The University of Hong Kong

Department of Social Work and Social Administration

SOWK3307 Working with Families

Take-home Quiz (Term paper)

Student’s name: Ho May Man

Student ID: 3035791866

Date of submission: 26/4/2024

Total number of words: 2417

I. Case Scenario
David is a 35-year-old night-shift taxi driver, and Bonnie is a 30-year-old housewife.

They have been married for 5 years and have a 3-year-old daughter, called Esther.

David broke his leg in a car accident 6 months ago and he has developed post-

traumatic stress disorder (PTSD), unemployed, staying at home every day. Bonnie is

then compelled work as a waitress. As a result, Esther receives less parental care.

When Bonnie is gone for work, she frequently sobs and looks for her.

Conflicts arise within the couple regarding the unequal division of family roles.

Bonnie has been facing challenges in reintegrating into the workforce after being out

of work for five years. Furthermore, she is burdened with the responsibilities of

caretaker after work as David holds traditional patriarchal beliefs, expecting Bonnie to

fulfill domestic duties and children-rearing. Bonnie believes David disregards her

efforts, lacks communication skills, and fails to alleviate her stress, leading to her

anger.

Their conflicts often stem from household chores, with Bonnie frequently blaming

David, who remains irrelevant. Bonnie tried to request David for help, but David

sternly refuses. Their conflicts starts usually when Bonnie has comforted Esther to

sleep to avoid affecting their daughter’s emotions. One night, after Bonnie felt unwell,

she asked David to do the laundry, but he ignored her. This triggered Bonnie's anger,

pointing her finger at David and scolded him, “You are nothing more than a piece of

trash!” “You are really useless!” David was pissed so he slapped Bonnie. Bonnie

threw a mug against David. The fight ended when Bonnie bawled at David and both

took no further action. Recognizing their troubled relationship, Bonnie sought

counseling to address their spousal issues and restore harmony.

II. Assessment and Intervention Plan

Johnson (1995) identified four distinct categories of intimate partner violence (IPV),

with David and Bonnie's narrative exemplifying Situational Couple Violence (SCV).

Summary of Situational Couple Violence (Johnson, 2006; Lawson, 2012; Hoskins et

al., 1985):

The aforementioned characteristics and factors can be observed in the given case

scenario. For example, both David and Bonnie displayed violent behavior, which was

unplanned and impulsive, arising from a quarrel. The acts of violence involved, such

as pointing, slapping, and throwing substances, were relatively moderate and did not

escalate further. Bonnie's dissatisfaction with David's financial situation and the

presence of imbalanced traditional gender roles contributed to Bonnie's furiousness.

Case Conceptualization
Presenting problems

1 Spousal miscommunication

Bonnie feels angry because David avoids discussing problems, and David never

concede to Bonnie in conflicts. Bonnie perceives talking to David as challenging due

to his lack of understanding. This miscommunication creates tension and further

hinders effective communication between the couple.

2 Spousal imbalanced family role

Bonnie is exhausted from work, doing household chores, and caring for their

daughter. Re-entering the workforce has been difficult for her. Meanwhile, David has

withdrawn from his role as breadwinner due to PTSD. He refuses to take on the

caregiving role as he perceives Bonnie should be responsible. As a result, Esther

receives less attention and support from her parents. Bonnie and David's frequent

quarrels impede the building of a healthy and loving family environment, which may

negatively affect Esther’s early childhood development.

Risk Assessment & Safety Plan

Risk assessment in SCV involves evaluating harm and identifying factors contributing

to violence risk to reduce its likelihood continuously (Boer et al., 1997). The primary

goal is to help clients recognize future violence dangers and find suitable solutions for

safety (Scott, 1995). A structured professional judgment approach combines actuarial

and clinical judgment, using guidelines and tools to evaluate risk factors and make

informed judgments (Hart & Logan, 2011). The Danger Assessment Scale assesses
the level of danger victims endure from couple violence (Campbell et al., 2003). It

considers conflict intensity, violence escalation, abuse history, weapon accessibility,

and the couple's current situation. This scale provides valuable information, identifies

hidden risks, and guides safety plan development. By considering interpersonal

dynamics, individual characteristics, and contextual factors, counselors integrate

expertise to understand Bonnie and David's distinct situation. Comprehensive

assessments addressing their specific risks and needs are made using the structured

professional judgment approach.

Given the mild to moderate level of violence, a 3-stage safety plan is recommended

(Dutton, 2000). Firstly, Bonnie and David need to enhance their risk awareness and

prioritize Esther's safety. Secondly, they should empower themselves to choose a

violence-free life. Finally, they should explore alternatives such as seeking help from

friends, relatives, or the police during intense conflicts.

