Families have been considered a source of heritage for many people through history and in different cultural and geographical settings. However, different people have different definitions and expectations of the concept of family, based on their evaluation of their individual needs and the consequent levels of satisfaction. This paper will look into the fictional family of Fitzgerald's attempt to relate different pieces of evidence from the film, My Sister's Keeper, to the concepts on a family practice that are discussed in the narrative. Kilpatrick and Holland (2009) provide an overview of how needs can be categories and qualified within the family as a social construct. Working with Families: An Integrative Model by Level of Need provides mechanisms in which families can effectively receive interventions as a detailed discussion of the relation of families to systems. The book is a great resource for deconstructing family as a social system and how the family relates psychologically with the rest of the community.
There are different levels of needs in a family as described in Kilpatrick & Holland's (2009) Working with Families: An Integrative Model by Level of Need revealed in Chapter 1. I believe that “My Sister's Keeper,” reveals the intricacies of raising a modern family especially one that has a chronically ill child. The physical primary needs are met by Brian, who is employed as a fire fighter. Brian Fitzgerald, the father, and husband, single-handedly manages to provide the income the family needs for food, shelter, clothing, and healthcare. Even though Sara Fitzgerald, the mother, and wife, is a trained and former practicing lawyer, she opts out of being actively involved in providing income for her family. However, Brian feels like his only role is to provide for his family, without considering that he should be participating in meeting the rest of the family's needs; spending too much time at work is how Brian evades his other domestic responsibility. This, therefore, leaves Sara to handle the rest of the needs, which are: the provision of safety, discipline, affection, emotional support to the family. Sara handles this poorly, with a specific bias to Kate, their terminally sick daughter, at the expense of the rest of the two children. The dysfunctional family then grows apart, with each member bearing resentment from the conflict, all the while trying to create a peaceful environment for Kate. According to Kilpatrick & Holland (2009), the basic physical needs are crucial for the existence of any family, but they are not enough. I believe that the Fitzgerald family is stuck at level two needs, where primary physical needs and protection from attack and disease is met.
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Different levels of needs pose different issues to be resolved. Kilpatrick & Holland (2009) state that the second and third levels deal with an authority structure in a family; the importance of this is that the family, just like any system must have a well-defined decision-making agreement. This provides the needed safety and boundaries of the members. “My Sister's Keeper,” was adapted from the novel written by Jodi, the parental role of the Fitzgerald is singularly handled by Sara. The whole idea overwhelms her, after which she decides to put her focus and attention to nursing Kate in her condition. In reference to the system analogy, when the management and the entirety of the decision-making process of the system are centralized, then a system is liable to break down. In my intervention with the second level of need according to Chapter 1 is that open communication and feedback channels should be created followed by a well-balanced delegation and distribution of duties and decisions. Each member will therefore have to agree to a role. I would have the Fitzgeralds write down the responsibilities they have around the house, things they should be doing, and where each person needs help. This session would reveal which member is being overburdened by duties, and where to help.
The family must provide identity to its members as a third level need, and build self-esteem, as well as self-actualization, which makes up the fourth and the fifth levels of needs. Kilpatrick & Holland (2009) have mentioned that members should feel accepted loved, valued and be supported in finding and fulfilling their destinies. The Fitzgerald’s in My Sister's Keeper does not have this. Anna has been made to believe that her sole purpose in life is being the life support for her sister Kate. My intervention would focus on problems. I would request each member to write their dissatisfaction with the family. I would read each dissatisfaction and request for each member to briefly respond to every point. From this, we would collectively provide solutions to the issues affecting the family.
