1. 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.

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

3. 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

4. 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.

5. 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.

6. 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.

7. 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.

8. 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.

9. 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)

10. 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.

11. 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

12. 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.

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

14. 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

15. 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

16. 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

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

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

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

20. The Nursing Process
Calgary Family Assessment Model