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Mrs. Chan has been married to Mr. Chan for more than 20 years. Her husband is a grocery store owner and he is very busy with his business. Every month, Mr. Chan gives her enough money to support the family. They have two children, a 11-year-old son and a daughter of 8 years old.
Genogram
Presenting problems
The client came to consult the worsening father-son relationship and her son’s behavioral problems. She perceived it as a result of witnessing spousal violence that she had been suffering for several months. She said her husband had a bad temper, showing no care or respect to her and he often beat her in front of the children after drunk. She remained tolerate and silent until the battery shifted to life threatening danger recently.
Worker’s perception of the problems
According to what Mrs. Chan has said and worker’s observation, there are three main problems in the family as listed below.
Spousal Violence
Mrs. Chan has been suffering from her husband’s irascible temper and violent acts over a long time. The domestic violence caused grievous harms to the client both physically and mentally. Empirical evidence shows that after physical abuse, the effects of psychological abuse can be even more damaging. Women survivors of domestic violence have greater possibility to show Post Traumatic Stress Disorder symptoms, along with dissociation, depression, anxiety and panic, with lowered self-esteem and self-efficacy, and low quality of life.
The Son’s behavioral problem
The two children have been exposed to their father’s abusive behavior to their mother. Witnessing a violent event, particularly one involving parents, is likely to result in children’s serious adjustment and behavioral problems. Witnessing is a stressor comparable in impact to the direct experience of a violent act. The symptom becomes stronger when the violence is 1) long lasting, 2) human designed,3) in which the aggressor and victim are close to them. Children are likely to produce PTSD reactions such as withdrawal, aggression and difficulty in concentration after exposure to violence. Thus school performance of the son deteriorated and his temper worsened. He went so far as to hide some weapons to attack his father in case to protect Mrs. Chan.
Family Relations
Family is a special social system which performs certain functions and certain responsibilities. It performs the essential function of attending to the social and educational needs, health and well-being, and mutual care of its members. The Chan’s family is in a dysfunctional status. Lacking communications in both spousal and parental relationships leads to blockings in giving cares, meeting needs, launching functions and performing responsibilities. Mr. Chan is busy on business every day and the whole family seldom have activities together. A stressful family environment under violence restrains expressions of feelings. Besides, children who witnessed domestic violence always face a problem of loyalty. Choosing either side to support will bring problems in family relations inevitably.
These three problems are not separated from each other. Instead, they are somehow in causal relationships. Spousal violence caused children’s behavioral problems and poor family interactions, so in the intervention process, we have to address the problems one by one according to this order.
Intervention phase
In order to get the family back to functioning, we devised an intervention plan for the above-mentioned problems based on informed consent to the client and ethic codes of social worker.
Objectives
Short-term objectives:
To keep the safety of Mrs. Chan and her children
To assess and to recover the trauma of Mrs. Chan and her children
To repress Mr. Chan’s aggressive behavior and stimulate his motive to change
Long-term objectives
To prevent any physical and mental abuse in the family
To improve parenting skills
To restore the communication and to promote harmonious and healthy relationship in the family
Strategy and rationales
PTSD Assessment —– The Keane MMPI(MMPI2)-PTSD Scale
As Mrs. Chan has been suffering from intimate partner violence for several months, the effects of the abuse on her should be detected by scientific methods. The Keane MMPI PTSD Scale has proven to be a reliable and valid measure of PTSD in battered women. If any symptoms are discovered, the worker would refer Mrs. Chan to professional therapist for further treatment.
Financial Helpance and Group training
Due to economic independence and isolation, the victim has very little money of her own and few people on whom she can rely when seeking help, so the worker would Help Mrs. Chan to apply for some financial Helpance like CSSA.
In addition, she lacks specialized skills, education, self-confidence, self-esteem, self-efficacy. Not foreseeing any means of livelihoods could exacerbate her sense of hopelessness, helplessness and hence depression. Therefore, trainings are necessary to help her find gainful employment to support herself as well as her children. Group training like gardening, handcrafting, cooking etc. can not only equip her with some basic professional skills but also provide her with more interpersonal network and social support. Increases in self-esteem are due to the opportunities for social interaction, creativity and self-expression (Parker, 2004).
Solution-focused treatment
There are a lot of theories to explain why individuals acquire violent behaviors in intimate relationships. The social learning theory suggests that the offenders learn by experiencing or witnessing violence and “intergenerational transmission of violence” exists in domestic violence. Others focused on psychopathology and personality characteristics. Biological and physiological factors can also help to produce violence. Substance abuse such as alcohol and drug consumption may also account the situation in some way.
However, as far as we know at the moment, we cannot tell the reason why Mr. Chan beats his wife. The only thing we are sure for the moment is that Mr. Chan should make a change to stop the abusive acts and restore the family functioning.
The solution-focused treatment deemphasizes problems and emphasizes the construction of solutions. Rather than asking the offender to be responsible for the problem, the treatment requests the offender to be accountable for solutions. The couple have been married for 20 years and Mr. Chan has always been hard working on business to support the family. Out of this love, plus the worker’s stimulation and guidance, Mr. Chan is expected to ascertain motives, set meaningful goals to eliminate violence and develop new behavior to solve the problems step by step. Assessment interview, individual, couple and family solution-talks and offender group training workshops will be carried out with the furthering of the intervention.
According to the self-changing process theory, there are five stages in the process of an individual’s change—-pre-contemplation, contemplation, determination, action and maintenance, while relapse is likely to occur at all stages. Therefore, the process would take a long time and it needs worker’s patience and encouragement all along.
Art therapy
In the Chan’s case, the son has probably shown some mild symptoms of PTSD. Without intervention, it will lead to inconceivable consequences. The girl’s condition should also be followed up although there is still no obvious symptom on her. Considering the age of the two children, the worker would adopt art therapy in the intervention. Children shows greater reduction in PTSD symptoms through creative expression such as drawing, painting, play, or storytelling. We plan to use this approach to Help children to identify and change destructive belief patterns, identify and express emotional residue, exercise personal control, make plans for future and break down the sense of isolation.
Family Gathering
Interactions and communications are essential to family functioning. The worker suggests Mr. and Mrs. Chan organize more family activities that can involve the whole family to promote the family relationship.
According to parent-child interaction therapy, such activities can modify modes between the parent and child, diminish child behavior problems and promote positive parenting. Moreover, family gatherings can give Mr. Chan a chance to know how his wife takes care of the children every day, which can promote love and respect between the couple. It is hoped that these activities can be held at least once per week.