family structure and function tools in family assessment Flashcards
A systematic way of understanding the family and to aid them in evaluating the impact of illness on a person and on his/her role in the family.
Family assessment tools
Family map is developed by __________, a psychiatrist - family therapist.
Salvador Minuchin
Facilitates the communication of information’s about a family system to colleagues so that they can be understood
Family map
Reflect family relationships and interaction patterns
Family map
Tool for obtaining a therapeutic ally for the delivery of care in the family
Family map
Provides schematic description on whom to ask for assistance in making decisions for the patient
Family map
Possible source of somatic complaint may also be identified
Family map
Author of Family APGAR
Gabriel Smilkstein
The purpose is to assess general family function
Family APGAR
The capability of the family to UTILIZE and SHARE inherent resources
Adaptation
Measures the satisfaction attained in solving problems by communication
Partnership
Refers to the freedom of change both physical and emotional growth
Growth
It is the intimacy and emotional interaction in the family
Affection
The member’s satisfaction with the commitment made by other members of the family
Resolve
APGAR scoring: 2
Almost always
APGAR scoring: 1
Some of the time
APGAR scoring: 0
Hardly ever
APGAR scoring: Highly functional
8-10
APGAR scoring: Moderately dysfunctional
4-7
APGAR scoring: Severely dysfunctional
0-3
What is SCREEM?
Social Cultural Religious Economic Educational Medical
Very important in the assessment of the family as to its capacity to participate in the provision of health care or to cope with crisis
SCREEM
Commonly used when the need for care is long or lasts a lifetime
SCREEM
Assess the resource of difficult and non-compliant patients
SCREEM
SCREEM family resources survey is developed by ____________.
M. Medina, Jr.
The goal is to develop a valid and reliable Filipino measure of family resources.
SCREEM family resource survey
Assesses the family’s capacity to participate in the provision of health care or to cope with crisis.
SCREEM family resource survey
SCREEM RES: 0-6
Severely inadequately family resources
SCREEM RES: 7-12
Moderately inadequate family resources
SCREEM RES: 13-18
Adequate family resources
Provides a predictable and chronological sequence of events in the family’s life, which can be related to clinical events and to the health maintenance of family members
Family life cycle
Description of the family dynamics through clearly defined stages of development.
Family life cycle
One has to explore whether family members seldom act INDEPENDENTLY or get OVERINVOLVED with each other.
Enmeshment
This is symbolized by three parallel lines.
Enmeshment
One has to explore whether family members are isolated from each other or have little emotional response from each other.
Disengagement
This is symbolized by dotted lines.
Disengagement
One has to explore whether the family members talk directly to each other about personal matters.
Triangulation
This is symbolized by an open-ended arrow with its open end embracing two individuals and the pointed end pointing to a third person.
Triangulation
One has to explore whether one member of the family is siding with one member.
Coalition
This is symbolized by a bracket.
Coalition
The behavioral skeleton around which family life is built.
Family structure
A family who is not open to negotiation in spite of the fact that circumstances render the old boundaries no longer appropriate is considered _______.
Rigid
It exist if couple spend little time together, have separate bedrooms or completely separate lives.
Rigid boundaries
Create dysfunctional families when members fail to adjust during phase transitions.
Rigid boundaries
Rigid boundaries may lead to ____________.
Disengagement
Establishing personal independence
Unattached adult (Leaving home)
Establishing an intimate relationship with spouse
Newly married couple
Dividing the various marital roles in an equitable way
Learning to live together
Opening the family to include a new member
Family with young children
Increasing the flexibility of the family boundaries to allow the adolescent to move in and out of the family system.
Family with adolescent
Accepting the multitude of exits from and entries into the family system
Launching Family
Adjusting to the ending of the wage-earning rates.
Retirement
Dealing with lessening abilities and greater dependence on others
Old age
Beginning emotional separation from parents
Leaving home
Developing further the EMOTIONAL SEPARATION from parents
Newly married couple
Establishing a new, more independent relationship with family
Learning to live together
Dividing the PARENTING ROLES
Family with young children
Adjusting to the ending of parenting roles
Launching family
Minimal emphasis on the family in the delivery of health care.
