Family Development and Assessment מבוסס על הספר Wright, L.M., & Leahey, M.(2013). Nurses and families, a guide to family assessment and intervention. Philadelphia: Davis Comp.

Introduction “A family is who they say they are” The family defined: (Wright & Leahy, 2000)

Introduction (cont.) Types of Families Biological family of procreation Nuclear family (incorporates one or more members of the extended family) Sole-parent family Stepfamily Communal family Homosexual couple or family

Introduction (cont.) Families may more appropriately be determined based on attributes of affection, strong emotional ties, a sense of belonging, and durability of membership. Nurse generalists provide support and referrals to families of ill clients. They should be familiar with the tasks of adaptive family functioning.

Stages of Family Development Stage 1. The Single Young Adult Goal: Accepting separation from parents and responsibility for self Tasks Forming an identity separate from that of parents Establishing intimate peer relationships Advancing toward financial independence Problems arise when either the young adult or the parents have difficulty separating from the previous interdependent relationship.

Stages of Family Development (cont.) Stage 2. The Newly Married Couple Goal: Commitment to the new system Tasks Establishing a new identity as a couple Realigning relationships with members of the extended family Making decisions about having children Problems arise when either partner has difficulty separating from family of origin or when the couple cut themselves off completely from extended family.

Stages of Family Development (cont.) Stage 3. The Family with Young Children Goal: Accepting a new generation of members into the system Tasks Adjusting the marital relationship to accommodate parental responsibilities while preserving the integrity of the couple relationship Sharing equally in the tasks of child-rearing Integrating the roles of extended family members into the family Problems arise when the parents’ lack of knowledge about normal childhood development interferes with satisfactory child-rearing.

Stages of Family Development (cont.) Stage 4. The Family with Adolescents Goal: Increasing the flexibility of family boundaries to include children’s independence and grandparents’ increasing dependence Tasks Shifting of parent-child relationships to permit adolescents to move in and out of the system Refocusing on midlife marital and career issues Beginning a shift toward concern for the older generation Problems arise when parents are unable to relinquish control and allow the adolescent increasing autonomy or when the parents cannot agree and support each other in this effort.

Stages of Family Development (cont.) Stage 5. The Family Launching Grown Children Goal: Accepting a multitude of exits from and entries into the family system Tasks Renegotiation of marital system as a dyad Development of adult-to-adult relationships between grown children and parents Realignment of relationships to include in-laws and grandchildren Dealing with disabilities and death of parents (grandparents)

Stages of Family Development (cont.) Stage 5. The Family Launching Grown Children (cont.) Problems arise when parents are unable to accept the departure of their children from the home and their status as adults, or the death of their own parents, or when the marital bond has deteriorated.

Stages of Family Development (cont.) Stage 6. The Family in Later Life Goal: Accepting the shifting of generational roles Tasks Maintaining own and/or couple functioning and interests in face of physiological decline Exploration of new familial and social role options Support for a more central role for the middle generation Dealing with loss of spouse, siblings, and other peers, and preparation for own death; life review and integration

Stages of Family Development (cont.) Stage 6. The Family in Later Life (cont.) Problems arise when older adults have failed to fulfill the tasks of earlier stages and are dissatisfied with the way their lives have gone.

Major Variations Deciding to divorce Divorce Stages in the family life cycle of divorce Deciding to divorce Planning the breakup of the system Separation

Major Variations (cont.) Divorce (cont.) Tasks Accepting one’s own part in the failure of the marriage Working cooperatively on problems related to custody and visitation of children and finances Realigning relationships with extended family Mourning the loss of the marriage relationship and the intact family

Major Variations (cont.) Remarriage About three-fourths of those who divorce eventually remarry. The rate of redivorce for remarried couples is even higher than the divorce rate after first marriages. Stages in the remarried family life cycle Entering the new relationship Planning the new marriage and family Remarriage and reestablishment of family

Major Variations (cont.) Remarriage (cont.) Tasks Making a firm commitment to confront the complexities of combining two families Maintaining open communication Facing fears Realigning relationships with extended family to include new spouse and children Encouraging healthy relationships with biological (noncustodial) parents and grandparents

Major Variations (cont.) Remarriage (cont.) Problems arise when there is a blurring of boundaries between custodial and noncustodial families.

Major Variations (cont.) Cultural Variations Caution must be taken in generalizing about variations in family life cycle development according to culture.

Evolution of Family Therapy Basic Models of Family Therapy Bowen’s Family Theory Structural Model Strategic Model

The Nursing Process Calgary Family Assessment Model