Family Therapy With a Depressed Adolescent, Essay Example

Limitations

Since structural family therapy is utilized to determine how the family structure impacts the relationships of family members, this method can be utilized to study a broad range of familial relationships that are built upon cultural and social values (Piercy, 1986). While this study attempted to build upon this theme as a whole, it was necessary to undertake a simplistic comparison in the interests of time and resource. Thus, a comparison of patriarchal and matriarchal families were emphasized, although it is possible that the trends noted in the results are true for other familial relationships as well. This demonstrates the value that understanding more about the efficacy of structural family in relation to unique standards of living is a necessary discovery.

An additional consideration is that this study was based primarily on assumptions that exist concerning modern families. It was therefore assumed that a differential power struggle occurs in matriarchal and patriarchal families. The research question tested two hypotheses based on this assumption. This stated that family members with patriarchal family structures will be more likely to feel that their participation in the family is suppressed, while family members with matriarchal family structures feel that they would benefit from a greater degree of support. Although this hypothesis was determined to be valid for the study population, it is important to emphasize that a larger degree of variables could be considered in this type of study. Therefore, additional studies should be completed related valuables that will help determine all of the factors present in this relationship (Vetere, 2001). While knowledge that the feeling of suppression is present is useful in therapy settings, it would be more valuable for therapists to incorporate a wider set of characteristics into their understanding of the situation.

Another important consideration in determining the validity of this study is the small patient sample utilized in the analysis (Goldenberg et al., 2013). To ensure that quantitative data could be generated, three matriarchal families and three patriarchal families were examined on study. This sample size was selected primarily because this is a preliminary study, and information concerning this relationship has never been definitively tested. Therefore, although it is not possible to confirm external validity of these results based on the experiment, this study confirmed a connection between the gender representation of a family and its tendency to be supportive.

Since six families will be evaluated, it will be challenging to control the researcher’s ability to treat each family equally in order to ensure that bias is avoided. It is important for the researcher to ensure that each family is treated as equally as possible, and should therefore script as much of the interactions during the baseline assessment and therapy sessions as possible. However, it is necessary to consider that effective therapy will be dependent upon the particular information presented from each family and the therapist’s ability to respond to it. Therefore, each therapy session will be different based on the fact that the relationship problems and lifestyle that each family has will be different as well.

A list of 30 eligible families will be compiled for each group and three families will be selected at random from each. These families will be identified by questioning friends and family and by partnering with several school psychologists. To eliminate variables, the six families that will be selected will come from the same zip code in order to control for socioeconomic status. Furthermore, each family will have the same number of family members and belong to the same race. Families will be preferentially selected if the parents are within a similar age range. If it is not possible to identify families for which all of these variables controlled, a case-control study will be conducted in which pairs of matriarchal and patriarchal families are closely matched based on these characteristics. This will allow each of the three pairs to have different demographics, while still enabling family structure comparisons to be made.

Furthermore, this study emphasized the utilization of the family environmental scale, which attempts to convert qualitative information to standard quantitative information that could be analyzed. A major limitation of this approach is that is possible that a researcher new to this technique will not rank each characteristic subscale in the same manner as an individual who has had much practice. Therefore, this data will be internally valid, allowing the families to be compared because a similar scale is applied across the board. However, this data will not be externally valid, meaning that it could not be compared to families studied by a different researcher or compared to data that has already been collected. If this research study were to be expanded, it would be necessary to collect a few researchers who will be conducting the observations and assigning characteristic scores and subject them to training. The goal of this training will be to ensure that certain traits and events are identified uniformly across the tests, and that this identification is consistent with a manner in which the scale has been used previously. If this is done with a larger sample size, the conclusions that are drawn from the study will be more valuable to the population of interest.

A final consideration of the limitations of this study is that it is challenging to utilize statistical analyses for a study with a small sample size. Due to chance alone, it is possible that the identified results are not reflective of the target population. As a consequence, none of the calculations used in this project could involve any assumptions of the normal curve. Since there are a total of six data points for each variable with the intention of comparing three of these points with the remaining three, there would be little benefit in generating values for the mean, median, and mode of each experimental group. To avoid assumptions that would typically fit the normal curve, a student’s t-test was used to compare the matriarchal families to the patriarchal families. For this same purpose, the variance of scores was also calculated to determine whether the scores of families in the same category are similar are different.

The methodology used for this experiment was selected because it effectively codes qualitative data into quantitative data. In this manner, the research could take advantage of statistical analysis that would not be possible with qualitative values. Ultimately, the goal of the research is to distinguish a difference between two different groups, and these differences become more apparent when behaviors are described in numerical form. After completing this research, if there is a need to identify confounding variables and to determine which patterns and relationship factors contribute to the differences between patriarchal and matriarchal families, a multivariate regression analysis could be performed. This would not be possible using qualitative data.

