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Treatment Phase

Session 1


The first session involved building a working relationship with the members of the Flores family and engaging them in a series of art tasks to help them begin to express themselves.

Method: Combining Strategic Family Therapy With Art

Both Mrs. Mesa and Sister Benedict were worried about the Flores family's covert no-talk rule. A no-talk rule was the Flores family's particular operationalization of the Latino values of respeto (i.e., respect), simpatia (i.e., likeability), and jeraquismo (i.e., hierarchical social structure; Evans et al., 2007).

Sister Benedict designed a series of five tasks to help the family members begin to express themselves:

• "Make an individual free drawing of anything that comes to mind."

• "Make an individual drawing of why you think you are here."

• "Make an individual drawing on how you would like the 'problem' to change."

• "Now together, make a joint mural about your family"

• "At this time we will review the drawings you have made."

She often used this series of tasks with families like Maria's that maintained structure by covert communication norms. The use of such tasks allows a family therapist to do the following without running directly counter to respeto, simpatia, and jeraquismo:

Elicit metaphorical information for planning future intervention.

• Provide drawing tasks that disrupt dysfunctional family communication patterns (e.g., a family's covert no-talk rule).

• Help family members express themselves free of covert familial communication norms. (Adapted from Sobol, 1982)

Given the tension present in the family system, each member of the Flores family welcomed Sister Benedict's initial suggestion that they start out by working on their own drawing. The therapists had a wide array of drawing materials available for the family members to use, including oil and chalk pastels and felt marker pens.

Free Drawing Art Task

Maria's free drawing was a weeping, pregnant image of the Virgin. In high school, Maria and Bonita were members of their parish's Legion of Mary. They enjoyed belonging to this group because of a strong devotion to Our Lady rooted in Latino cultures (i.e., marianismo).

After 20 minutes, Mrs. Mesa had the family members stop their drawings and share them with the whole family. Maria showed her drawing of the Virgin. The family was moved to tears by Maria's expressive representation of the Virgin. Without words, they surrounded Maria. Bonita even took Maria by the hand. Sister Benedict read these nonverbal behaviors as a sign that the family had moved to some new level of communication, a new level that contained acknowledgment of, and empathy for, Maria's suffering. To concretize this new connection to Maria, Sister Benedict directed the other family members to add to Maria's drawing through the production of a joint mural.

Family Mural Art Task

After the mural was completed, Mrs. Mesa asked each family member to discuss the feelings the mural evoked about the family. At this point, Britney asked her mom why her drawing of Our Lady was weeping. Maria hesitated, and then began to sob quietly. The final art process put the entire family together to create a family mural on one piece of paper. Through the art task sequence, the family was moved from a distant to a closer physical proximity. At the end of the family art process, the therapists reviewed all of the drawings with the family.

When Rosa asked Maria why she drew a weeping Virgin Mary, Maria replied that the Virgin weeps for Maria because the Virgin understands the sorrow of pregnant, unmarried women. Then Maria walked over and knelt in front of her mother and began to weep uncontrollably herself. Rosa looked at her and softly said, "This is why you married Mark and left the family." Maria nodded yes, and Rosa kissed her on the forehead in reconciliation.

Sessions 2-5


The next four sessions involved rebuilding family connectedness and "trying on" new styles of communication.


Again, Sister Benedict used art tasks to facilitate culturally salient modes of communication. Despite this work, Maria's full reentry to her familial life remained blocked by her belief that, as a divorced woman, she could not participate in the sacramental life of her parish. This left Maria feeling marginalized in the Flores family. Sister Benedict corrected Maria's mistaken notion that divorced persons could not receive communion. She also set up an appointment for Maria with a member of her own religious order who does marriage tribunal work. This sister would help Maria to receive a marriage annulment so that she would become free to remarry in the Church.

During one of these middle sessions, the art tasks served as a potent stimulus for self- discovery. Maria's chalk pastel drawing recounted her strong devotion to the Blessed Sacrament during her high school years. Maria shared how this devotion had helped her weather the typical turmoil of adolescence. Mrs. Mesa helped Maria negotiate with her parents to babysit Britney and Mark Jr. three times a week so she could spend an hour meditating in the Perpetual Adoration Chapel at St. Gregory's. Later, Maria reported to Mrs. Mesa that these hours were meaningful to her and gave her a sense of peace she had not felt in a long time.

Session 6: Termination

As Maria began to reenter full family and parish life, her dysthymia lifted and she began to have more energy for her work and her children. By the final session of family therapy, Maria reported that neither Britney nor Mark Jr. was having any disciplinary problems in school. Also, Maria's increased energy had begun to help her build a productive relationship with her in-laws, Rob and Susan Jones. Mrs. Mesa and Sister Benedict worked with Maria to help her outline the boundaries she wanted to set in her relationship with the Joneses.

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