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Running head: ASSESSMENT AND INTERVENTION PLAN

Assessment and Intervention Plan Marion Grant-Johnson CNDV 5381-M01 Lamar University

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ASSESSMENT AND INTERVENTION PLAN Assessment and Intervention Plan Individuals attend couple and family counseling for a variety of reasons. Some may seek premarital counseling to help prepare for an upcoming marriage, yet others may need to find ways to deal more effectively with a child who is acting out, and, others may seek couples’ counseling to understand why they feel distanced from each other after years of marriage. In each of these cases, counselors can use assessment techniques effectively to gather information, develop hypotheses, evaluate treatment progress and outcomes and facilitate change (Gladding, 2018). This paper is an assessment and intervention plan for a family who is trying to save their marriage after the husband drinking habits has led to problems in the marriage. This paper goes through the legal and ethical considerations for this couple as well as the multicultural considerations, family life cycle, the theoretical model that will be used for treatment, the assessment techniques, the intervention plan, the family prognosis, and a final reflection. Legal and Ethical Considerations The therapist's primary responsibilities are to protect the rights and to promote the welfare of his or her clients (Gladding, 2018). When working with couples, an intervention that serves one person's best interests may be counter-therapeutic to another. The primary reason that families tend to seek therapy is because they have conflicting goals and interests. With this couple, the man wants to save the marriage because of the children and because they have been together for a while. However, the wife wants specific things to be done by her husband before she can continue the marriage. For example, she wants family dinners with her husband, she wants him to be home directly after work instead of going to drink with his buddies, she wants him to care more for the children, and she wants him to help out more around the house.

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The therapist must insure that improvement in the status of one family member does not occur at the expense of another family member. The family therapist should become an advocate of the family system and avoids becoming an agent of any one family member. The other legal and ethical consideration has to do with confidentiality where the therapist and each family member will have to decide how to share information between family members. They can either decide to treat each family member as an individual so that no information is being shared or they can decide to share all information with all members. Multicultural Considerations This assessment plan is for a Caucasian family who is in a heterosexual marriage. Their religion was not disclosed in the videos but I am assuming that they are both of the same religion or similar religions. Both partners are working and money issues were not disclosed in the videos. Both partners have no physical or mental disabilities. There are no family life cycle considerations for this couple in the video. Theoretical Model The theoretical model that I would use with this couple is the psychodynamic model. The psychodynamic model says that to understand and remediate negative couple interactions, it is usually necessary to uncover individual psychological issues that do not simply follow from systemic or behavioral concepts (Hewison et al, 2016). The psychodynamic model emphasize that abnormal, maladaptive behavior makes sense when examined through the lenses of important, often unconscious, human motives, fears, and defenses (Gladding, 2016). Psychodynamic model focuses on common human concerns and conflicts over trust, dependency, autonomy, shame, guilt, honesty, intimacy, identity, and self-esteem (Hewison et al, 2016).

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This model would work perfectly with this couple since there are individual problems that must be solved before the couple can function as a family. From the video, it is shown that most of the problems in the marriage stems from the husband drinking problems and his inability to spend enough time with his family. By understanding why the husband is behaving the way that he is behaving, the psychodynamic framework will have to be used. To also help the wife in understanding how to work on herself, I will have to understand her background and her way of life. Specific Issues The couple was previously separated due to the husband alcoholic problems and his inability to spend more time with the children. The husband has been to jail due to alcoholism and the couple has gotten back together. Both partners want to work on their marriage and are willing to do what it takes in order to make their marriage work. The husband criminal record might pose a problem to them recovering since it might become a problem when he is searching for employment. Their children and the years that they have spent together are their strengths. Assessment Techniques The assessment techniques that I would use with this couple include family interviews, mapping techniques including a genogram, Taylor-Johnson Temperament Analysis, Dyadic Adjustment Scale, and the Marital Satisfaction Inventory-Revised. The family interview will tell me the family structure and composition, the family process, relationship patterns, family affect, family organization, and family diversity (Nielsen, 2017). The interview will provide insights into the family dynamics that may be corroborated by the other assessment strategies. Mapping techniques involves having family collaborate with the counselor to graphically represent some pertinent representation. It is used to gain information and observe family

