Genogram

A working agreement “defines the type of relationship the parties have with each other…ensure everyone understands the roles each party plays, defining specific tasks as well as detailing realistic expectations and targets everybody can meet during the agreement,” (Byrne, 2012). The importance of a working agreement is more ethical than it is legal, but it remains a backbone of any effective intervention. According to Byrne (2012), “working agreements do not have specifically required elements, they do have many common features.” These features include the following four sections: assessment, prioritizing, contracting, and evaluation (Murphy & Dillon 2003). A working agreement should ideally also include statements of confidentiality, statements of informed consent, treatment goals, roles, expectations, and responsibilities of all parties. Intervention methods used to attain goals and their frequency, duration, length, and location of the meetings should also be discussed. Likewise the means of evaluation or measuring progress toward goal attainment, and how the working agreement can be renegotiated are important parts of the working agreement. The consequences of either party not upholding the agreement and how unforeseen complications will be handled are also discussed.

Client Background: Pamela is a 29-year-old female who is currently in a tumultuous relationship with her husband, who she describes as “controlling.” She works as a part time bookkeeper and lives in Colorado Springs with her children and her husband. One of her children is autistic.

Assessment: Client has a long history of family dysfunction and abuse. There is also a history of mental illness in the client’s family. She reports that her mother, uncle and older sister are all diagnosed with bipolar disorder. Moreover, Pamela’s husband has also been in jail. The relationship is at a critical point, as Pamela and her husband have been separated and are now trying to get back together.

Prioritizing: A primary goal of treatment is to mend the relationship between Pamela and her husband Carl. Therefore, the priorities of treatment include family therapy. The children should ideally be included in some of the family therapy sessions, as they are impacted by the relationship and any ongoing treatment. Regular family therapy with and without the children is strongly recommended.

However, Pamela and Carl need to attend individual psychological counseling sessions. Pamela has stated that she was happiest when her husband was in jail and she was dating other people. Therefore, she needs to be able to demonstrate greater commitment to the marriage in order to make therapy worthwhile. Carl has his own issues that need to be worked out in therapy. Carl’s childhood was tumultuous. His mother went to prison for drug-related charges and he lived with his aunt. Carl does not recall much about his father or any other male figure in his life. Individual therapy will have the goal of greater self-awareness on the part of both Carl and Pamela. Both parties should be committed to their personal growth and development, aside from their relationship.

Contracting: The working agreement must include statements of confidentiality and statements of informed consent. In addition to these written statements, the client(s) will also need to sign forms that detail their course of treatment and what it entails. For example, if it is determined that family therapy sessions will be attended once per week for six weeks, the clients need to agree with this.

Evaluation: Evaluation will be ongoing. The therapists involved in this client’s case should be tabulating results from both family and individual counseling sessions. Ongoing evaluations will include self-reports as well as observations made by the therapists.

References

Byrne, D. (2012). What is a working agreement? EHow Money. Retrieved online: http://www.ehow.com/facts_6967078_working-agreement_.html

Herman & Knuth, (1991). What does Research Say about Assessment. Retrieve on December 7, 2009 from: http://www.edtech.vt.edu/edtech/id/assess/assess.html

Murphy, B.C., & Dillon, C. (2003). Interviewing in action: Relationship, process, and change (2nd ed.). Pacific Grove, CA: Brooks/Cole Thomson Learning.

Office of Human Resource SC (n.d.). Prioritizing Goals. Retrieve on December 7, 2009 from: http://www.ohr.sc.gov/OHR/Online/prioritizinggoals.pdf