1. www.enthusiasticlife.net Family Structure PART SET Dr MargiAnne Isaia, MD MPH PCC DrAnneenthusiasticLife 1

2. FAMILY STRUCTURE Family = those who are tied together through their common biological, legal, cultural and emotional history and by their implied future together Structure and organization = factors that contribute to the health of the family.

3. STRUCTURE (TYPES) OF FAMILIES: Nuclear family: the traditional type, husband, wife and their children; seen as the main provider of socialization for the young and as a preserver of cultural traditions Single-parent family: one parent, either biological or adoptive, who is solely responsible for care of self and child/children Blended (remarried, step): family created when two people marry and at least one of them has been married previously and has child/children

4. STRUCTURE (TYPES) OF FAMILIES: Dual-career family: both husband and wife in the labor force (spillover effect = participation in one domain –work- affects participation in another domain-the family) Child-free family: couples who consciously decide not to have children or remain child-free as a result of chance (marrying late) or biology (infertility) Special-needs-child/children family: many challenges, depending on whether the needs are a result of disabilities

5. STRUCTURE (TYPES) OF FAMILIES: Gay/lesbian family: same-sex couples without children or with children from a previous marriage or as a result of artificial insemination Aging family: headed by someone 65 years old or older Multigenerational family: household includes child, parent and grandparent

6. STRUCTURE (TYPES) OF FAMILIES: Grandparent-headed family: grandparents taking care of their children’s children (divorce, substance abuse, neglect, abandonment of parenting duties, teen pregnancy, mental health problems, unemployment, incarceration) Military family: special problem due to the nature of the work military personnel perform All types of families have challenges. Some of the variety of family forms work better than others in handling life events. The roles family members enact are a part of family’s structure and make a difference with regard to family health.

7. FAMILY ORGANIZATIONAL FORMS 1. Symmetry/complementary 2. Centripetal/centrifugal 3. Cohesive/adaptable

8. 1. SYMMETRICAL/ COMPLEMENTARY FAMILIES In a symmetrical relationship, interaction is based on similarity of behavior. Each partner is versatile and tries to become competent in doing necessary or needed tasks. For example, either a man or woman can work outside of home or take care of children (post-gender relationship). The major type of difficulty: when partners do not minimize differences and instead compete with each other, or when one member of the relationship is not skilled in performing a necessary task.

9. 1. SYMMETRICAL/ COMPLEMENTARY FAMILIES In a complementary relationship, family member roles are defined more rigidly, and differences are maximized. One member of the couple is dominant or submissive, logical or emotional; if members fail to do their tasks, such as making decisions or taking care of the children, other members of the family are adversely affected. Sometimes this type of family is organized around traditional gender roles. If these roles become stereotyped, the relationship’s stability and satisfaction will suffer.

10. 1. SYMMETRICAL/ COMPLEMENTARY FAMILIES Both symmetrical and complementary forms of family life will work as long as at least two conditions are met: a)members in the relationship are satisfied with and competent in their roles; b) there is sufficient interrelationship of roles so that necessary tasks are accomplished. Meeting these two conditions is not always possible. Couples do best if they practice parallel relationships (both symmetrical and complementary); exchanges occur as appropriate.

11. 2. CENTRIPETAL/ CENTRIFUGAL FAMILIES Families with a centripetal style (directed toward a center) have members who view the relationship satisfactory as coming from inside the family. The children are too tightly held by the family and are prone to be antisocial, irresponsible and egocentric. Young adults are unable to leave home.

12. 2. CENTRIPETAL/ CENTRIFUGAL FAMILIES Families with a centrifugal style (directed away from the center) are characterized by the tendency to expel members and view their relationship satisfactory as coming from outside the family. The children are likely to become socially isolated, disorganized or withdrawn. In all families, periods of both closeness and distance occur during individual and family life cycles. Family health- Beavers’s concept: Extreme in either centripetal or centrifugal style of family interaction are likely to produce poor family functioning.