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dynamics while mapping technique is being completed. The mapping technique that I will use with this family is the genogram. With the genogram, the counselor along with clients draw family tree that records information about family members and relationships over at least 3 generations (Gladding, 2016). The genogram helps to identify cross-generational transmission of family patterns (Gladding, 2016). This will tell me if the husband has a family history of drinking and of abandoning other family members. It will also tell me if the wife has a family history of togetherness and dependency. This genogram will help me to understand why certain problems are occurring within this family. The Taylor-Johnson Temperament Analysis measures 18 dimensions of personality that is important in individual adjustment and interpersonal relationships (Nielsen, 2017). By using this tool, I would be able to influence mom and dad personal characteristics in the relationship. This will also help me to identify individual improvements and provide both parties with selfawareness about factors that are affecting their relationships. The Dyadic Adjustment Scale is a self-report measure of relationship adjustment (Nielsen, 2017). By measuring both partners’ perceptions, I can see where the ratings are different and ultimately gain a clearer picture of where the problems are rooted. The Marital Satisfaction Inventory-Revised is used in identifying the nature and extent of relationship distress with couples beginning or considering therapy (Nielsen, 2017). This tool will be used to tell me the kind of damage that has been done in the marriage. It will allow me to understand just how much each party is willing to do in order to make the marriage to work. Intervention Plan When working with this couple, my first step would be to create an alliance where both partners feel safe and accepted by me. I will be able to create the alliance by attending to the

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tasks that are important for clients, understanding clients perception of the problem, me responding and being accessible to clients, creating a safe environment for clients to explore their distress, working through paperwork and explaining the different instruments, and by having open discussions about their treatment plan. I will know that I have built the therapeutic alliance when the couple starts to attend every session, be puncture to sessions, participate during the sessions, work on their assignments, and show up the therapy prepared. The next step would be to assess each partner’s goals and agendas for therapy and to ascertain whether these goals are feasible and compatible with partner’s agendas, and the nature of the therapy. To complete this step, the clients would complete the Marital Satisfaction Inventory-Revised, Initial assessment questionnaire, and the Dyadic Adjustment Scale. These assessments would help me to get a clearer picture of the couples’ problems. Next, we would create a therapeutic agreement between the couple and therapist. This will be a consensus as to the therapeutic goals and how therapy will be conducted. Next would be to complete an assessment of safety and contraindications for therapy. This is where we would discuss the nosecret policy, as well as individual sessions to ask about abuse, affairs, and addiction. The sessions will then move into the experience of each partner to sense how each constructs their experience of this relationship. This would be done by assessing for view of self and other, and their description of their action tendencies. The next step would be to make hypotheses as to the vulnerabilities and attachment issues underlying each partner’s position in the relationship. Next is to track and describe the typical recurring sequences of interactions that perpetuate this couple’s distress and to crystallize each partner’s position in the interaction. The understanding of how the present relationship evolved and what prompted the couple to seek

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therapy will also be assess here. A genogram would be completed so that I can understand the blocks to secure attachment and emotional engagement within and between partners. Next is to sense how this couple responds to interventions and how easy or difficult the process of therapy is going to be by making them to take responsibility for their actions. Partners will recognize the cycle that is keeping them emotionally distant and try to identify the needs and fears fueling that cycle. The alcoholic addiction would be discussed here. The next step would be to frame the couple’s problem in terms of the way the couple interact and the emotional responses that organize such interactions. The couples’ awareness of their own role in the conflict and decrease pursuit withdraw/ withdraw – withdraw/ attack – attack cycles will be assess here. We will work on increasing awareness of own role in relationship conflicts, by having the couple complete an assignment as evidenced by 2 less critical behaviors per week and fewer conflicts. Finally, we would formulate a coherent and meaningful picture of the patterns that define the couples’ relationship as well as how they create them. Partners will engage in a new kind of dialogue about emotions, attachment issues, and cycles, and how these all go together. Previously unformulated or avoided experience is encountered, claimed, and congruently expressed to each other. The last step in the process would be to help each partner deal in a constructive way with the other person’s new behavior. Finally, the couple will complete a closing interview asking them if they have acquired the necessary knowledge to stay in the marriage. Follow-up assessments will be scheduled at a three-month interval follow by once every six months or until the couple decide to no longer seek treatment.