Authorization

Since the study was comprised by selecting members of the community in addition to those who attend the local clinic, it was necessary to initiate a specific consent process in order to ensure that all rights of the participants were protected. The observations, interventions, and evaluations will occur at the home of each family in order to ensure that the behaviors that they are engaging in are natural and not forced.

The primary need for obtaining participant authorization falls to the families with children under the age of 18. It is important to consider that minors are unable to consent for themselves, but they will be allowed to participate in the study if both parents agree to allow the child to participate after discussing the study with him or her. To ensure that the child is aware of his or her rights, he or she will be read the participant consent form in simple language and given the opportunity to answer any questions. Even though the child’s signature holds no legal value, he or she will be asked to sign the consent document in the presence of his or her parents. The parents will then sign the document as well if they agree to the terms.

It is also necessary to ensure that the consent process is simplistic for adults. For the same purpose, the documentation will be presented in clear language. Since the ability to acquire a translator is outside of the scope of this project, only participants that speak English will be recruited in order to ensure that the consent process remains uniform.

The beginning of the consent document will explain the purpose of the study in addition to the role of the participants without revealing any information that will interfere with the generation of results. It will welcome the patient to the study, and identify that the purpose of the investigation is to determine how different families interact with one another. They will not be told why they were selected, but provided with details concerning how the observations and interviews will occur and how frequently they are expected to participate. The privacy of contact information will be discussed as well, and the researcher will agree to only contact the families at the indicated times by the preferred contact method.

An additional portion of the consent agreement that will be highlighted is that the observations will occur in the home of each family at a scheduled time. It is permissible for families to disagree with this clause, but it will disqualify them from the study. If doing so is permissible, each family will be scheduled several observation times at the beginning of the study, ask asked to contact the researcher approximately 24 hours before an observation to reschedule the appointment.

The consent form will also emphasize that participants are not required to participate in the study and are free to withdraw at any time. Furthermore, they will be notified that they have the ability to ask questions at any time, and provided that the answer to the question does not interfere directly with the results of the experiment, these will all be answered.

Since members of the community will be collected for this experiment, it is necessary to gain proper authorization from partner clinicians in order for the information to be gained initially. Therefore, the selected clinician must have already approached several clients to determine whether it would be appropriate to contact them for such as purpose. If permission in this setting is not given, the information could not be used to contact the clients. However, if the clients are present in the office and the researcher is present, it would be possible to recruit them directly from the office. However, all patients, whether recruited by mail or in-person, should be provided with several days to review the consent form by finally agreeing to participate in the study. Those who respond after waiting several days will be more likely to continue with the study throughout the duration of the trial period.

Procedure

Three matriarchal families and three patriarchal families will be selected from the community by consulting a local clinician. A list of 30 eligible matriarchal families and 30 eligible patriarchal families will be compiled for each group based on the clinician’s records. After obtaining prior consent to contact the families and explaining the experimental process to them, three families will be selected at random from each study group. To eliminate variables, all families that are considered to be eligible for the study will be those that come from the same zip code in order to control for socioeconomic status. Furthermore, each family will have the same number of family members and belong to the same race. Families will be preferentially selected if the parents are within a similar age range. If it is not possible to meet this criteria, a different clinic will be identified to serve as a base for participant recruitment.

Each of the six families will be observed once and participate in a structural family therapy focused three times following the gathering of this baseline information. Each of these sessions will occur one week apart, and the research study will occur over a one month period in order to ensure that all recruited families remember that they are participating. Throughout these four evaluations, the family environmental scale will be utilized to determine how both families rank in each of the 10 standardized subscales. The family characteristics that will be examined using this model include a variety of relationship dimensions, personal growth dimensions, and system maintenance dimensions are rated. A score from 1 to 100 will be obtained for subscale characteristic. A score that represents the average of these 10 characteristics will be used to assess the impact of the family environment family functioning for each of the six families (Goldenberg et al., 2013). Each family type will be compared by taking an average of each score across the three families and then conducting a student’s t-test to determine the extent of the variance between the two groups.

During the baseline observation, the researcher will attempt to identify recurring interactions amongst family members, determine whether they are positive or negative in nature, and attempt to determine the impact that the head of the family has on these interactions. In this manner, the researcher will generate an understanding of preexisting knowledge of the family before the counseling sessions, which will allow the questions asked and discussions had to be more directed to the particular case. Each therapy session will build upon the previous ones in an attempt to reverse the negative patterns that occur in the relationships between the family members.