Individual and Family Needs

To fully understand the case scenario and develop appropriate interventions, it is

crucial to consider the individual and family needs involved.

Bonnie is facing immense stress from her career and family responsibilities. She

struggles to balance being the breadwinner and caregiver, leading to limited time with

her daughter. Bonnie also desires a healthy and constructive communication pattern

with David, where she feels heard and understood. On the other hand, David seeks

understanding and support for his PTSD, longing for empathy and patience from
Bonnie to navigate his emotional challenges. He also grapples with a diminished

sense of self-worth since losing his role as the family's sole breadwinner, and he

resists taking on caregiver responsibilities due to concerns about his masculinity.

Esther, their daughter, requires sufficient parental care and love during her early

childhood. She struggles to adjust to the sudden shift in her mother's availability and

feels neglected and frustrated when David fails to soothe her crying during the day.

Regarding family needs, fostering mutual understanding and respect, facilitating

healthy communication pattern and effective conflicts-resolution are all vital. As such,

their relationship can be improved, and a more loving and caring environment can be

constructed for Esther's upbringing. Balancing family roles and duties is another

essential need. Bonnie currently juggles the roles of breadwinner and caregiver, while

David has withdrawn from his responsibilities. Achieving a balance of family role

will reduce stress and burdens on individual parents, enhance cooperation and

communication within the family, allow both parents to actively participate in child-

rearing, strengthen the parent-child bond, and foster a healthier and more harmonious

dynamic.

Intervention
The first step is to address the couple's beliefs about violence and help them

understand that it is not a solution to their underlying needs. Open and honest

communication should be fostered to uncover their genuine needs and thoughts,

promoting mutual understanding and support. Establishing a regular and effective

communication pattern can repair their conflict-ridden relationship and restore

harmony. They should then discuss the distribution of family roles and duties, a major

trigger of previous conflicts, aiming to reach a mutual agreement. The ultimate goal is

to maintain effective communication, mutual understanding, and a preference for

open discourse, negotiation, and compromise instead of resorting to violence during

disagreements.

Therapeutic Approaches

(1) Satir’s Family Therapy (Beaudry, 2002)

According to Beaudry (2002), this perspective recognizes individuals' inherent

resources for personal growth and transformation, as well as their capacity for lifelong

learning. The focus is on coping methods rather than the problem itself. Therapy aims

to raise self-esteem, empower decision-making, and foster congruence between

feelings and expressions (Banmen, 2002). Setting positive objectives and addressing

the impact of negative experiences are also emphasized to enhance clients' coping

abilities and promote personal growth (Banmen, 2002). The overall goal is to

facilitate clients in developing effective coping strategies, fostering inner

transformation, and promoting overall development.

The Satir Iceberg Metaphor demonstrates the interconnectedness of thoughts,

emotions, and beliefs, showing how changes in one area can have positive effects in

others (Xian et al., 2022).

By using Satir’s Family Therapy, the counselor can create a safe and non-judgmental

space for Bonnie and David to explore and express their emotions. Through active

listening and validation, the counselor can help them uncover underlying feelings and

encourage them to express themselves honestly. This process promotes effective

communication, enhances understanding, and fosters empathy between Bonnie and

David. The counselor can also facilitate an open discussion with Bonnie and David to

identify their shared vision for their family. Even though their daughter did not

directly involve or witness the violence and conflicts, she could still suffer from the

poor family dynamics and imbalanced family roles. By collaboratively defining

specific positive goals to rebalancing family roles and creating a loving environment

for their daughter, the counselor can help them establish a therapeutic roadmap.

Regular check-ins and progress monitoring could be carried out to ensure that they

stay on track and maintain motivation.

By using Satir iceberg metaphor, counsellor can analyze David’s inner thoughts and
behavior thoroughly:

The counselor's initial focus could be on addressing David's expectation. The

counsellor would emphasize the ultimate expectation of him is to be a prominent role

in the family and there are different ways to achieve it, apart from being breadwinner.