ASSESSMENT AND INTERVENTION PLAN Research The miracle question will be used as a part of the intervention since it helps both partners to probe their own dreams and desires, and learn about their partner’s dreams and desires (Ramisch, 2009). It can aid a couple in understanding what both they and their significant other need in order to be happy with the relationship (Ramisch, 2009). Several assignments will be given throughout the therapy including cuddling at night, more time with each other, and more time with the family. Homework assignments are meaningful and intentional therapeutic activities incorporated into counseling and psychotherapy to facilitate client adjustment and benefit (Pachana & Kazantzis, 2016). The assignments will allow them to reconnect with each other and with their children. Building good rapport with clients is an integral part of any counseling relationship (Biesen & Doss, 2013). I will work to make each partner comfortable with me, with the idea of therapy, and with each other. If the husband is still struggling with alcohol abuse, I will give him a referral to go and see an addiction counselor since I am not adequately trained in addiction counseling. A referral for counseling should be considered when you believe a client’s problems go beyond your own experience and expertise, or when you feel uncomfortable helping a client with some issue (Dutch & Ratanasiripong, 2017). The use of genogram is an integral part of psychodynamic therapy since it focuses on individual’s past history (Nielsen, 2017). Relational patterns tend to get passed from generation to generation until someone takes the initiative to work through these in the context of psychotherapy (Nielsen, 2017). When we come to understand how each individual is triggered by their partner and how that may be connected to experiences they had in childhood and adolescence, it helps each person develop a deeper understanding of their partner, an awareness

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of how their own behavior is impacting their partner, and the potential for greater emotional intimacy (Nielsen, 2017). Family Prognosis After listening to the couple, it seems like both parties are interested in making their marriage to work and both are willing to put in the work that will be require to save the marriage. I do believe that the marriage can be saved. However, the father will have to quit drinking, work on his court case, and spend more time with the family. The wife will also have to find her weaknesses to work on and ways in which the family can spend more time together. She will also have to be willing to support her husband through his court case and him quitting alcohol. I believe that if she stands by him, it will bring them closer and strengthen their bond. This marriage can be saved if the proper tools and adequate effort are put in. Reflection This course was well structured and easy to follow. The course textbook was also easy to read and understand. However, I did have problems keeping up with the schedule since the schedule was not the traditional schedule that I am used to. This course was also difficult for me because I am currently volunteering in a part of Africa that has little to no internet connections and electricity. I knew before coming to Africa that I would have some problems but I did not think that it would be too big of a problem. It would take me hours to connect to the internet and by the time I finally connect, the computer battery is dead. It has been a struggle but I am glad to have finished the course. Because the textbook was so great at explaining everything in the simplest terms, I believe that I am prepared for marriage, family, and couple counseling. There will be some challenges along the way because I am a new counselor but I think I have enough tools at my

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disposal to excel. Everything that I have learned from this course will enable me to work effectively with my clients and provide them with the highest quality service. Overall, I enjoyed this course especially since I will be using some of the tools that I learned from the course to help keep my marriage on track. I have also learned to evaluate myself and my marriage before I can consider working with clients.

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References Biesen, J. N., & Doss, B. D. (2013). Couples’ agreement on presenting problems predicts engagement and outcomes in problem-focused couple therapy. Journal of Family Psychology, 27(4), 658–663. Dutch, M. S., & Ratanasiripong, P. (2017). Marriage family therapist’s attitudes toward evidence-based treatments and readiness for change. Journal of Psychotherapy Integration, 27(4), 540–547. Gladding, S. T. (2018). Family therapy: History, theory, and practice. (7th ed). Upper Saddle River, NJ, Pearson. Hewison, D., Casey, P., & Mwamba, N. (2016). The effectiveness of couple therapy: Clinical outcomes in a naturalistic United Kingdom setting. Psychotherapy, 53(4), 377–387. Nielsen, A. C. (2017). From couple therapy 10 to a comprehensive model: A roadmap for sequencing and integrating systemic, psychodynamic, and behavioral approaches in couple therapy. Family Process, 56(3), 540–557 Pachana, N. A., & Kazantzis, N. (2016). Effective use of therapeutic homework assignments. In I. Marini & M. A. Stebnicki (Eds.), The professional counselor’s desk reference., 2nd ed. (pp. 105–109). Ramisch, J. L., McVicker, M., & Sahin, Z. S. (2009). Helping low-conflict divorced parents establish appropriate boundaries using a variation of the miracle question: An integration of solution-focused therapy and structural family therapy. Journal of Divorce & Remarriage, 50(7), 481–495...