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  • Subject Name : Nursing

Family Therapy

Laila is a nine-year-old girl who lives with her mother and her elder sister. She is in third grade and has performed a very good in her last class. During the last few days, she has refused to go to school and has missed about eight school days. However, this was not the situation earlier. Earlier, she loves to go to school and always wake up early in the morning and get ready herself. However, now, at the start of school, she cries, screams, pulls her hair, digs at her face, and punches the wall.

Some time she also makes false experiences of health issues such as headaches, vomiting, leg pain, and stomach-aches.she has started developing a phobia of school-going. This may be because her best friend has left school and has shifted to another city. These developmental characteristics are because of separation from her friend. It creates disturbances in the mind of Laila and develops separation anxiety. Due to this, she has started phobic of dogs, Scholl, speaking in public and has symptoms of generalise anxiety disorder obsessive compulsory disorder.

Overview of Therapeutic Intervention

Family therapy is important to the form of treatment that helps in supporting and providing treatment to children through the interaction of family members (Society of clinical child & adolescent psychology). The focus of family therapy is to develop a strong relationship with parents and children, it helps in solving a child’s difficulty through the approach of the family system. Some of the types of family planning that can be followed in Laila's case are as follow:

  • Family-based family treatment – in this type of therapy, parents made responsible to change their behaviour to help the children (Carr, 2018). Laila’s mother must also adopt various strategies for implementing child management and problem-solving skills.
  • Functional family therapy – this therapy type can also be implemented by Laila’s mother. In this therapy, a parent may motivate their children towards school importance and participation. Laila's mother must adopt good management skills to reduce the problematic behaviour of Laila through communication, effective parenting, and management approach.
  • Multidimensional family therapy - this is a family-centred treatment approach that is responsible to influence a variety of behaviour issues. The therapy helps in dealing with issues such as problem-saving, decision making, and guiding the children.
  • Multisystemic Therapy – the therapy is parent-centred, as it helps in guiding the parent to deal with the antisocial behaviours, substance problems, delinquency, and child development (Carr, 2018). Laila mother must adopt this kind of multisystemic therapy as Laila is suffering from social distress due to the transfer of her best friend. This approach will help Laila’s mother to address the issue and also help her to make Laila comfortable with social interactions.

The rationale behind the family therapy is that it will help in improving communication, handling the family situation, solving the family issue, handling child care development easily. The family intervention is important and has a positive role in child development. The intervention helps in marital problems, inconsistency parenting skill, handling the child’s emotions, and making children socially interacting. According to Varghese, Kirpekar, Loganathan (2020), the family model help in understanding family problems, help in understanding child issues, child stress, and family problems. In this case, Laila’s family need to follow a good family therapy that will help them to make Laila realise about school importance and provoke her in becoming socially active. Family therapy provides various advantages to the patient, family, and pubic. These are improving communication within the family; enhancing relationship; generating self-esteem; family stable and stronger; coping skills during situation changes; good parent-child communication.

Clinical Skills

Laila is facing the problem of school phobia and practising school refusal. Thus, its problem needs to be addressed as soon as possible to save her future and carriers. I was a counsellor will provide my best approach to handle Laila’s problem and will try my best to make her again back to school. I will make Laila’s a mother comfortable and would try to be found the issues of Laila’s absents. Through her mother interactions, I learnt that how parents are eagerly involved in saving the lives of children. Her mother is very fond of learning new things and new approaches so that she can apply them to build a good future for Laila. From the conversation, I learnt the nature of parent, problems faced by the parents when their children are in some issue. This will help me in my future cases as it provides me with an insight into the parent-child relationship.

Through this, I learnt a new thing about melding children beliefs. Parents are solely responsible for mould the behaviour, thinking, and perspective of their children. As in this case, Laila’s mother is successfully able to change the perspective of Laila regarding social interaction. As Laila hs lost all her hope in going to school and also develop the characteristic of social distancing with other children and people, however, with the positive attitude of her mother she regains her confidence. Another thing that I learnt from this case is volunteering, the case has touched my inner body and I want to solve the case positively, also would like to help Laila. I started indulging in case more by taking a meeting with Laila, her school friends, and her teacher so that I can develop a strong understanding, nature, and perspective of Laila that her mother also doesn’t know. This additional information helped me to solve the issue and also provide me with an approach to do a proper family intervention.

Critique Analysis

School refusal is a psychosocial problem that may cause children difficulty in attending school (Marynard, 2015). School refusal may be due to reluctances to attend school, prolonged absentees, experiencing emotional distress, antisocial behaviour, and feeling of social determinant in school (Marynard, 2015). Long-term school absenteeism student may experience little education, lees friends, and less respect, that may cause an economic, medical, marital, and psychosocial problem in long term (Pffug & Schneider, 2015).

In the case also, Laila is refusing school for the past few weeks, the reason for her refusal is separation anxiety. However, long-term school refusal may lead to substantial heterogeneity and risk such as school dropout, social adjustment issues (Ingles, Macia, Fernandez, Vicent, Monteagudo, 2015). Many research studies found that systematic desensitization, behaviour therapy, contingency management help in reducing school absenteeism and reduce separation anxiety (Ingles et al., 2015). Thus, if Laila continues school absenteeism then it may cause long-term issues to her studies and her carrier.