During the three therapy sessions, role-playing activities will be employed as an intervention. Each family member will be presented with the opportunity to pretend to be one another in order to allow each family member to recognize why their interactions contribute to negativity and to provide each family member with the ability to determine the other’s perspective (Will, 1985). All family members will have the ability to participate in this exchange with the family leader, in addition to one another. The success of this intervention will be studied over time by determining comparing the family environment scale following each session (Adam et al., 2010).

Each family will be followed up with one month following the final therapy session and the results will be recorded. The progress that each family makes will be tracked over time. It is expected that different problems will be common for each family type, whether it is patriarchal or matriarchal. It will be the responsibility of the researcher to determine how the role-playing activities should be effectively adapted to benefit each type of family. No assumptions should be made prior to the start of therapy for any group, aside from utilizing the knowledge that the researcher has gained concerning the relationship problems that each family has. It is important for the researcher to record how these strategies have altered for each family as the sessions continue in addition to determining how this intervention has contributed to the stability of each family either short or long term.

In order to eliminate bias, it would be necessary for all six of the families on study to be observed using the same criteria. Therefore, it would be helpful for the researcher to record the exact steps taken as the observation progresses to ensure that all families are observed equally. With the exception of the interventions that are applied as a consequence of identified family patterns, the therapy sessions should be equivalent in nature. For example, the researcher should maintain the same level of involvement in each session, offer each family similar advice, and allow the family to engage in their own discussions an equal amount across the board. This should be the case for all observation and therapy sessions.

Data Analysis

In order to perform statistical analyses that will allow the comparison on the two family groups, the family environment scale will be used to code the information retrieved from the baseline observation and therapy sessions in a manner that will allow the results to have a qualitative value. As mentioned in the procedures, all family environment scale characteristic subscales will be utilized. A score from 1 to 100 will be obtained for each characteristic, and the individual score from each characteristic will be averaged together to compute a total score for each family. A score that represents the average of these 10 characteristics will be used to assess the impact of the family environment family functioning for each of the six families (Goldenberg et al., 2013). Next, each family type will be compared by taking an average of each score across the three families. A student’s t-test will then be utilized to determine whether there is a statistically significant difference between both matriarchal and patriarchal families. The variance of scores will also be calculated to determine whether the scores of families in the same category are similar are different, which will also be necessary in order to understand the results (Creswell, 2013).

Specifically, data collection of this sort would involve assessing each family on the basis of their cohesion, expressiveness, conflict, independence, achievement orientation, intellectual-cultural orientation, active recreational orientation, moral-religious emphasis, organization, and control. This would involve rating each family on a scale of 1 to 100 for each trait and averaging their score together. This would allow the researcher to draw conclusions pertaining to the stability of different family types based on the aforementioned characteristics. Thus, this analysis is not a general understanding of the differences between these two types of families, but a targeted analysis of several variables.

In this particular experiment, the family environment scale will be used several times throughout the procedure. First, it will be applied during the initial observation in order to generate an understanding of each family’s baseline treatment before therapy. It should also be applied immediately following each of the three therapy sessions so that the researcher will be able to track the progress of each family over time. These numbers will be analyzed to determine whether or not the role-playing intervention is successful for each family in addition to determining the extent to which this is the case for patriarchal and matriarchal family types. Therefore, a student’s t-test will be used to compare the baseline family environment score to the final family environment score after the last session of counseling to determine whether the therapy and intervention applied was successful. The percentage of success for each family type will be compared so that conclusions concerning the efficacy of using this method for each family type could be confirmed.

Relevance

This experiment is intended to serve as a preliminary study for a future experiment that would recruit a larger sample size of participants provided that the results showed promise for predicting a trend in a larger percentage of the population. Before this is possible, it would be necessary to determine whether there is a significant difference between the two family types in question. If this is the case, it be worthwhile to invest the time and money into creating a study on a larger scale. Therefore, it is expected there would be value in determining whether the results of this study could be considered externally valid to the target population as a whole. This would help contribute to the field of family therapy as a whole because it would provide clinicians with a greater understanding of how different therapy methods could be applied to different patient populations.

A particular concern in family therapy is that a lot of patients enter therapy from unique cultural and life experience settings, and it is often difficult for the therapist to truly understand how to best treat these individuals. Therefore, it would be useful to conduct studies to determine what methods and modifications of these methods would be most effective for different patient populations. While this study doesn’t determine which therapy methods would be the best for a majority of social groups that are of interest, it does provide researchers with information about the gender gap that is present in the ways that modern families are being raised, which has implications about their interactions and relationship difficulties (Hare-Mustin et al., 2004).

