Carla And Tomàs: A Case Study

Carla and Tomàs, have come to therapy seeking assistance with their current relationship. Carla states distress around her identity, “When we are out in public, we are read as a straight couple. It feels so weird to me -- my feelings for Tom haven’t changed, but I feel like I have lost a part of my identity”. While, Tomás presents with two conflicting positions. During his hormone therapy, he reports feeling really good and solid within himself, however, his response to Carla indicates feelings of guilt for causing unnecessary hardship.
Therapy
My first step, in working with this couple, was to establish how the session would look. I outlined to both Carla and Tomás, that we would be talking about them; what they want and their current situation, for about 40 minutes. After that, I would take a brief break to consult with my supervisor and then return with some feedback or suggestions. In doing this I was setting the stage for goal-oriented work. From this point on, as Walter and Peller (1992) outline, my
In establishing what Carla and Tomás are already doing that works we can start to build a solution. Depending on the particular couple's needs you may want to do more exploration in terms of what the client’s desired outcomes are before looking for exceptions where they are currently occurring. To do this, an alternative would be another solution-focused intervention called the miracle question. The miracle question works from a hypothetical frame to help identify what the clients would want to work towards. However, it is important to follow the specific solution focused format when conducting this intervention. With both interventions, though, we are following the assumption that change is constantly occurring and can be constructed within our therapeutic conversation. For a visual understanding of how to construct solutions, refer to Walter & Peller (1992), page 64, figure