1. Memphis AID Including Family in the Rehabilitative Process

2. On the Agenda  Trait, peeve, wish  A look at Family Systems  Some Stressors  Beyond Technology  Our Views  Defining Family  The Role of Family  A Little Word Play

3. A Few Technicalities  Family Systems Perspective  Each member plays a role/functions within a unit  Interdependent: Members are affected by another’s role  Natural need for cohesion/collaboration  Communication is key  “The connectedness and reactivity make the functioning of family members interdependent. A change in one person's functioning is predictably followed by reciprocal changes in the functioning of others” (The Bowen Center 2014).

4. Sources of Stressors  Marital conflict; Dysfunction in one spouse  “Impairment of one or more children- The spouses focus their anxieties on one or more of their children. They worry excessively and usually have an idealized or negative view of the child. The more the parents focus on the child the more the child focuses on them. He is more reactive than his siblings to the attitudes, needs, and expectations of the parents.”  “The process undercuts the child's differentiation from the family and makes him vulnerable to act out or internalize family tensions. The child's anxiety can impair his school performance, social relationships, and even his health” (The Bowen Center 2014).

5. Results of Stressors  One more thought:  “Emotional distance- This pattern is consistently associated with the others. People distance from each other to reduce the intensity of the relationship, but risk becoming too isolated” (The Bowen Center, 2014).  Key terms:  Distanced  Isolated  Anxiety  Triangular stress

6. Break it Down  Don’t be thrown by terminology  “impairment”: not acceptable when speaking about disability  “child”: there is no age limit on disability  “more reactive”: this does not mean rude or unruly  “isolation”: manifests personally, academically, socially, and/or professionally  “anxiety”: a prolonged feeling of stress; marked by fearful anticipation Let’s go back…

7. Our Diction  What we would say:  “Members operate within a unit to promote the overall well-being of the family. Anxiety is produced by prolonged exposure to stress or having ominous anticipation. One with a disability (i.e., Bowen’s “child” or “impaired adult”) can often be the focal point of worry or stress. This is not to place blame on the individual with a disability, but merely to acknowledge natural occurrences. Family members create different levels of report and communication to deal with extraneous stress. Worry feels like the natural action for support members, while the survivor internalizes the worry, feeling responsible for causing discord. This perception of responsibility can lead to isolation and a deregulated sense of self.”

8. Too Much Reading  Let’s talk:  Can we define ”family”?  What’s importance does your family have/not have?  When, in what situation, do you receive family support?  Have you experienced familial stress post-injury? In what way?  How do you deal with stress?

9. Defining Family  Who comes to mind when you think “family”?  Father; Mother  Sister; Brother  Grandparent; Grandchild  Aunt; Uncle  Niece; Nephew  Cousins  Family systems generally start with the smaller nuclear family, those you live with. But, it is easy to forget your support potential.

10. More Family  Do personal or family friends come to mind?  What we’re driving at: isolation  Isolation is often based on fear or guilt  Can lead to depression, more anxiety, or complete apathy  Why harp on isolation?  You are a genuinely unique person with attributes, skills, and ideas of no one else’s. No matter the injury, you still have the capacity to live a life of fulfillment and contribution.

11. A New Style  Have you noticed a difference in your family after your injury?  Perhaps loved ones acting more protective?  Not knowing where your role is/where you want it to be  Family: Have you noticed a difference in how you respond to stress? Caregiver fatigue: A natural deterioration of motivation to provide care. This in no way reflects level of love or caring. When called upon to provide more and more over time, caregivers can begin to feel less enthusiastic, feel more stress, anger, or apathy. At this point, the caregiver needs to decompress. But how?

12. Where to Go  So, family life may be different.  Different roles, affects, reactions, stressors  Can recognition of change be all that important?  We argue yes, but what to do with that knowledge…

13. Some Ideas  Communicate honestly  Share emotion, don’t throw it  Find coping skills  Acquire an interest  Try something new together  Set goals  Recognize your own responsibility  Relaxation techniques for fatigue

14. What’s the Point  Family plays an important role in rehab and re-integration  Family can be nuclear, close nit; it can be extended, more expansive  Each member of the family has a role, or general modus operandi  These roles interact and form connections or barriers  When stress overwhelms the family unit, everyone is affected  Finding coping strategies for stress or subsequent anxiety will benefit everyone in the unit

15. Getting to Know Each Other  A new spin on family feuding: restriction edition  As you know, we want families to flourish, not feud.  A little hokey maybe, but stay with it for a second…  In this game, your fellow members will try to illicit a character trait, pet peeve, or greatest wish. All of you will have filled out slips of paper listing specific words for each of the three aspects of your personality. If your slip is chosen, you may describe your trait or wish in any manner you chose, but you cannot use any of the words written on your slip. Talk it out, act it out, give them clues to what you wrote. Find a way to communicate together for a common goal. If achieved, spoils will be enjoyed!