Patriarchal and matriarchal families will have opposing strengths and weaknesses, and it is necessary to define what these are according to these broad family structures. Doing so will help researchers gain a greater understanding of the impact of gender role and family relationship patterns, which will allow us to modify structural family therapy to provide a greater extent of benefit to these particular groups. Ideally, a larger study would be able to extend this to the understanding of gender and cultural factors as well, however it is necessary to first characterize these broader relationships before more definitive studies of this sort could take place (Broderick et al., 2009).

As mentioned previously, this study has the potential for opening up inquiry that will help researcher identify how to differentially treat members of different cultures during family therapy (Kim, 2003). However, just as culture is an important determinant in the success of structural family therapy in relation to gender, the race and religion of participants are important for the same purpose (McGoldrick et al., 2005). Therefore, there is a wealth of knowledge left to discover in the field of family therapy, as many of these different patient variables have not been considered previously. Since there are many variables that impact family dynamics and values, it is necessary to consider how each of these relate to familial gender roles. While it is necessary to consider all of these different factors in a therapy session, it may be possible to group familial interactions according to whether these families are predominantly patriarchal or matriarchal.

It is important to emphasize that the role of the family continues to evolve as time goes on. Therefore, it is beneficial to determine what these changes are and to alter therapy so that these individuals can help follow societal trends that are considered to be normal or ideal. The goal of all therapists is for the greatest number of people to achieve mental health, so it is important to adapt to these trends of normality so that we can best define how the field needs to evolve over time.

Ultimately, this research serves as a baseline that other researchers would be able to build upon. This study introduces many new concepts to the field of family therapy and calls for the need to explore these connections in a greater depth. Since therapists are interested in determining how they could improve their interactions with their patients in a manner that will allow them to achieve a greater level of success, a good start would be by modifying and improving upon the current methodology used. Once we gain a greater understanding of the roles that gender, religion, and culture play in the efficacy of family therapy, we will be able to make more accurate generalizations about our patient populations (House, 2012).

In conclusion, structural family therapy is utilized to determine how family structure impacts the relationships of family members. This information can be used to identify problematic relationships that have formed as a consequence of the specific structure utilized by a particularly group. Therefore, structural family therapy can be utilized to determine the different types of problems that matriarchal family structures and patriarchal family structures typically encounter. This information could also be applied to different types of families that have become prevalent in the modern era. Ultimately, the family environment scale will be used to determine whether family members with patriarchal family structures are more likely to feel that their participation in the family is suppressed, while family members with patriarchal family structures feel that they would benefit from a greater degree of support. To test this hypothesis, three matriarchal families and three patriarchal families were selected from the community and observed at baseline in addition to being provided with treatment therapy three additional times, one week apart. Their family relationships, behaviors, and patterns will be noted throughout each of the six evaluation utilizing the family environment scale characteristics. During the three therapy sessions, role-playing activities were employed as an intervention. Each family was followed up with one month following the final therapy session and the results will be recorded. It is plausible that different problems will common for each family type, whether it is patriarchal or matriarchal. This research will be beneficial because it will allow researcher to understand the differences that must be applied when using structural family therapy on the basis of the family’s actual structure. Furthermore, this will pave the way for future analyses of this sort, as there are many different family dynamics that can be examined in this manner. This will ultimately enhance professional practice because it informs professionals that there is a need to further develop an understanding of the different situations that therapists could occur based on the changing structure of families.

References

Adam B,Ramli M, Jamaiyah H, Noor AM, Khairani O. (2010). Comparison Of Family Environmental Scale (Fes) Subscales Between Malaysian Setting With The Original Dimension Of Fes. Mjp Online Early. Retrieved from http://mjpsychiatry.org/index.php/mjp/article/viewFile/77/71

Broderick P, Weston C. (2009). Family Therapy with a Depressed Adolescent. Psychiatry, 6(1): 32-37.

Goldenberg H, Goldenberg I. (2013). Family Therapy: An Overview. Belmont, CA: Brooks/Cole.

Hare-Mustin RT. (2004). A Feminist Approach to Family Therapy. Family Process, 17(2): 181-   194.

House, Karen Elliott. (2012). On Saudi Arabia: Its People, past, Religion, Fault Lines and Future. Knopf.

McGoldrick M, Giordano J, Garcia-Preto N. (2005). Ethnicity and family therapy. New York, NY: The Guilford Press.

Kim M. (2003). Structural Family Therapy and its Implications for the Asian American Family.The Family Journal, 11: 388.

Piercy F. (1986). Family Therapy Sourcebook. New York: Guilford Press.

Vetere, A. (2001). Structural Family Therapy. Child Psychology and Psychiatry Review, 6(3), 136.

Will D. (1985). Integrated Family Therapy. London: Tavistock.