Greg, 40, and Melanie, 38, come to therapy with their son Adrian, who is 13. Greg explains that Adrian has always been a little different. He describes his son as a reader and a dreamer who was uninterested in roughhousing with other boys as a child, but preferred to play with girls, building elaborate dollhouses out of cardboard boxes that they would turn into castles or spaceships or the settings for historic dramas. Adrian says, "I like to tell stories where lots of different things happen to the people: They fall in love, they have adventures, but sometimes they just hang out and make dinner or talk together as friends." He currently has two close friends, both girls. He says they like to get together and watch TV or look at magazines. "Sometimes we cook things. I make really good oatmeal cookies; Mom taught me!"

The family appears to be white and middle-class. You learn that Greg is a high school history teacher, and Melanie works in upper management for a health insurance company. Adrian is slender and does not show signs of entering puberty yet. He wears his hair long and is dressed in skinny jeans, red Converse high-tops, and a baggy red-and-yellow-striped hoodie. You learn that he normally does well in 8th grade but has been failing gym class this year because he refuses to change in the locker room. He says he is not sleeping well lately and is having a hard time concentrating in his morning classes, so his grades are slipping there as well.

When you meet with Greg and Melanie alone, Melanie in particular expresses concern about Adrian's development. She says, "It is time for him to stop being such a child and grow up a bit, make some friends with other boys. I have tried to get him interested in soccer or baseball, but he says he does not like sports, which is no excuse for this gym class thing, by the way. I have made play dates with some friends with boys his age and set them up with computer games and things, but it never seems to go well and he does not want to go back. He is not interested in scouting, even though he likes nature and science. He is just got to stop mooning around and join the real world!" Greg says to his wife, "Look, Melanie, why can't you just say what you are really worried about? You're afraid he is gay." Greg explains that he has a younger brother who came out in his early 20s, and although "It was a bit hard for the family at first," most family members eventually accepted him. "Melanie does not have anything like that in her family," Greg tells you. "Both our families are Christian, and we go to church with Adrian, but her parents were much more traditional than mine. I think she accepts gay people in theory, but it would be hard for her if it were her son." "Adrian is not gay," Melanie retorts with some anger. "He is just behind the other boys. When he starts to develop, he will be noticing girls like the rest of them, you will see. I just do not want him to get murdered in high school for being effeminate."

Meeting with Adrian alone, you ask him why he thinks his parents have suggested therapy. "Mom is freaking out because she thinks I am gay," he says matter-of-factly. "She always has, since I was little." He describes being punished by Melanie for playing dress-up with his female friends in elementary school, when he was playing the role of a princess being rescued from a castle by an ugly troll. "She said it was weird and I should play the troll instead. I told her no, and she sent my friends home and made me sit in my room all afternoon." He says he has "not drawn any conclusions yet" about his sexual orientation. "I'm just not interested in dating anyone, boys or girls or anyone else. Maybe I will be gay, or maybe I will be straight, or maybe I will be something no one has made up yet."

Discuss which Structural theory chosen for your case study, including how you made your choice out of the following:

• Bowen Family Systems.
• Structural Family Therapy.
• MRI Brief Therapy.
• Milan Systemic Therapy.
• Solution-Focused Brief Therapy.
• Narrative Therapy.
• Emotionally Focused Therapy.
• Contextual Family Therapy.
• Feminist Family Therapy.
• Address the following points using your chosen theory as a lens:
  • How would assess the clients in the case study?
  • Who would you meet with, and in what sequence?
  • What assessment methods, formal or informal, would you use to gather information?
  • Which areas would you consider most important to investigate?
  • What are the clinical issues that this case presents?
  • How would your chosen clinical approach describe these issues?
  • How would this clinical issue have been viewed in the past?
  • If the contemporary perspective is different, what has influenced the change?
  • What diversity issues are relevant to this case?
  • What aspects of diversity would you need to know more about to understand the context of these clients?
  • What ethical, legal, or crisis issues in this case would you need to attend to?
  • What issues raised by this case would require you to research the clinical literature to expand your knowledge or seek supervision to cope with areas of discomfort or bias?
  • What kind of supervision would you need to stay within your scope of competent practice?
• Evaluate the need for referral to community resources. What options for these resources exist in your community? Be specific.