(c) love publishing: monit cheung & patrick leung11 the case approach: psychodynamic and family...

(c) Love Publishing: Monit Cheung & Patrick Leung 11

The Case Approach:Psychodynamic and Family of Origin (FOO)Meeting 3

© Cheung, M., & Leung, P. (2008). Multicultural practice and evaluation: A case approach to evidence-based practice. Denver, CO: Love.

Instructors who adopt this book may use this PowerPoint to teach your course without prior permission. Please address questions and comments to [email protected].

© Love Publishing: Monit Cheung & Patrick Leung 22

Mary’s DSM Diagnoses—An Example

Axis I: Clinical disorder Axis II: Personality disorder Axis III: General medical conditions Axis IV: Psychological &

environmental problems Axis V: Global assessment of

functioning


Mary’sAxis I: Clinical Disorders

300.01 Panic Disorder300.04 Dysthymic Disorder313.82 Identity Problem307.1 Eating Disorder:

Anorexia Nervosa–Binge Eating Type


Mary’sAxis II: Personality Disorders

309.28 Adjustment Disorder with Mixed Anxiety and Depressed Mood


Mary’s Axis III: General Medical Conditions

NoneUnexplained Headaches


Mary’s Axis IV: Psychosocial & Environmental Problem

V61.1 Partner Relational ProblemsWant to Complete Graduate School


Mary’s Axis V: Global Assessment of Functioning

GAF=60 Moderate Symptoms


DSM-IV-TR?

Joe’s DSM Diagnoses?

Do we also need one for each family member?

One for the entire family?


Psychodynamic and FOO

Theories & Applications


Psychodynamic Practice

Goal To free clients of unconscious

restrictions so that they will be able to interact with family members and become healthy persons on the basis of current realities rather than unconscious images of the past.


Psychodynamic Stems Freudian Drive Psychology

Sexual and aggressive drives Anxiety is an unpleasure associated

with punishment because of a particular wish

DM use Self Psychology

Human beings crave appreciation Object Relations Theory /

Attachment Theory Need for attachment and relationships


Joe and Mary

Assign two role plays in pairs First two persons: Issue 1:

Unstable Relationship (pp. 93–94) Next two persons: Issue 2:

Children as the Focus (pp. 95–96)In groups of 4 discuss what it is

like to use only psychodynamic as your approach


Tic-Tac-Techniques


Psychodynamic Techniques:Write down 9 techniques (i.e., the corresponding number) on the bingo sheet. No repeats!!You need to get all 9 to win a prize.

1. Analysis of Anxiety Root

2. Confrontation3. Dream Analysis4. Enactment5. Exploration6. Free Association7. Interpretation8. Intrapsychic

conflict analysis9. Projection

10. Reexperiencing11. Resolving past

issues12. Seeking the

Unconscious13. Transference14. Using Past

Feelings15. Universalization16. Investigating the

Family of Origin


Practice

Form a group of two students Take turns and practice each

technique (from 1–9) Process what social workers would

do with these techniques

1616

Psychodynamic Techniques

DM analysis Genogram Object relations evaluation

Cultural values and norms Central egos Unconscious forces

© Love Publishing: Monit Cheung & Patrick Leung


DM Analysis: pp. 114–115In pairs, read each example and find the DM

A. Compensation B. Denial C. Displacement D. Introjection E. Projection F. Rationalization G. Reaction Formation H. Regression I. Repression J. Sublimation


DM Analysis: Applications

Direct Approach: You said you ___; that sounds like a psychological defense. What are you worried about?

Indirect Approach: People usually hide their feelings behind what they talk about; what kind of feeling do people have when they hide it?

Game: Let’s try this game to see if you have use any DM in the past in your relationship. (Pay attention to contrast healthy vs. unhealthy DM’s)


Families of Origin TheoriesFOO Principles

Primary motivation is to establish a successful relationship.

Early relationships with parents create frustrating experiences that the child couldn't change.


Families of Origin TheoriesFOO Principles Introjects may surface later in life

through: Forming close relationships through marrying

and having children Allowing the frustrations experienced in the

family of origin (FOO) in childhood to be recreated

Resulting intrapsychic problems because of unresolved conflicts in the FOO

Selecting partners who will precipitate the re-experiencing of unresolved FOO conflicts

Projecting unresolved issues from FOO onto children, which causes symptoms in children.


Families of Origin TheoriesFOO Principles

Problems are best resolved by taking them back to the FOO source by:

Exploring the past to resolve issues with the FOO

Relating to their own spouse and children as they actually are, rather than as symbols of unresolved conflict in the FOO.


James Framo’s Techniques Meet with both partners in couple sessions Focus on events occurring in each FOO Initiate “group” family sessions Prepare couples who are reluctant Draw the couple's attention through preparation

for “FOO sessions” Develop an agenda of issues to be discussed

with the FOO Spouses are not included in the initial FOO

session Spouses may be included in a later FOO session


Limitations

Not designed for couples with minor marital difficulties

May not have access to their FOO Highlight the need for individual

therapy, which may not be the original intent of the family

Assumptions are based on past experiences in the FOO


Joe and Mary Again…

In the same group, Three members role-play; one member

observes, reading the technique line Issue #3: Unresolved Conflict (pp. 96–

99) Issue #4: Family of Origin Issues

(pp.99–101)Discuss: What techniques you would use

with your clients?


FOO Techniques

Using past feelings and experience to gain insight

Seeking the unconscious Universalization Investigating the Family of

Origin


Practice

Form groups of two students Take turns and practice each

technique (from 10–16 in your Tic-tac game) by reading the line to your partner

Process what social workers would do with these techniques


How does a genogram help your client?

Find the most significant relationship issue Conflict patterns FOO Transmission

Beware of repeated incidents Health/Illness Issues Job Causes of Death Role & Responsibilities

Identify life cycle perspectives


Daily Affirmation

Today I continue to seek and find people who are positive, healthy and nurturing.

Fishel, R. (1988). Time for joy. Deerfield Beach, FL: Health Communications.

(c) love publishing: monit cheung & patrick leung11 the case approach: psychodynamic and family...

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