria ( as Hector) and Hector ( as Maria)
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