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Tuesday, December 9, 2008

Marriage Counseling Case

Margaret and Jonathan have been seeing you in couples counseling for 5 months. One of the issues that they have been in sharp disagreement about is Jonathan's mother, Ellen, who has lived with them for 2 years. Margaret has assumed more of the care over the past year, because Jonathan's job requires that he travel each week. There are two teenage children in the home—one is a senior in high school and the other is in the tenth grade.
Margaret and her mother-in-law get along well enough, but the original agreement when Ellen moved in was that she would only stay for 1 month until she found a place of her own. Since that time, Ellen fell, broke her hip, and became very depressed. In the last session with Margaret and Jonathan, Margaret informed her husband that unless Ellen moved out, she would file for divorce. This was stated in the last 5 minutes of the session, right before she stormed out of the room. As you review your notes, you begin to plan how to conduct the next counseling session, which both agree to attend.
Answer the following questions:
What are the key issues you will address?
What strategies will you use to acknowledge each partner's struggle with Ellen?
What do you hypothesize is Ellen's role in this couple's dilemma?
What is the effect of this family's struggle on each adult and the children?

My Answer:
First of all before this counselor take the responsibility of becoming a marriage counselor must seek advice on someone who has a level of expertise on marriage and divorce.

Mental health counselors who offer couple and family counseling are obliged to deliver only those services they can provide competently. The American Counseling Association (ACA), one of its divisions, the International Association of Marriage and Family Counseling (IAMFC), and the Council for Accreditation of Counseling and Related Education Programs (CACREP) view couple and family counseling as a specialty area within the profession of counseling. Counselors providing couple and family services are expected to have professional counseling competence as a foundation for couple and family counseling competence (Welfel, 2001).

Otherwise, playing the role of a marriage counselor, both must agree during the initial session to get the counseling and accept the fact that two individuals are in crises, solution must take place and Divorce is not the only solution. The issue is how both Margaret and Jonathan can come out with a solution without compromising their marriage and their relationship with Ellen both as mother, mother-in-law and grandmother to their children.

Ellen’s unexpected health condition became a burden to the family and it is expected that now that both have to suddenly have to take care of three people. It is unexpected that this sudden responsibility will create conflict to the marriage of Margaret and Jonathan including their children. Divorce is not the solution.

Another major issue that should be address is Ellen’s depression. Both have to accept the fact that depression is not normal and must be look upon by family members. Being the mother of Jonathan, they will be both responsible for her well-being.

According to the Epidemiologic Catchment Area Study (ECAS) sponsored by the National Institute of Mental Health (U.S.) in the 1980s, depressive symptoms occur in approximately 15 percent of people over sixty-five years of age. At least 3 percent of elderly people suffer serious depression, especially those who reside in nursing homes, where the rate of depression approaches 15 to 25 percent (Ainstworth, 2000)

Although Ellen is the responsibility of Jonathan (assuming he have no other siblings and father), his next alternative is to find a nursing or adult-care residence that will accommodate Ellen for the time being. During this process, Ellen must know that this is a “trial” basis while her son and daughter-in-law mend their issues and possibility of divorce. Like most changes, this may be unacceptable at first to Ellen and may even aggravate her depression.

Late-life depressions may involve withdrawal from previous social, hobby-related, and recreational pursuits because the elder has lost interest or does not have the energy. Self-neglect may result in the depressed older person putting less emphasis on personal appearance and hygiene, as well as loss of interest in cooking and eating, with subsequent weight loss (Ainsworth, 2000).
If Ellen is eligible for Medicare, she may draw the additional expense there for accommodation of her new home and maybe for 1 or 2 years, she may return to move back to Jonathan / Margaret

This solution is not perfect but it will save a much vital issue: Divorce - which may possibly cause depression for Jonathan, Margaret and the 2 children. The couple and Ellen has to make a hard choice: another environment and additional expense for Ellen versus the damage of Divorce.

References:

Ainsworth, P. 2000. Understanding Depression: Understanding Health and Sickness Series, Publication: Jackson, Miss. University Press of Mississippi.

Welfel, E. R. and Ingersoll, R. E., 2001. The Mental Health Desk. New York John Wiley & Sons, Inc. (US)

Last edited on: November 18, 2008 11:31 PM
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