Case Study Cooper Family

The Cooper family consists of Susan (age 42), Matthew (age 41), Savannah (age 16) and Milton (age 9). The family dynamics interplay to create the crisis in this system. Savannah is in the process of developing an eating disorder and cutting as a means to deal with her intense emotions. The family’s value of perfectionism contributes to this development and creates chaos within all members of this system.
Susan is an achievement orientated woman and spends long hours at work. She upholds unrealistic standards for her husband and children. Susan’s commitment to exceeding at her job position has led to problems in her relationships with her husband and children. The high standards set in place for herself and family members has created undue

stress resulting in externalizing behavior problems in her son and internalizing behavior in her daughter.
Matthew is suffering from low self-esteem issues that are affecting the family system. His sense of self-worth is tied up to his ability to do well at work and to make the most money. Mathew was the main caregiver of his children and because of his perfectionism, he is taking full responsibility for his son and daughter behavior problems. His wife is supporting this position and is unwilling to accept her contributions to this issues
Kohlboeck, Quadflieg, and Fichter (2011) defined the difference between externalizing behavior problems and internalizing behavior problems. Accordingly, external behavior problems are marked by defiance, aggression and antisocial features whereas internalized behavior evidenced by withdrawal, dysphoria, and anxiety.
Milton’s acting out behavior is a component of the dynamic’s existing within the family system. His diagnosis of Oppositional Defiant Disorder is displayed in his teasing his sister and breaking her art project. Loeber (2000) concludes that ODD is a problem with families and not individuals. Milton is also a perfectionist and displays a strong sense of social justice according to his standard of behavior. He is intolerant of others behavior and gets into physical fights within the school setting. His maltreatment towards his sister results from his parents ‘behavior as well as the dysfunctional family structure. (Kiselica & Morrill-Richards, 2007)
Savannah self-evaluative criteria create feelings of devastation as perfectionism is unachievable. Hewett, Flett, and Ediger (1995) proposes that this high drive for perfectionism connected to eating disorders symptoms as well as the development of self-harming behavior. According to this perspective, three facets of personality form the core of eating disorder and self-harming behavior patterns. The contributing features identified as vulnerability: low novelty seeking, excessive harm avoidance, and reward dependence.
Biopsychosocial factors contribute the development of eating disorders and self-harming behavior. The biological component have identified certain chemicals in the brain that control hunger and appetite are found to be unbalanced as well as a pattern of these disorders running in families. The psychological mechanisms impacting the development of eating disorders and self-harming behaviors include low self-esteem and feelings of inadequacy and loss of control in their life. The social factors were contributing to the development of these disorders related to societal values on thinness and perfectionism.
Family's Perspective
The initial reason that counseling session came about due to concerns about their daughter’s self-harming behavior.

The issues affecting the Cooper family system consists of eating disorder, self-harming behavior, acting out behavior, sibling maltreatment, and martial discorded. The focal point of this system is Savannah’s eating concerns and her recent acting out behavior. They are unaware of how each member’s behavior is contributing to these identified issues.

The theoretical perspective approach useful for analyzing this family is the family systems theory. This approach views individual problems in relationship to other family members and significant others within the social environment. The family system theory is easily amendable to include techniques from other theories including cognitive behavioral strategies to create the most effective treatment plan for the client systems.
Unique Needs of the Members of the Family System
Each member of the Cooper family of unique needs is relative as these are contributing to the dysfunctional structure of this system .Identified individual needs are an important component of developing a healthy family structure. The Cooper family must be aware of each other’s unique needs to enable the balance within the system to return to homo

