CASE TREATMENT STRATEGY PAPER: CASE STUDY

 

Jeff and Sandy Williams present themselves in your counseling agency. Sandy Williams has called for an appointment and cited family issues along with couple conflict between her and her husband. The office receptionist makes an appointment for the entire family of four.

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Jeff and Sandy have been married 21 years. Jeff owns his own used car business, but the downturn in the economy has created financial difficulty for him and Sandy. Sandy has been employed as a teacher’s aide at a local elementary school for 10 years. Their oldest son, Jacob (18) was diagnosed with Asperger’s syndrome several years ago. The youngest son, Leo (15) is having trouble at school.

You have seen the family for two sessions; thus far, the issues presented are that Jeff has a drinking problem. He drinks each day when he arrives home from work and continues until he goes to bed. The next day he remembers little of his late night behaviors or conversations. This has created conflict between him and Sandy.

Due to slow business at the car lot, financial pressure has added to family anxieties. You sense that spending behaviors and lack of financial management are areas that may need some skill building.

Over the last 4–5 years, Jacob’s awkwardness has alienated him socially. Jacob suffers from depression and overall sadness. He feels alone, misunderstood, and struggles with any kind of social engagement. Although Jacob is present during the family counseling sessions, he is both disengaging and silent. He sits, looking at the floor and rocking back and forth. A couple of times when you attempted to draw him into the conversation, he became agitated and began screaming.

Both Sandy and Jeff are perplexed about Jacobs’s behavior, lack of social skills, and lack of empathy; however, Jeff reacts with anger toward Jacob more so than Sandy. This results in Sandy being angry with Jeff for his reaction toward Jacob. The couple also suffers from loneliness and believes that this may be connected to Jacob’s disorder. They both voice that they feel that no one really understands Jacob or what they go through as a family. Due to Jacob’s disorder, the family seldom visits with friends or extended family. Many times when they have attempted to do things socially, Jacob either acts out or wants to return home early. This, again, angers Jeff and saddens Sandy.

Sandy and Jeff are also extremely frustrated with various individuals connected with the school system. They indicated that the school is not doing enough to help either of their two sons.

Leo has not contributed much to the conversation while in counseling and seems distant and disengaged from his family. When you have made attempts to draw Leo into the conversation, he has responded with comments like, “I guess so,” or “whatever.” Leo’s grades have been slipping from a B average to a D average over the last couple of years. Leo has few close friends, stays home if he can when the family goes on an outing. He seldom goes out with the family anymore. He reported being increasingly frustrated over the last few years.

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