A family system is prone to face disintegration within members when their needs are not met; this is synonymous with any social system. As indicated by Kilpatrick & Holland (2009) systems have wholeness, each part or section within the system has to be in full functioning condition in order for the system to be effective. The Fitzgerald’s in My Sister's Keeper is facing a crisis; Anna feels that she has been objectified by her parents for the sake of Kate her sister, while Brian is completely overlooked. Brian and Sara, decide to have a genetically modified child who fits into the profile of a donor for the leukemia condition that Kate, the second child, as well as the first daughter, had been diagnosed with. This disregard for Anna as a human being is exemplified during her birth when Sara refers to her as a thing, a mere object, her creation that serves the purpose of saving the life of Kate. Anna and her elder brother Jesse feel that they do not get the attention, affection, moral and emotional support from their parents, and more so their mom who is practically present in their life. There vivid consequences as a result of unmet needs in the film, My Sister's Keeper are: Jesse becomes dyslexic while Anna, a teenager, attempts to sue her parents in an effort to be granted medical emancipation.
Families as systems have interpersonal interactions that eventually define the environment and the development of consequential responses. According to Kilpatrick & Holland (2009), the members of an ecological system react to the changes in the environment and also after the interaction, either positively or negatively. In My Sister's Keeper, the environment that the parents either consciously or subconsciously create is the centralization of the family's operation; everything revolved around Kate and her illness. Brian avoids the house as he engages more time in his work, trying to justify his absence with the fact that he is the sole provider; the more time he spends at work, the more money he earns to cater for his family. Sara quits her job claiming that Kate needs her attention. Jesse develops a dyslexic disorder, while Anna moves to court to challenge her parents from taking away one of her kidneys to help Kate. Each member of the family is therefore left with the realization that nobody was consciously involved in ensuring that the family operated as a functional unit.
In selecting an intervention for family crises, Kilpatrick & Holland (2009) have theorized a few guidelines. The selected theory and situational analysis must first consider the basic physical needs. It is pointless to address other levels of need when the critical survival needs are left unmet. Secondly, the intervention must have a correctional concept, such that there is an eventual change in behavior and interpersonal family interactions. After the family members have expressively defined their points of conflict, the intervention must be able to create a different experience and encourage commitment, as a correctional measure.
I would suggest a couple interventions. The first is Solution-Focused Family Interventions by Jeffrey J. Koob as provided in Chapter 9 (Kilpatrick & Holland, 2009). This intervention focuses on the family to look and invent solutions from within and between themselves; agreeing to the developments and committing to the changes. Using this intervention, I will talk to the Fitzgerald household in one meeting. I will then ask each individual to define his or her perception of the crisis and a fictionalized concept of their ideal family situation. Jeffrey J. Koob introduces this as the concept of a miracle question. As with the Fitzgerald’s, this would bring everyone on board with the solution, provided all members are present during the sessions. Lastly, I would allow them to prescribe how the ideal family concept can be achieved without bashing at an individual person, and using positive statements rather than negative ones.
The second intervention I would consider applying to the Fitzgeralds situation is in Chapter 9 which is Nancy R. Williams’s Narrative Family Interventions (Kilpatrick & Holland, 2009). This intervention aims at changing how narratives define the family by basing on positive stories instead of the bad ones. I would summon the whole family to one meeting, and take a solemn commitment that everyone would sit through the session even if it was unconformable and that one should only speak when it is their turn to speak. After which I would ask each member to take turns in telling incidences where he or she felt undermined, or any negative story that had affected them. I would repeat the same narration session but with the family responding by each giving happy stories. This session will be in response to therapeutic questions. The narratives will determine who among the family is most blamed for bad experiences, and who is most responsible for the good ones. I would call the people who have ranked highly, and explain to them the consequences of their actions. I would, therefore, try to get commitment towards a more positive outcome
Families are unique in number, structure, economic and cultural settings both as single units and collective identities. The professionals and social workers that deal with families and their subsequent care must be able to appreciate the diversity and the differentiation. However, studies reveal that families can be defined as intricate and elaborate systems, with structural needs and functionalities. As with systems, families can be analyzed and corrective measures may be prescribed as well as positive practice can be derived from others.
Reference
Kilpatrick, A., & Holland, P., (2009). Working With Families: An Integrative model by Level of Need. Pearson.