stations.
Susan is a perfectionist and views her self-work through her work achievements and the money she earns. Susan appeared to be judgmental of the other members and utilized this as a tool to enhance her self-esteem. To change the dynamics within the family, she needs to develop self-esteem based on who she is rather than what she accomplishes. Susan must give up her desire to control other members and realize that the only person she can control is her behavior.
Matthew is also a perfectionist and views his worth through earning money and his children’s achievements. He is experiencing excessive guilt over his parenting skills and believes that he handles his children’s current behavioral problems. He needs to improve his self-esteem by focusing more on his character and being able to learn to be able to identify his unique strengths and abilities. Both Susan and Mathew must accept their humanness and imperfections.
Milton is displaying deviant behavior towards his sibling and his peers at school. Because of his diagnosis of ODD, Milton needs to receive social skills training to increase his flexibility and improve social skills to assist him in reducing his frustration tolerance with his sister and his peers. Milton also needs his parents to attend parenting training programs where they are taught positive ways to manage his behavior, discipline techniques and age appropriate supervision.
Savannah is a perfectionist like her parents and places her self-worth is what she accomplishments. She has lost her sense of control and her eating disorders, and self-harming behavior is the method she is utilizing as a means to gain this control and deal with intense emotions. Savannah needs to improve her self-esteem as well as learn new ways to manage unpleasant emotions.
Culture of the Family System interplays with Society's Expectations
The Cooper family upholds many of the traditions of the dominant society. The parents and daughter are achievement orientated and strive for perfection in all their accomplishments. Even though the role of the caregiver and breadwinner is nontraditional, the family still supports the position that the man should earn more income than the woman. The family seems to be a modern family but are unable to let go of part of this dominant views.
Milton aggressive behavior is appropriate for his gender and is less concerning than if Savannah displayed this. While Milton is externalizing behavior problems through his aggressiveness toward others; Savannah internalize her behavior issues through her eating disorder and self-harming behavior patterns.
The family culture is experiencing stress related to shifting the roles but not changing the role expectations. Milton and Savanah continue to act out behaviors that are consistent with gender role. Mother and father are experiencing relationship issues related to the underpinnings of the traditional social expectations.
The media influence all members of the Cooper family. Media and peer interactions affect Savanah's behavior. She upholds the position that thinness is related to having a perfect body type. Milton spends his free time playing violent video and computer games as well as watching violent movies. Susan and Matthew are buying into the belief relating to achievement and role expectations.
Children’s and Adolescent Culture
Children and Adolescent Cultures have their unique beliefs and values.

Their parents and caregivers continue to hold influence over this development, but noted differences are noted. Both children and adolescents are affected by technology advances and exposed to this on a daily basis. Media also shapes children and adolescents view their world. Media influences fashion defines beauty and encourage upholding the beliefs and values of the dominant culture. The noteworthy differences in modern youth culture are their need for immediate gratification, absence of long-term thinking about life and the world, expecting bail-outs with consequences and focusing on appearance rather than

debts.
Children and adolescent cultures influence the family system by setting standards for beauty and expectations for behavior. The mass media use of the unrealistic models sends women a message that to be beautiful you must be unhealthy. These sociocultural standards make it difficult for many women to achieve satisfaction with their physical appearance. The development of an eating disorder is encouraged by cultural influences and perfectionism.
Interventions
Savannah meets the criteria for a diagnosis of an eating disorder with self-harming behavior patterns. Cognitive Behavior techniques a research-based and supported in evidenced based research studies. The main elements of current effective treatment approaches are many. The most important technique in working with her is developing a strong therapeutic relationship. Educating her on the CBT model and methods to reduce cognitive distortions and about self is essential elements of the treatment course. The therapist must also challenge the dietary restraints through the cognitive process as a method to change eating patterns. Another evidenced technique is teaching self-monitoring behaviors including the thoughts, beliefs and emotions associated with their diet. As Susan’s counselor, focusing on changing her thought patterns would be an essential elements since thoughts affect feelings and behaviors.
Prevention Techniques for Eating Disorders
As a therapist working with the family in crisis, the protective measures that can continue to reduce the likelihood of further crisis would focus on developing resiliency within the individual and family system. Parents are the focal point of change as they need to be able to adapt their value of perfectionism and begin to accept failure as part of the learning process. The entire family system needs to develop self-esteem skills unrelated to what they do but who they are.
Another aspect that requires attention is to teach social skills, problem-solving skills and coping skills as techniques to enhance the family’s ability to handle stressful situations. Parents must be able to learn concrete skills to Milton and Savannah to increase their capacity to develop friendships and other areas of struggle.. The family system would also benefit from anger management skills as a method to handle anger producing situations. The parents are required to attend parenting skills training programs as a means to change Milton’s ODD behavior patterns and to support Susan her recovery process.
Part Two
The Children and Counseling class have provided me with new insights on to how to work with these populations. My employment is in this capacity and allows me to utilize the techniques taught in working with the children and adolescents that I currently serve. The methods implemented were appropriate, but I was unclear that these were research based. The counseling videos enable me to see the application of these techniques in an actual therapy sessions.
Strengths
Evaluating strength is a significant component of being a professional counselor. The course provided me with opportunities to do this. As a counselor, I have a natural approach and have experienced success in engaging my clientele. .The techniques that I implement in my daily work with this population have been shown to be supported by evidenced base research. The values I possess coincided with the ethics and standards of the social work profession presented in the class structure. The discussion post have provided me with new insights on dealing with children and adolescents that I currently was unaware of and will include as part of my knowledge bases. Because I am changing directions in my employment, the family therapy and techniques from the various therapeutically approach enhanced ability to work with these systems.
Increasing Knowledge Base
The Child and Adolescent Counseling Class has presented me with new information that I need to explore. There are four particular areas that I need to investigate. John Summers Flanagan and his Tough Kids Cool Counseling Approach provided useful techniques for working with challenging youths inspired me to research his approach. I tend to struggle at times providing services to adolescents with a diagnosis of ODD, Conduct Disorder, and Anti-Social Disorders. Studying techniques implemented in the Tough Kids and Cool Counseling approaches will broaden my knowledge base while providing useful tools for interacting and designing more efficient treatment plans for this group.
The second area that necessitates further exploration is the diagnosis process including how to implement the DSMV in determining what mental disorder the individual may possess. I struggle with the idea of labeling individuals because this limits our ability to see beyond their diagnoses. As a social worker working with the mentally ill population, I would view their diagnosis as just a component of the individual’s identity as this should not entirely define whom they are. Many times the individual’s mental health diagnosis becomes a barrier to providing services. Professionals often utilize the diagnosis as a method to explain behaviors of the clients even if the behaviors displayed are typical responses for everyone. The mental illness defines the entire person rather than just a part of him or her. Thi diagnosis fails to take into account the individuality of the client limits our ability to provide quality services for this population.
Counseling and social work practices must adhere to the standards of evidenced based practice demanded by managed care. Since therapy sessions are limited effective interventions must be identified and utilize within the therapeutic process. I tend to differ on researched base intervention strategies since this tends to lead to a one size fits all treatment approach. As a practitioner, I must be able to adhere to the standards set-up my insurance companies that possess limited therapeutic knowledge yet make judgments regarding the number of sessions needed based on the diagnosis criteria. Therefore, I must continue to update my research to ensure evidenced based, and adhered to in my counseling practices.
The third area that requires more researching is in the area of understanding family dynamics and how these interplay to create the mental disorders and the behavior patterns that children and adolescents are exhibiting. For example, research studies have supported the position that abnormal functioning occurs in families of children with AHD. Deault (2010) suggest that children with ADHD have shown to have poorer overall family functioning. He concludes that these family systems tend to be less relaxed, less cheerful and more and utilize an authoritarian style of parenting. This information would be useful in assessing and making changes within the ADHD family system. However, there are various mental health disorders, and continuous education must be perused to design effective treatment plans and intervention strategies based on the identified family dynamics.
The final area that I lack knowledge in is different techniques implemented in the various therapeutic approaches. The areas I would like to include cognitive behavior therapy, Traumatic Focused Cognitive Behavioral Therapy and the systems and ecological theories. Each approach provides different tools that therapist can draw on when working with women and children. Drawing from just one approach limits the effectiveness of serving the needs of our client systems.

