Dana is a young and beautiful woman with family members that seem to constantly put her down whenever they get together. They appear to be self-centered and attention seeking. The mother has set expectations she places on her family and seems angry whenever they do not meet those expectations. For example, the mother suggested Dana get breast enlargement surgery to appease her boyfriend Matt. Her sister, Joanie also commented on Dana's appearance, making sure to let Dana know she appeared overweight or had a large rear end. These comments can and do affect people's self-esteem especially when the source of such comments are from people that person loves or is supposed to trust.
Dana takes everything and says nothing, agreeing with the remarks and feeling like she truly is overweight even if objectively people see her as very attractive. She also cannot say how she feels even around her boyfriend. Matt for example, wished to engage in coitus with her and she did not want to. However, she did engage in coitus and then later proceeded to binge and purge. Dana appears to lack assertion in her actions and acts in a submissive, complacent manner.
Dana does not communicate her feelings, her desires, and that results in loss of self-esteem, self-worth, and potential body image issues. She needs to communicate with her mother, her sister, and her boyfriend how she feels when they comment on her appearance or ask her to do something she does not want to do. She must voice her concerns in a way that shows her expectations but does not result in unnecessary conflict. Dana appears to not handle stress well from not being able to graduate from college and binging and purging every day. Therefore, cognitive behavioral family therapy may be the best option as it involves addressing specific issues in a shorter time frame and allows the therapist to direct the behaviors. While it can come with many issues, cognitive behavioral family therapy may help address long standing family problems in a creative, imaginative way (Poulsen et al., 2014).
The reason why the mother and sister must be present and not the father and brother is because they do not contribute to the problems as much as Joanie and Dana's mother do. The brother is in Peace Corps and the father takes a suggestively submissive role besides the mother. The main problems in communication appear to come directly from Dana's interactions with her sister and mother. Here the relationships must be analyzed to see why Joanie makes such negative remarks of Dana and why the mother is always making remarks on Dana to improve her appearance.
While there are other models useful in such a case as Dana's cognitive behavioral family therapy seems the most useful due to the family dynamic and the lack of communication among the family members, especially towards Dana. Nevertheless, solution-focused therapy and narrative therapy have their uses. For example, narrative therapy helps the patient identify skills, value, and the knowledge to live these values so that person can successfully confront whatever problems...
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