University Psychology: Family Therapy Session Review Report

This report provides a comprehensive review of a family therapy session conducted with an 89-year-old Alzheimer's patient, Mrs. A, and her two daughters, Shirley and Alice. The patient is experiencing depression and social isolation, exacerbated by her daughters' infrequent visits. The therapist utilizes structural family therapy, mapping the family structure and identifying dysfunctional patterns. Interventions include strategic orientation, cognitive behavioral therapy, thought diaries, communication training, and psycho-education to restructure the family dynamics and improve communication. The report details the client's positive reaction, with reduced depressive symptoms and increased family interaction. The session's goal was to restore and maintain family interaction, emphasizing a family-focused approach to address the patient's issues within the broader family context. The family was instructed to continue with thought diaries and a follow-up session was planned to assess the progress.

Running head: SESSION REVIEW
Review of Therapy Session
Name of the Student
Name of the University
Author Note

SESSION REVIEW
Description of the Issue
The family consists of an 89 year old widowed mother A, her two daughters, Shirley
(53 years old) and Alice (49 years old). Mrs. A has been widowed for 14 years and has
worked as registered nurse for 30 years before retiring 19 years ago. She worked as a
registered nurse in adult health care nursing home. Mrs. A has been living alone for several
decades after both of her daughters got married. The daughters, Shirley and Alice have
children and as they live out of town, they rarely come to meet their old mother. The first
signs of Alzheimer’s started to show in Mrs. A few years ago, with symptoms increasing ever
since then. Her husband had a chronic illness history of hypertension and stroke, the latter
being the cause of death. Mrs. A is currently being diagnosed of stage 6 of Alzheimer’s
dementia. She is currently under care of an adult care nursing home and faces extreme
difficulty in doing daily activities. With increased risk of death, poorer health and social
isolation acting in against her mental health, Mrs. A is suffering from extreme symptoms of
depression.
Her two daughters along with their family members have come to town to take of
their aged mother after being requested from the nursing authorities. However, even though
in town, the daughters and their children, seldom visit their aging mother and help her in
performing daily activities. The patient feels sad all day, feels fatigued and denies any form
of social interaction with anyone, even with family members when they come to meet her.
She has been brought to a therapist so that effective interventions can be provided to treat her
depressive symptoms.
Theory behind Intervention
A psychotherapy known as structural family therapy was developed by Salvador
Minuchin. In this type of therapy, the structural and functional problems of the family
members are addressed, ensuring that every member of the family takes part in the therapy

SESSION REVIEW
session and not just the patient that is suffering from the disease or symptoms (Colapinto,
2015). Minuchin developed the theory with a particular goal of restructuring the family
system and bring them along a more healthy line. Family members who have been observed
to having issues in solving family members require few changes in the organization, order
and change in structure of the family (Nichols & Colapinto, 2018). By altering and realigning
the family structure, important behavioral changes in the family can be observed that can
improve the overall structure, ensuring that the psychotherapy session is not limited to the
particular patient alone.
Summary of the Session
The family members including the daughters, Shirley and Alice along with Mrs. A
have been called on to take part in a closed room therapy. After the first meeting with the
family members, the therapist drew a map of the family structure and further investigated
about other members of the family to draw hierarchy and identify subrelationships,
subsystems and boundaries. Using this outline of the family structure the therapist identified
the necessary changes in the family and planned to restructure it. The therapist asked the
family members to role play and take sides, which can be deemed essential in changing the
dynamic of the relationships and disrupting the negative pattern in the family subsystem.
Session Initiation
The therapist analysed any the relationship dynamics between the daughters and the
aged mother by asking several questions to them individually. Few sessions were conducted
with only the daughters, Shirley and Alice in the room and individual session with Mrs. A
was also conducted. It was revealed that both of the daughters had a common perception that
they got too busy after getting married and staying out of town that they never got time to
visit their mother. Mrs. A also stated that she was very upset as her daughters gradually

SESSION REVIEW
completely forgot about her existence and she also stopped contacting them, as she thought
she was bothering them.
Intervention Introduction
The therapist used strategic orientation to present a problem to the family situation. It
is evident that the patient is living alone, which has been a strong determinant of depression
and has led to social anxiety in her. Further analysis by the therapist showed that the family’s
inability to solve the problem has led to further worsening and escalation of problems.
Intervention Description
The therapist used cognitive behavioral therapy as strategic family therapy to
restructure the family. This type of therapy intervention emphasizes on the importance of
external social forces to ensure behavioral modifications (Epstein, Dattilio, & Baucom,
2016). Thought diaries, communication training and psycho-education were provided under
this therapy intervention (Patterson et al., 2018). Communication skills were coached by the
therapist which ensured improvement in listening skills of the family members and helped in
anger management of the patient. The family members were taught to listen empathically,
convey negative communications and express positive feelings among themselves.
Client’s Reaction
The patient, Mrs. A, after the session, followed the instructions provided by the
therapist. She expressed her discontent with the daughters, to which the daughters
apologetically acknowledged. The client was happy with the intervention as she got back to
share the day with her daughters. The daughters decided to visit their mother weekly and
bring their children also. Mrs. A was very happy and her depressive symptoms started to
reduce as she interacted with more people than before.

SESSION REVIEW
Closing the Session
The therapist asked the family members to continue the thought diary for a week post
intervention. In a final session, the family members were called once again together to share
their feelings. Restoring and maintaining family interaction was the primary goal of the
intervention provided by the therapist. Structural family therapy is more family focused,
which helps to ensure changes in all the family members to help address the family without
targeting the patient alone.

SESSION REVIEW
References
Colapinto, J. (2015). Structural family therapy. In Handbook of family therapy (pp. 134-147).
Routledge.
Nichols, M. P., & Colapinto, J. (2018). Enactment in Structural Family Therapy.
Epstein, N. B., Dattilio, F. M., & Baucom, D. H. (2016). Cognitive-behavior couple therapy.
Patterson, J., Williams, L., Edwards, T. M., Chamow, L., & Grauf-Grounds, C.
(2018). Essential skills in family therapy: From the first interview to termination.
Guilford Publications.