Moreover, in order to make his daughter admire him, instead of simply earning a

living to support the family, he could consider showing more care and support her,

and provide a sense of security to her, both physically and emotionally. Moreover,

fathers are important in laying down family rules and enforce them so that he could

gain authority in the family (Palm, 1993). More importantly, the counselor can convey

to David that assuming greater responsibility in household matters does not confine to

doing household chores, and acting as a caregiver does not diminish his masculinity

or deviate from the traditional father role. In traditional Chinese father roles, fathers

often have significant decision-making responsibilities and disciplinary duties with

their children. By encouraging a change in the perceptions of David, he may be less

reluctant to take up more family role and may be more willing to share parenting

responsibility with Bonnie. The counselor can engage in individual sessions with
David to facilitate self-esteem development. Techniques such as reflective listening,

providing positive feedback, and helping him identify his strengths and worth. By

encouraging David to actively participate in decision-making and problem-solving,

the counselor can empower him to regain control and agency in his family dynamics.

By using Satir iceberg metaphor, counsellor can analyze Bonnie’s inner thoughts and

behavior thoroughly:

The counselor's initial focus could be on addressing Bonnie’s expectation as her

failure in achieving her expectation may prompt her impulse aggressive acts.
Considering she is the initiator of the violence accident; it is crucial for the counselor

to stress to Bonnie that availing herself of violence is not an effective means in

fulfilling her expectations. Besides, her aggressive verbal confrontation and violence

behaviors may stem from her anger towards David, which is driven by her perception

of David would always neglect her needs and would never talk to her effectively.

However, the counselor can help foster empathy and understanding in Bonnie towards

David, recognizing that he may be grappling with feelings of diminished self-worth

and experiencing fear and anxiety about his healing process. As such, Bonnie could be

more willing to use a softer tone and avoid using a judging attitude when

communicating with David. The counselor can teach Bonnie practical coping

strategies tailored to her specific needs, including teaching communication skills,

conflict resolution techniques, and stress management strategies. For instance, role-

playing exercises, active listening exercises, and meditation techniques can be utilized

to enhance her coping skills. By practicing these strategies in real-life situations,

Bonnie can navigate challenges and conflicts more constructively, avoiding potential

violence events, leading to a healthier communication with David.

III. Discussion

It is important to note that there is never a flawless therapeutic approach. Counsellors

could only strive to use the most suitable approach for the clients to empower them

for better changes.

Satir’s Family Therapy may have its limitations in effectiveness when clients lack

motivation to change. If clients feel reluctant to explore their inner thoughts and
engage in the therapy sessions, the effectiveness of the therapy could be hampered

(Carlson & Sperry, 2000). However, Bonnie is motivated to change, considering the

prolonged conflicts with David and struggle with her overwhelming family role, she

took the initiative to seek help from counsellors. On the other hand, David’s inner

thoughts are discovered from the therapy session, even if he seems to be indifferent

about family issues and unwilling to take up more family role, he may still care a lot

about the family and willing to contribute at the bottom of his heart. Therefore, David

could be willing to change when he is aware of alternatives to contribute to the family

instead of being the breadwinner. On top of that, the couple undoubtedly share the

same goal – to protect their daughter and nurture her growth. Therefore, with the

given protective factors, Satir’s family therapy could promote positive changes in this

case scenario.

In addition, Satir’s Family Therapy has its edge of motivating changes in clients

instead of guiding changes in clients directly in Structural Therapy. This suits the case

scenario more as David has high ego and he might feel uneasy to be challenged and

being asked to change his thoughts and behaviors. In contrast, when he realizes his

inner thoughts and needs and provided with new insights proactively, he may be more

eager to pave his own way and decide to change his behavior to fulfill his needs.

However, there are limitations of solely applying Satir’s Family Therapy in this case.

Satir's approach focuses on individual empowerment, enhancing self-esteem, and

fostering effective communication and understanding within the family. While this

can be beneficial in helping Bonnie and David express their emotions and improve
their communication, it may not directly address David's post-traumatic stress

disorder (PTSD) or provide the necessary support for his recovery. Addressing

David's PTSD requires specialized knowledge and techniques that may be beyond the

scope of Satir's approach. PTSD can have a significant impact on an individual's

mental and emotional well-being, and it often requires specific interventions, such as

trauma-focused therapy or cognitive-behavioral therapy (CBT), to address the

symptoms and promote healing (Kliethermes et al., 2017). Referring David to a

counselor or therapist with expertise in trauma and PTSD would be important to

provide him with the appropriate treatment and support.

Additionally, a structural approach could be beneficial in this case scenario. A

structural approach focuses on the underlying patterns and dynamics within the family

system, including power imbalances, roles, and boundaries (Olson, 2000). In this

case, David's traditional patriarchal beliefs and expectations contribute to the conflicts

and imbalance of family roles. By addressing these structural issues, the counselor can

help Bonnie and David redefine their roles and responsibilities within the family,

promote equality, and establish healthier dynamics. However, due to word limit,

structural approach is not included in intervention.

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