vargas family case study: fifth session


Paradoxical directives are used when a therapist thinks that the family may resist a direct intervention. The therapist convinces the clients to keep their symptoms and slowly introduces directions that help to institute change (Goldenberg, Stanton, & Goldenberg, 2016). These directives commonly take on two forms prescriptive which is when the therapists ask the client to do something or descriptive which is when the therapists relabel a behavior that is already being done in a positive manner (Goldenberg et al., 2016). Using these directives asks clients to hold off on changing and intended to provoke defiance (Goldenberg et al., 2016). The purpose of directives is to get the family or the client to decide what they will not do after being told what to do to help the family abandon dysfunctional behavior (Goldenberg et al., 2016). When designing a paradox, a counselor should consider three steps. Redefining is the first step that is used to change the family’s understanding of the problematic symptom (Goldenberg et al., 2016). Prescription is the second step a counselor would need to consider, which is a directive that is concise, brief, and encourages the family to recoil the instruction (Goldenberg et al., 2016). The third step is restraining, are strategies that help the client understand that change will happen, but it is best to do it slowly (Goldenberg et al., 2016).

Reflexive questioning which are used for families to reflect on actions, beliefs, perceptions all the while constructing new ways of thinking and behaving (Goldenberg et al., 2016). These questions help the counselor to understand more in depth from what the client means, their concerns, but also gives them the chance to read their body language which helps them understand what they are not saying (Goldenberg et al., 2016). With this intervention strategy the counselor must consider what type of question to ask as there are many different types of reflective questions a counselor can ask in order to help the families reflect on their concerns and how they may change them. These questions in particular help families more past their current fixed beliefs or ideas and achieve new meaning as they readjust their behaviors (Goldenberg et al., 2016).


Goldenberg, I., Stanton, M., & Goldenberg, H. (2016). Family therapy: An overview (9th ed.). Boston, MA: Cengage.


The Vargas family arrives to their 5th session together and on time. As a follow-up to the last session’s focus on the family structure, you decide to consider a strategic approach this week. To check in, you invite them to share any feedback from last week’s session. Bob reports that he apologized to Elizabeth for “mishandling the suspension thing” then complains that Elizabeth is still “holding a grudge.” He admits that he often does not understand why she gets so upset and that he wants her to be happy. Elizabeth acknowledges that the apology “is a start” and suggests that the reason Bob doesn’t understand is that he “doesn’t ever listen” to her. Bob tells Elizabeth that he listens, but gets frustrated because he doesn’t know how to “fix it.”

You notice Frank and Heidi sitting together, quietly looking at a book while their parents talk. You inquire about any noticeable changes made during the week. Both parents claim to have made an effort to avoid raising his/her voice and report being pleased with their conduct. When asked about the children, Elizabeth reports noticing improvement. Bob, however, expresses frustration with Frank’s constant need of redirection and numerous reminders to complete his chores. Bob also noted an increase in Heidi’s demands for attention. 

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