Dalton and Bacon (2018) suggest that school refusal among children can be stooped or can be limited through the adoption of various comprehensive models. These models are family-oriented therapy to attain self-esteem, enthusiastic, and focussed toward their child goal and studies. The family models provide positive psychology to provide strength-based, relationship-focused, and growth-oriented approach to intervening with patient families (Conoley, Plumb, Haley, Vancil, & Hernandez, 2015). These models lead to the development of a strong relationship between school staff and parent to make a good childe future. Laila also develops the character of false experiences of health issues such as headaches, vomiting, leg pain, and stomach-aches.she has started developing a phobia of school-going. If the problem was not solved then Laila may find it difficult to cope and will be problematic for her to excel learning.

Problematic school refusal may require special clinical attention and clinical solution. As in this case, Laila is stressed up because of her friend, but instead of making new friends, she opted the behaviour of school avoidance. This option is quite not suitable and good for any studious child. Her parents need to help her to explore the new beginning and to make new friends. For this, Laila’ parents need proper clinical counsellor for their behaviour of school refusal. The counsellor techniques, meetings, and discussion will prompt her parents to change the life of Laila and guide her to adapt the challenge that comes in life. This can also be evaluated from the paper that, the several clinical-based cross-sectional and longitudinal approaches such as comprehensive multi-informant assessment, medical basement, functional reports, and parent-teacher report may help in dealing with children’s stress (Prabhuswamy, 2018).

According to Prabhuswamy, (2018), Cognitive behaviour therapy provides an inter-relationship between dysfunctional thoughts and behaviour to influence the positive change. The treatment provides opportunities intervention that involves family communication, teacher communication, and problem-solving skills. The procedure provides various benefits as collaboration and making of agenda-setting, providing a clear rationale, providing educational hangouts, regular feedback, self-monitoring, problem-solving, and constructive feedback to their parent (Prabhuswamy, 2018).

Laila’s mother can be given a proper medical management approach to rule out any organic, inorganic cause of the problem. The school-family conference helped Laila to return o school as these conferences may inbuilt the sense of school culture, school environment among Laila. Family counselling also helped her parents to better understand the problem, situation, and issue behind school refusal. The parent counselling helps them to guide and provide emotional support to Laila. The counselling also prompts her parents about the ideas, and ways they can use to motivate Laila regarding school. Laila family must adopt operant behaviour techniques. These techniques involve the reward system that is desired behaviour of Laila is rewarded with gifts to increase their frequency of working and building their self-esteem.

These interventions, management methods and clinical practices of parents have helped Laila to move forward in her life and avoid school absenteeism. With these activities, Laila has developed a sense of self-esteem and belief, and now love to go to school. She has developed the art to social interactions with people and learnt how to make new friends. Now she goes to school every day and participates in school functions as well. This cannot be possible if proper family therapy is adopted. Family intervention is the base to solve all the issue related to child development, his/her goals, and her degree of social interaction.

From the above case, it can be concluded that school refusal is common in children, adolescent, and younger kindergarten. The factors responsible for school refusal include separation anxiety, weaker social interaction, and family problem. However, the influence and the impact of school refusal are quite dangerous as it may affect their carrier, their life, and their family. Timely intervention and family support help children to come on track and back to school. Laila suffered because of separation anxiety, and need proper support from family, friends, and school. With the adoption of family intervention, children communication, and family-focused interaction, the issues of school absents can be reduced. These interventions create a positive attitude within Laila’s thinking and her parent’s perspective that finally helped her to go to school regularly.

References for Family Therapy

Carr, A. (2018). Family therapy and systemic interventions for child-focused problems: the current evidence base. Journal of Family Therapy, 41(2).

Dalton, J., & Bacon, V. Chapter 2 - School refusal. Complex Disorder in Paediatric Psychiatry, 11-21.

Ingles, C., Macia, C. G., Fernandez, G. Vicent, M., Monteagudo, M., Current status of research on school refusal. European Journal of Education and Psychology, 8, 37-52.

Maynard, B., Brendel, K., Bulanda, J. Heyne, D., Thompsom, A. & Pigott, T. (2015). Psychosocial interventions for school refusal with primary and secondary school students: A systematic review. Cambell Systematic Reviews, 11(1),

Marynard, B., Heyne, D., Brendel, K., Bulanda, J., Thompson, A., Pigott, T. (2015). Treatment for school Refusal among children and adolescent: A systematic review and Meta analysis. Research on Social Work Practice,28(1) 56-67.

Pffug, V. & Schneider, S. (2015). School absenteeism: An online survey via social networks. ChildPsychiatry & Human Development, 47(3).

Prabhuswamy, M (2018). To go or not to go: School refusal and its clinical correlates. Journal of Paediatrics and Child Health, 54, 1117-1120.

Society of clinical child & adolescent psychology. (n.d). Family therapy. Retrieved from https://effectivechildtherapy.org/therapies/what-is-family-therapy/#:~:text=The%20goals%20in%20Functional%20Family,effective%20parenting%2C%20and%20conflict%20management.

Varghese, M., Kirpekar, V., Loanathan, S. (2020). Family interventions: Basic principles and techniques. Indian Journal of Psychiatry, 62, 192-200.

Remember, at the center of any academic work, lies clarity and evidence. Should you need further assistance, do look up to our Nursing Assignment Help

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