Jack’s formulation, a systemic approach

Using one of the examples provided, clearly summarise the service user’s experience of distress

Jack has had many experiences of distress including periods of mania and low mood. When Jack was young two of the male figures in his life were violent towards him, this might have caused Jack to feel lost and frightened. He had feelings of self-loathing caused by his father, perhaps, making him turn to alcohol and failing his GCSEs. It did not help that at this time, his parents had a divorce and his dad left, which could have led to Jack feeling confused and uncertain about his place in the family and in society. This may have made him feel alone with no one to talk to which could have caused his paranoia and delusions.

Provide a plausible explanation of the development and maintenance of the service user’s difficulties, and how they may relate to one another; drawing on psychological theory and principles and details provided in example

There are many factors in Jack’s life which have contributed to his difficulties. The difficulties are mainly due to his father, as when Jack was younger he was an alcoholic and violent, the difficulties then developed because of his father leaving and divorcing his mother and then seeing his father’s reflection in the mirror which brings back the emotions he had when he was younger. The effect on the family of the father leaving was distressing for Jack, his mother and sisters. Perhaps for Jack, this was more distressing, as he may have seen himself as the father figure after his dad left and the fact, they lost their house and lost contact with the Italian community he could have blamed it on himself. As it has been set from when he was younger, that his family had strong expectations of him, as the only son, being successful. Jack experiences confusion and feels lost in relation to his father leaving after everything he has done which perhaps causes Jack to portray the qualities of his father onto another male figure he looked up to, Robbie Williams, saying he stole from him (like his dad taking away the family’s comforts and happiness) and that he raped one of his sisters (like his dad’s violence towards the family).

The family display beliefs about the man being the ‘breadwinner’, as the dad had a successful business and Jack was going to continue this success, so Jack feels Robbie Williams stole his success (his talent for music). The difficulties are interpersonal within the family, mainly affecting himself and his mother because of their relationship to the father, due to Jack being the only son and the mother being divorced by the father which clearly affects her emotionally. The relationships in the family are affected by the difficulties Jack had. Jack’s relationship with his father is affected as he has mixed feeling of love and hate towards his father. His relationship with his mother is affected because of the downward spiral caused from the loss of his father and from the pressure Jack felt to hold the family together as the only male figure. The relationships also affect the difficulties, as his dad leaves the family and the mother kicks Jack out the house. His mother and sisters may have felt Jack was behaving similar to the father and became frightened so admitted him to hospital.

Effectively outline the benefits and limitations of diagnosis- for explaining the service user’s difficulties and devising an intervention

Benefits

  • Jack having someone to talk to about his feelings will be good for him as he felt unable to confide in his family and talking about his thoughts may help the therapist understand the delusions
  • Having a diagnosis may help Jack come to terms with his delusions as he may be able to understand why he has these thoughts and he will be able to get help from services
  • Jack being diagnosed may help him not feel alone, as other people experience similar thoughts and feelings

Limitations

  • Jack knowing about the diagnosis may make it worse as it could make him blame himself more and make him feel less masculine and successful
  • Jack may find it hard to confide in people and trust them since his father left him and his mother kicked him out during the hard times in his life

Briefly outline an intervention plan clearly related to the service user’s experience of distress and your explanation of the development and maintenance of the service user’s difficulties

A possible intervention for Jack would be family therapy, in order to help resolve family issues with his mother and sisters, so Jack no longer feels alone. This would help Jack to express his thoughts and feelings about his experiences to his family and hear their experiences, so they can understand each other’s difficulties. During the family therapy, the family could design a genogram to display the family relationships over generations and their medical history. It can help the family pick out patterns of behaviour that are destructive and help the family understand how relationships are viewed from different members of the family.

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One thought on “Jack’s formulation, a systemic approach

  1. This is on the right lines, well done!
    Some thoughts to help:
    In section one, be careful to separate out the current signs of distress and the reasons Jack may have become distressed, which belong in section two.
    Name the theoretical approach you are taking in section two and make sure your points link to this approach, using appropriate references.
    Nice benefits and limitations, but don’t put these in bullet points for your final essay.
    Weaving more references throughout the formulation would strengthen it.

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