Cultural intersections and systems levels in counseling

A clinical case is presented in which a systemic approach to psychotherapy was used. This approach to clinical work is crucial in that the interactive pattern of social and institutional relationships is seen as the context for treatment. Systems theory allows the clinician to move away from a cultural way of thinking about clinical work focused on the individual, and instead views the individual in interaction with multiple systems as the focus for clinical intervention. This case study illustrates the nature of systemic work by demonstrating four levels of systems that have an impact on work with the patient: the individual level, the family systems level, the clinic system level, and the agency level. The case highlights how therapists in training might consider the context of larger systems that influence the environmental and psychological factors in their patients' lives.