13. 2. CENTRIPETAL/ CENTRIFUGAL FAMILIES Optimal health family: clear boundaries, capable of negotiation, individual choice and ambivalence respected, warmth, intimacy, humor. Adequate health family: relatively clear boundaries, negotiating but with pain, ambivalence reluctantly recognized, some periods of warmth and sharing, interspersed with control struggles. Severely dysfunctional family: poor boundaries, confused communication, lack of shared attentional focus, stereotyped family process, despair, cynicism, denial of ambivalence.

14. 3. COHESION/ ADAPTABILITY Regardless of timing, all families have to deal with family cohesion and family adaptability (flexibility), according to Olson’s model (circumplex model of family functioning) Family flexibility is the amount of change in its leadership, role relationships and relationship rules. The specific concepts include: leadership (control, discipline), negotiation styles, role relationships and relationship rules. The focus of flexibility is on how systems balance stability versus change.

15. ADAPTABILITY (FLEXIBILITY) ranges from low to high, in four categories: Rigid: authoritarian leadership, strict discipline, roles seldom to change, too little change Structured: leadership sometimes shared, somewhat democratic discipline, roles stable, change when demanded Flexible: shared leadership, democratic discipline, role sharing change, change when necessary Chaotic: lack of leadership, dramatic role shifts, erratic discipline, too much change

16. IN TERMS OF FLEXIBILITY couples and families with problems often have difficulty balancing stability and change. These relationships are either too rigid or too chaotic. Central or balanced levels of flexibility (structured and flexible) are more conducive to good marital and family functioning; Extreme levels of flexibility (rigid and chaotic) are the most problematic for families as they move through the their life cycle.

17. FAMILY COHESION is defined as the emotional bonding that family members have toward one another. Specific concepts (variables) used to diagnose and measure the family cohesion dimensions (Circumplex Model) are: 1)emotional bonding; 2) boundaries; 3) coalitions; 4) time; 5) space; 6) friends; 7) decision-making and interests; 8) recreation. The focus of cohesion is how systems balance their separateness versus togetherness.

18. COHESION RANGES from low to high on the following four levels: Disengaged: I, little closeness, little loyalty, high independence Separated: I-We, low-moderate closeness, some loyalty, interdependent (more independence than dependence) Connected: I-We, moderate-high closeness, high loyalty, interdependent (more dependence than independence) Enmeshed: I-We, very high closeness, very high loyalty, high dependence

19. IN TERMS OF COHESION problems in families often occur because of their inability to balance separateness (autonomy) and togetherness (intimacy). It is hypothesized that the central or balanced levels of cohesion (separated and connected) make for optimal family functioning. The extremes or unbalanced levels (disengaged or enmeshed) are generally seen as problematic for relationships over the long term. The degree of adaptability and cohesion within families is dependent on their life-cycle stage and their cultural background.

20. THE CIRCUMPLEX MODEL is sensitive to ethnic and cultural diversity as reflected in the following hypothesis: If a family's expectations support more extreme patterns, families will then operate in a functional manner as long as all the family members like the family that way.

21. FROM CLASSICAL AUTHOR “God Himself gave Adam a companion. He provided "an help meet for him"--a helper corresponding to him--one who was fitted to be his companion, and who could be one with him in love and sympathy. Eve was created from a rib taken from the side of Adam, signifying that she was not to control him as the head, nor to be trampled under his feet as an inferior, but to stand by his side as an equal, to be loved and protected by him. A part of man, bone of his bone, and flesh of his flesh, she was his second self; showing the close union and the affectionate attachment that should exist in this relation”. EGW. AH 25.3

22. FAMILY REFLECTION What kind of family did you grow up in? How did it function? How was similar to other families you knew? How did it differ? What kind of family do you live in now? How is that played out in regard to your closeness or distance from members of your family? Does your culture dictate a special norm? What adaptability and cohesiveness do you see within your family at present?

23. REFERENCES Gladding S. T., Family Therapy, History, Theory and Practice, 5 th edition (2011) Olson, D. H., Circumplex Model of Marital & Family Systems “Empirical Approaches to Family Assessment”, special edition of the Journal of Family Therapy (1999) White, E.G., Adventist Home