Insights Gained from the Course
The course have provided new insights into working with this population. I gained knowledge about play therapy and the effectiveness this has on children. I have had the privilege of observing this therapy but was somewhat unclear on how this process works. The knowledge gain from this course enable me to understand what was occurring in these therapy sessions. I normally would have stayed away from art therapy due to my limited artistic ability but discovered that you do not have to be an artist to be able to utilize this approach.
I have also gained insight into the diagnosis process and useful techniques to employ with children and adolescents that have this approach. Because of my limited understanding of the biopsychosocial approach to evaluating the framework by which mental disorders form, I can assess the client population I serve through this tool. I realize from my research throughout the course that individuals have a trigger for the onset of mental illness, but environmental conditions well determine if the trigger level will occur. I have observed in family systems where one child is mentally ill but not the others are ineffective even though they possess the same genes and environmental conditions.
was unable to comprehend why this occurs and has learned valuable knowledge about resiliency and how this is protecting them from the development of the mental health disorders.
Development of eating disorder is an area that I did possess some knowledge in terms of its development. However, I was unfamiliar with effective treatment methods and techniques that are appropriate for working with these individuals. The discussion questions assigned as well as feedback given by other students enabled me to gain more insights on Eating Disorders development, effective techniques while serving this population as well as prevention methods.
Increasing awareness that treatment approaches and intervention strategies are continuously changing, and evolving encourages me to become more familiar with research studies and evidenced based techniques. Because we are dealing with human beings, I have learned that there is no exact science that will accurately provide the accurate intervention strategies that will work perfecting with every individual. I have also increased my awareness that when designing a treatment plan that individuality of the client system and needs are imperative to the success of the treatment process.
Children and Adolescent Counseling has provided a framework for addressing the needs of this population. The present theories and intervention tools will enable me to provide quality of services for children, adolescents, and their family systems. Diagnostic and assessment procedures allowed me to comprehend how the methods are applicable in the mental health field. The information presented becomes the foundation for my work with children and adolescents in my counseling role.