Level I
Ongoing medical information and advice. WORKS COLLABORATIVELY with patientd and families, and understands the triangular nature of the patient-doctor-family relationship.
Level II
Feelings and support. The physician understands normal family development and how families react to stress.
Level III
Assessment of family dysfunction and provision of intervention. It is the most common involvement among patients who are alcohol or drug abusers.
Level IV
Family therapy
Level V
The traditional type of family.
Nuclear family
Was long considered by most societies as being the ideal way of raising children
Nuclear family
Children find stability and strength and usually have a lot more opportunities because of the financial ease of both parents
Nuclear family
Couples who either choose not or cannot conceive children
Childless family
Often considered as the “forgotten family” as it doesn’t really meet the traditional rules set by most societies
Childless family
Includes a wife, a husband working and living together
Childless family
Most of these families choose to own a pet or keep contact with their nephews or nieces as a substitute
Childless family
Represents the biggest change in a society if we are to speak about family structures
Single-parent family
Usually close and are always looking for ways of solving their issues together, like dividing up the chores around the house.
Single-parent family
Just as about as frequent as nuclear family, although they have a tendency of having more issues, like discipline problems or adjustments periods
Step-family
Includes 2 or more adults who have some sort of relation, either by marriage or blood.
Extended family
Grouping of individuals which are formed for specific ideological or societal purposes
Communal family
Considered as an alternative lifestyle for people who feel alienated from the predominantly economically oriented society
Communal family
Classification based on descent:
Patrilineal, Matrilineal
Classification based on residence
Neolocal, matrilocal, patrilocal
Classification based on authority
Equalitiarian, matriarchal, patriarchal
Classification based on naming
Patronymic, matronymic
Classification according to relationship
Conjugal, unmarried
Classification according to set-up
Democratic, authoritarian
Classification according to social class
Lower, middle or upper class
Member gives some priority to the needs of the group over his own needs.
Functional Family Relationship
Recurrent patterns of behavior by which individuals fulfill family functions and needs
Family roles
Concerned with the provision of physical resources (food, shelter and clothing), decision making and family management
Instrumental role
To provide emotional support and encouragement to family members
Affective role
Assignment of responsibilities within a family that enables the family to function properly
Role Allocation
Make decisions on who will be responsible for completing a certain task for fulfilling a particularly responsibility
Role Allocation
Refer to a family members sense of responsibility for completing the tasks of an assigned role
Family accountability
Parents in healthy families understand that they are responsible for disciplining their children.
Family accountability
5 Essential Roles For Effective Family Functioning:
- Provision of resoures
- Nurturance and support
- Life skills development
- Maintenance and Management of the Family system
- Sexual Gratification of Marital Partners
Created for the purpose of defending against others
Permanent alliance
Seriously disrupt a family’s functional adaptive capacity
Permanent Alliance
Disruptive and distorts the normal balance of family relationship
Permanent Alliance
Has distorted thinking and believes that they are basically responsible for the other person’s dysfunction
The Enabler
Tends to blame others, makes strong peer alliances, and is often disciplined by teachers or other adults for breaking rules.
The Scapegoat
Always, volunteering, very responsible and manifests a drive, almost a compulsion, to be on top.
The Hero
Often gets lost in the shuffle
The Lost Child
Tends to be funny or distracting and gets attention frequently. This student likes to hide, make faces, pull the chair from someone else, otherwise act out.
The mascot
Assigning of blame to a person or things for fault of others
Scapegoating
Object is to draw off tension that cannot be resolved in the usual manner and assign it to another
Scapegoating
Frequently occurs in a strict authoritarian family
Scapegoating
One in which the wife is dependent and infantile and in which the husband’s self esteem and fragile maturity depend on keeping her that way
Doll’s house family
The husband’s ego strength and borderline maturity rely upon the continuation of this relationship
Doll’s house family
The spouses are not merely unhappy but ar openly hostile to one another, often competing for loyalty of the children
Shizophrenic family
Children lack a warm, affectionate relationship between parents and children
Delinquency
Common among boys who have lost their father or passed through an important formative years (ages 4 to 8) without a father figure present or with one present who serves inadequately in the paternal role
Delinquency
Deprived of a supportive environment and raised where care is impersonal and inadequate often shows developmental difficulty and high susceptibility to diseases and can also affect the child’s IQ.
