When we meet with the family, we require a framework for analyzing and assessing the relationship, interaction, and patterns that operate within its structure. We must also evaluate whether the overall family is functional or dysfunctional. In the case of Mrs. R, the determination is that the family is dysfunctional.
1. The client, Mrs. R, is a patient in a mental hospital, where she is diagnosed as a chronic schizophrenic, undifferentiated type. Earlier, Mrs. R. and her husband Mr. R. had appeared before family court on charges of child neglect. Mrs. R's bizarre, delusional responses to questions from the court led to the recommendation of hospitalization. The charges of child neglect were based on the finding that Mrs. R., the mother of ten children ranging in age from two years to 14 years, could not feed, change, or train her youngest children nor could she touch or acknowledge any of her offspring. Mrs. R. is essentially nonverbal; her voice has a strained unnatural sound. She distrusts people and is aloof and withdrawn. Prior to hospitalization, Mrs. R. earned a small income from steady night work.
Mr. R. fails to function adequately as a father the family system. He had withdrawn from his wife verbally and emotionally, and generally spent much of his time away from the home. Mr. R. had deserted his family four years earlier, but returned home under court order, rather than face a jail sentence. Upon his return, Mr. R. did nothing to maintain the marital or family relationship, nor did he assist with physical care of the children. Essentially, Mr. R. blamed his behavior on Mrs. R., who refused to prepare her husband's meals and refused sexual relations with him, fearing pregnancy. (She used a contraceptive preparation which had been ineffective.) Although Mr. R. is employed, the family receives the maximum AFDC grant, and lives in a deteriorated old building in a ghetto neighborhood. The family manages poo...