bowenian therapy case study

1. BOWENIAN CASE STUDY
OSORO MOENGA FREDRICK-
THERAPIST
0717268348

2. • Kristen and her family experience multiple dysfunctions in the home that stem
from a variety of multigenerational aspects, family triangles, sibling positioning,
and family process issues. As a child, Kristen grew up in an abusive household.
Her father, an alcoholic was abusive. Although it is not clear if he was abusive to
his wife and daughter, it is safe to assume he was. Problems with the father
resulted in an alliance triangle between Kristen and her mother, Juana, and her
father, George. In this situation, the triangle would be the mother focusing her
attention and emotions towards the child because of the neglect and abuse
received from the father. The household problems would also create a
multigenerational problem where both Kristen and her mother had unresolved
attachments to the symptoms of the alcoholic father and the family triangle.
These issues further complicate the current relationship between Kristen and
Juana and enhance Juana’s attachment to the oldest son, Ronnie.
•
There is also sufficient information that reflects on Kristen’s unresolved issues
influenced her past marital choices. Kristen stated that her first husband and
Ronnie’s father was also an abusive alcoholic. However, her current husband Tony
is the opposite and breaks the behavioral mold of her past. Furthermore, Juana’s
unresolved issues with George, combined with Ronnie sharing similar behavioral
traits to George have manifested in Juana emotionally projecting an unhealthy
and overly-protective relationship with Ronnie that inhibits differentiation and
enhances troubles between other family members; here we discover the second
triangle. The second triangle is between Kristen, Juana, and Ronnie, and fueled by
the problems between Kristen and Juana, which acts as an enabler for Juana to
become intertwined with Ronnie.

3. • Kristen’s concerns about Ronnie’s behaviors stem from his occasional
aggressiveness, most likely fueled by Juana’s attention, and Kristen’s projection of
unresolved past family experiences. Although there is minor discussion
surrounding some other family members, there is enough data to extrapolate the
third triangle, which would include Tony, Kristen, and the middle-placed daughter,
Brittany. The triangle is a result of problems between Kristen and Tony, which
results in Tony and Brittany spending more time together that with other family
members. Over time this triangle will most likely impede Brittany’s ability to
differentiate herself adequately from her father, and manifest as a disassociative
pattern between Brittany and the rest of the family.
While it is fair to note that a fourth triangle involving Kristen and Tanya is
apparent, there could be multiple third-party causations, and lack of more
accurate information would lead to speculation. However, noting that Tony is more
withdrawn, quiet, and reserved and that Kristen and Tony have experienced
problems with Juana, there is an indication that Tony would be the third factor in
this equation. Exacerbating the problems is the oldest daughter Sophie. Sophie
displays a high level of dissociation and emotional cut-off from the family. Sophie’s
dissociative behavior is likely a result of sibling positioning as the oldest daughter
and second oldest child, combined with Ronnie’s aggressive behavior, problems
between Juana and Kristen, and the triangles that exist between her parents and
other siblings.

4. Treatment Plan Considerations
The treatment plan should be designed to emphasize a combination of continued therapy for the family to
help improve family structure, communication, and homeostasis. Progress will be measured by milestones to
show areas of improvement, or identify areas still in need of improvement. The plan is implemented in
phases that allow the family time to explore the issues and come to conclusions with minimal guidance from
the therapist. The first step of implementation should be therapy sessions to help the family talk, hear each
other, and discover solutions. The second stage is to help the family identify and break old routines that may
enhance anxiety in the home and to encourage changing interaction patterns between family members. The
final stage would include a reduction and progression towards ending therapy once family homeostasis
improves. There are areas where specific family members may seek additional counseling to address
unresolved issues.
Family therapy sessions should continue to help the family members identify communication and active
listening opportunities to aid in disarming argumentative postures, feelings of not being heard, and
improving relations between family members. Continued counseling will also assist family members to
identify existing triangles, multigenerational transfers, and sibling placement issues. As the family begins to
discover these issues through open communication, they will start to define solutions for them. Juana and
Kristen may desire to seek additional counseling to recognize and resolve past issues that influence current
tensions. Also, Juana, Kristen, and Tony should be encouraged to spend equal time with the children, and the
family should be invited to change the family routine to foster more interaction and togetherness, and
potentially start to change associative behaviors of “favorites” between family elders and children.
Tony and Kristen should be encouraged to spend time together as a couple to restructure and redefine their
roles as less adversarial and reactive to active and communicative. Reestablishing the bond and cohesiveness
of the marital couple will have a dramatic impact on the overall family structure. The children should be
encouraged to spend time together as siblings, which should help identify areas of commonality and interest;
a concert or movies perhaps. These activities should reduce triangular interactions that currently exist,
promote a healthier home life, and increase healthy differentiation pattern development.

5. Long Term Goal: Improve family structure,
communication, and interactions
Short Term Goals/Objectives
1. Continued family counseling to help family
recognize communication and other problem
areas
2. Juana and Kristen seek additional counseling
for past issues
3. Break old routines
4. Encourage family members to spend more
time in groups and as a family
5. Reduce therapy sessions

6. Milestones
1. Family arguing and contention begins to balance.
Communication improves
2. Past issues become resolved. Mother and daughter are
talking more openly. Fighting reduces.
3. Breaking old routines introduces exploration as a family.
4. Reduces existing family triangles. Helps family members
find commonalities. Notable reestablishment of family
structure.
5. As the family structure, communications, and
interactions improve, a reduction in therapy sessions will
show significant progress.