Alisha (14 years old) was referred to a psychologist, for psychotherapeutic intervention, because of
concerning eating behaviour. Her mom, Tisha (45 years old) reported that she has found chocolate
bar wrappings hidden in Alisha's room, and has also noticed the remnants of vomit in the toilet
bowls. In the parent intake interview, Alisha's parents, Tisha and Clinton (53 years old) indicated that
Alisha was sexually abused by an unknown offender at the age of three. This was reported to the
SAPS, and an investigation ensued, however, the perpetrator was never identified. At the time,
Alisha refused to go to school, threw violent temper tantrums and had nightmares at night. Her
parents took her for play therapy with a counsellor, and the behavioural difficulties subsided. Alisha
was never informed about the abuse, and the parents decided not to tell anyone in the family. At
age 13 years old, Alisha developed social and performance anxiety, had very few friends and felt
awkward around others. She performed well academically, and was a competitive athlete and
dancer.
However, since beginning Grade 8 this year, Alisha has become more lethargic, and doesn't have
sufficient energy to compete competitively. Her academic marks have remained stable; however,
she no longer enjoys school. In her first few sessions with the psychologist, Alisha disclosed that she
struggles with her anxiety and is feeling down, and has begun binging on certain foods, and then
purging when she feels "stuffed". She is concerned about these behaviours, and said "I just want to
feel normal again, what is wrong with me". She also reported that she feels her parents favour her
younger brother, Dante (11 years old), and that he gets all the attention.
During the therapy sessions, it became clear that there appears to be some discord in the marital
relationship. Tisha is a hairdresser, and appears to be supportive of her daughter, however, Alisha
reports that her mother often criticises her, and has emotional outbursts when she feels stressed.
But that her mother supports her, and she struggles to make decisions without her mother's input.
Clinton, on the other hand, spends a great deal of time playing golf and drinking with friends, and
spends very little time with the family. In public, the parents present as cohesive and loving,
however, Alisha reports that her parents often argue, especially if Tisha is stressed, or when Clinton
is drunk.
Question 1:
Based on the case study above, draw a comprehensive ecomap of the family. Use the following
symbols in your ecomap.
1. Males indicated by a
2. Female indicated by a
3. Deceased indicated as
4. Ambivalence.
5. Distant relationship
6. Close relationship
7. Conflictual relationship M
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