Emotional deprivation
A relationship has been shown between incontinence in children and the strength of maternal relationship during the early formative years.
Enuresis
Bedwetting is greatest if total disruption of the family occurs through either divorce or abandonment.
Enuresis
Major cause of death in children over 1 year old in developed countries
Accidental injuries
5 Major Forms of Family Disorders:
- Uncompleted family unit
- Willed family dissolution
- Empty shell family
- Externally caused crisis
- Internal catastrophe
Any event, past or present that changes the lifestyle or presents a significant strain upon family organization.
Crisis
A crisis identified with short and long term addition of one or more to the family structure.
Addition (Hill’s Taxonomy of Crisis)
Examples: Adoption, birth, marriage, unplanned pregnancy
Associated with the threat of loss or actual departure of a family member
Abandonment
Examples: Planned departure, separation, death, stow away
A crisis that occurs when a family member initiated a change in a previously ordained family moral code
Demoralization
Examples: School suspension, alcoholism, drug abuse, delinquency, infidelity
Crisis involving gain or loss of wealth, power or position in the family or extra familial society
Status change
Examples: Loss of income, sudden fame, expulsion, loss of freedom
State of impaired functioning that occurs when an individuals resources are inadequate or unavailable to meet an intense stressor or an accumulation of stressor
Disequilibirium
Assets that serve to nurture an individual and those that supply the means for solving stressor-induced problems
Resources
Refers to adjustment by the family to stressors within and outside the family
Coping
State of family disequilibrium that results from the failure of an individual to identify or use resources to resolve a stressor induced problem
Crisis
The use of pathologic defense mechanisms to escape from an unresolved crisis, resulting in a state of impaired emotional and social functioning.
Maladaptation
State of impaired interaction or nurturing within the family that follows the use of abnormal defense mechanisms to escape from anxiety of unresolved family crisis.
Pathologic disequilibrium
Family function is continuously deteriorating because of failure to resolve a crisis, may eventually lead to family dissolution.
Terminal Disequilibrium
Seeing but refusing to acknowledge what one sees and hearing but negating what is actually heard
Denial
Involves purposeful, UNCONSCIOUS SHIFTING from one object to another the interest of solving a conflict.
Displacement
Actually plays a crucial role in ego development but can be used a defense mechanism when a person unconsciously incorporates the characteristics and qualities of another person or object into his ego system.
Identification
Differs from identification in the fact that this involves internalization of the characteristics of another person or object, creating a radical shift or alteration in the person.
Introjection
Individual provides a plausible but inaccurate justification for his or her failures
Rationalization
Consist of expelling and withholding from conscious awareness of an idea or feeling
Repression
The redirection of feeling and desires and especially of those unconsciously retained from childhood toward a new object.
Transference
Individual retreats to an earlier developmental stage that was more secure and pleasant and/or the use of less mature response in attempting to cope with stress.
Regression
Performing an extreme behavior in order to express thoughts or feelings the person feels incapable of otherwise expressing.
Acting out
Reduces anxiety by converting dangerous thoughts, feelings, behavior or impulses into their opposite feelings, impulses or behavior.
Reaction formation
Reduces anxiety by thinking about events in a cold clinical way
Intellectualization
The defensive conversion of psychic derivative of bodily symptoms tendency to react with somatic rather than psychic manifestations.
Somatization
Perceiving and reacting to an UNACCEPTABLE INNER IMPULSE and their derivatives as though they were outside the shelf.
Projection
Redirecting or acting put unacceptable impulses or wrong urges into SOCIALLY ACCEPTABLE IMPULSE
Sublimation
Consciously forcing the unwanted information out of conscious awareness.
Supression
Process of counterbalancing perceived weakness by emphasizing strength IN OTHER AREAS
Compensation
Satisfying internal needs THROUGH HELPING OTHERS
Altruism
