1. Family Systems: Stresses & Adaptation

2. Overview
An individual family’s experience of stress, crises, and subsequent adaptation is an ongoing and dynamic process.
The process of adaptation is affected by the family’s response to a stressful event, their available resources, and presence or absence of effective coping strategies.
Adaptation exists on a continuum from positive adaptation (bonadaptation) to maladaptation, resulting in increased or decreased family functioning.

3. Development of the theory
The original family stress theory was developed by Reuben Hill (1949), who studied families’ responses to war, war separation, and eventual reunion after WWII.
The ABCX Model detailed how the three factors (the ABC components) of a stressor event, the family’s perception of that stressor, and the family’s existing resources interacted to predict the likelihood of a crisis (X) occurring.

4. Sociologists McCubbin and Patterson (1983) developed the Double ABCX Model, which added postcrisis variables (e.g. coping mechanisms) to explain how families recover from crisis and achieve adaptation over time.
Theory originally based on longitudinal research involving families in which a father/husband was a POW or MIA during the Vietnam war.
Families facing a stressor event experience phases of adjustment and adaptation, exemplified by a range of processes in which the variables interact.

5. Assumptions
Families over the course of life face hardships and changes as a natural and predictable aspect of family life.
Families develop basic competencies, patterns of functioning and capabilities to foster the growth and development of family members and the family unit, and to protect the family from major disruptions in the face of transitions and changes.

6. Families develop basic and unique competencies, patterns of functioning, and capabilities designed to protect the family from unexpected or non-normative stressors and strains and to foster the family’s recovery following a family crisis or major transition or change.
Families draw from and contribute to the network of relationships and resources in the community, including its ethnicity and cultural heritage, particularly during periods of family stress and crises.

7. Families faced with crisis situations demanding changes in the family’s functioning work to restore order, harmony and balance even in the midst of change.

8. Systems theory and the Double ABCX Model
The family is viewed as the “system”, where experiences of one family member affect the experiences of other family members.
Family systems theory and the Double ABCX model highlights the integral influence of the family system on each individual member's development and vice-versa
Systems theory (and the Double ABCX model) recognize interactions of the parts are not "static" and constant but "dynamic" processes.

9. Concepts: ABCX Components
Stressor (A)
Life event or transition impacting the family unit that has the potential for changing the family social system.
Defined as distinct from stress.
Can occur in any aspect of the family’s life- roles, functions, goals
Examples include chronic illness in children, cancer, and elder care

10. Existing Resources (B)
All families have some level of resources.
Concept of existing resources is the family’s use of community and intrafamilial systems. i.e. SES, parents education
May be adequate or inadequate depending on the nature of the stressor event or family’s level of functioning

11. Perception of the Stressor (C)
Defined as the meaning the family assigns to the crisis event and the total circumstances that lead to the crisis.
In other words: how well does the family define the problem, grasp the problem and understand the situation?

12. Crisis (X)
Defined as the “demand for change”.
Continuous variable that reflects the sum of the family’s disorganization, turmoil, disruption which is triggered by an event.
In the model- crisis is regarded as the family’s inability to retain stability.
If the family is able to meet the demands of the stressor than the crisis may be averted.

13. ABCX Component Interactions
Stressor (A) → interacts with resources (B) → family’s perception of stressor/how stressor defined (C) → produces the crisis (X).

14. Putting Theory into Practice
Current nursing research focuses on family adaptation to chronic illness.
Requires nurses to understand the stages of illness and how families respond to the illness process
Theory assumptions help to guide practice that recognizes family needs beyond a one-time event

15. Future Developments Increasing number of “stressors” faced by families
Increasing prevalence of chronic disease
Increasing complexity of family structure
Although the model in its entirety can be cumbersome, the elements can easily be broken down and applied to an almost infinite combination of factors.