Session 1

Bob and Elizabeth Vargas have been married for 10 years. Theyhave two children, Frank (8) and Heidi (6). Bob teaches high schoolPE and coaches football, wrestling, and baseball. Elizabethrecently quit her job where she was an attorney in a law firm thatspecializes in Family Law. She enjoyed her work, had a passion foradoption cases, but decided to stay home for a few years while thekids were young. Elizabeth believes that Frank might have ADHD. Shecomplains that he cannot sit still, does not listen, is forgetful,and is always getting hurt. She believes that much of theseinjuries are due to Frank’s impulsivity. Elizabeth suggests youtalk to Frank’s teachers who have noticed that he has troublewaiting his turn, will often blurt out answers without raising hishand, and frequently loses things. Elizabeth acknowledges thatFrank has always been an active child, but believes thesebehaviors, including picking on his little sister, are gettingworse. Bob seems to be amused by these anecdotes and accusesElizabeth of “overreacting,” stating that, “Boys will be boys.” Bobsuggests you talk to his parents, both retired teachers, who agreewith him and don’t think there’s anything wrong with Frankie. Younotice Heidi sitting close to Elizabeth, playing on her mother’scell phone. She glances up occasionally when her brother approachesbut is otherwise engrossed with the game. Frankie began the meetingsitting between his parents but noticed Legos in the corner and wasimmediately attracted to them. He interrupts several times to sharestories about his teacher, classmates, and his grandparents,despite numerous reprimands from his mother. After a few minutes,Frank asks to use his dad’s phone (in a hurry, Bob had left it inthe car), wanders around the office, looks out the window andcomments on a squirrel, then grabs the phone from his sister who,of course, protests. After Elizabeth had quieted the commotion, youquestion any recent changes. Bob and Elizabeth both acknowledge anincrease in marital tension and admit to having several arguments aweek, some in front of the children. Bob blames Elizabeth for being“too high-strung” and says she just needs to relax. Elizabeth saysshe is unable to relax, fearing Frankie will end up damaging thingsor hurting himself or Heidi. She says that if Frankie would be ableto control his behaviors, their marriage would improvedramatically. This, they report, is the reason for seeking therapyfor Frankie.

Session 2

Elizabeth arrives on time with Frank and Heidi for the secondsession. Elizabeth appears somewhat frazzled and tells you that shehad just heard from Bob who said he would be “a little late”because he “lost track of time.” You note Elizabeth’s frustration,which she confirms by saying this is “typical.” She proceeds toshare that she feels “completely disregarded,” especially afterhaving shared with Bob the night before how important thesesessions are to her. You notice that Heidi seems upset as well andlooks as if she has been crying. You ask her how her day is goingand she tearfully tells you that Frankie tore up her school paperwith the gold star on it. Elizabeth elaborates that Frank hadbecome angry and ripped up the picture that Heidi was proudlysharing with her. Frank, who had gone directly to the Legos,appears oblivious to the others in the room. When you ask him abouthis sister’s sadness, he replies, “Who cares? She always gets goldstars!”

As you were about to further explore these feelings, Bob arrivesstating, “She probably told you I’m always late, but hey, at leastI’m consistent.” You notice Elizabeth’s eye rolling and direct yourattention to the children, asking them about what brought them toyour office. Heidi says, “I’m good but Frankie’s bad at school, andit makes Mommy and Daddy fight.” Frank, who had helped himself toone of your books to use as a car ramp argues, “I hate school. It’sboring and my teacher is mean.” Bob attributes Frank’s boredom tobeing “too smart for the second grade…what do they expect?”Elizabeth responds that they, like her, expect him to follow rulesand be respectful, and suggests that Bob should share those sameexpectations. Bob dismisses Elizabeth’s concerns by saying, “He’s anormal boy, not like all your friends from work who you say are‘creative.’”

You notice Elizabeth’s reaction and decide to redirect yourattention to Frank. You ask him what bothers him most about school,to which he replies, “I get in trouble, then I don’t get to haveall the recess time, then I can’t play soccer because they alreadystarted and they won’t let me play.” You notice Frank’s interest insports and probe for more information. You learn that he is quiteathletic and has been asked to join a competitive youth soccer teamthat plays on Saturdays and Sundays. You discover another source ofdiscord when Elizabeth shares that Bob “feels strongly” thatSundays are to be spent only at church and with family. Bobconfirms that after church on Sundays, they spend the rest of theday with his parents, siblings, nieces, and nephews. Elizabeth saysthat Sunday mornings are the only time she gets to be by herselfand that she typically joins the family around 1:00 p.m. Bob adds,“Apparently Liz needs time to herself more than she needs God andher family,” and suggests she should appreciate his family morebecause “it’s the only family she has.”

As the session comes to a close, you share your observations ofthe family by noting their common goal of wanting to enjoy familytime together. You also suggest that while Frank’s behaviorchallenges are troubling, perhaps you could focus next week onlearning more about each parent’s family of origin in hopes ofgaining a better understanding of the couple’s relationship.

1.What are two current presenting problems for the Vargasfamily?

1a. How are the presenting problems maintained according to thenarrative therapy perspective?