Family Interventions CHAPTER 35

Family Functions Management Boundaries Communication Clear Diffuse or enmeshed Rigid or disengaged Communication Emotional-supportive Socialization

Frameworks of Family Therapy Strategic Model Assumes that changing any single element in the family system will bring about change in the entire system Structural Model Explains family problems from perspective of dysfunctional boundary and role structure

Working with the Family The family as a system The identified patient Family triangles Nuclear family emotional system

Assessment Assessment is usually intermixed with treatment: Family system and subsystems Individual members of the family Phases of family life cycle Sociocultural context Multigenerational issues

Nursing Diagnoses for Family Interventions Impaired parenting Dysfunctional family processes Caregiver role strain Ineffective denial Defensive coping

Outcomes Identification Reduce dysfunctional behavior of individual family members and resolve/reduce conflicts Mobilize family resources, encourage adaptive family problem-solving behaviors, improve family’s communication skills, heighten awareness and sensitivity to other family members’ emotional needs Strengthen family’s ability to cope with major life stressors and traumatic events, including chronic physical or psychiatric illness Improve integration of family system into societal system

Planning Immediate and long-term needs of the family should be determined Analysis of assessment data Identify most appropriate family interventions Psychoeducational teaching: accepting the illness of a family member, understanding medications, finding community resources, and regaining or acquiring a sense of control and balance in family life

Implementation Counseling and Communication Techniques: Develop and practice good listening skills. View family members in a positive, nonjudgmental way. A nonjudgmental manner promotes open and flexible communication. Listen to each family member’s perspective of a situation.

Implementation Continued Family therapy Traditional Psychoeducational Self-help groups Case management Pharmacological interventions

The family of a child with attention deficit hyperactivity disorder (ADHD) and behavioral problems is referred for family therapy. Select the appropriate goal for family therapy.

The patient will develop stress-reduction techniques. The parents will provide structure and limit-setting. The patient will be adherent to medication regimen. The patient will be free from aggressive behavior.