1. Family Wellness

2. Family
A group of persons united by ties of marriage, blood or adoption; consisting of a single household; interacting and communicating with each other in their respective roles of husband and wife, mother and father, son and daughter, brother and sister, creating and maintaining a common culture (Burges and Locke 1960)
A small social system made up of individuals related to each other by reason of strong reciprocal affections and loyalties and comprising a permanent household (Berman)

3. Family
Semi-closed system of actors occupying interrelated positions defined by society of which the family system is a part as unique to that system with respect to role content of the positions and to the ideas of kinship relatedness. (Rogers)

4. Types of Families
Nuclear- typically consists of a married man and women and their children
Extended- linked together by virtue of kinship bond between parents and children and/or between siblings. Includes 3 generations- the family of procreation merges with the family of origin; can be unilateral or bilateral
Blended- includes stepparents and stepchildren
Communal- group of individuals who are formed for specific ideological or societal purposes.

5. The Family Systems Theory
Minuchin (1978)
Family is a continuous interlocking human relationship, organized in such a way that when there is a change in one family member, the other family members are affected
Based on the following concepts:
The family is more than a collection of individuals
Families have repeating interaction patterns that regulate member behavior
An individual’s symptoms may have a function within the family
The ability of adapt to change is the hallmark of healthy family functioning
There are no victims or victimizers in families

6. Family Structure
Hierarchy- how power of authority is distributed in the family
Boundaries- rules defining who participates in the subsystem and how they participate
Coalition- relationship between atleast 3 people, where two people collude against the other
Alliance- positive relationship between any two members of a system
Role selection- unconscious assignment of roles to each family member

7. Family Process Enmeshment- occurs when boundaries are diffuse
Disengagement- characterized by boundaries that are too rigid
Triangulation- occurs when a third person is drawn into a two-pair system so as to diffuse anxiety or conflict
Family patterns- ordered sequence of interaction that typify how families function

8. The Family Life Cycle Unattached young adult Newly married couple
Family with young children
Family with adolescents
Launching family
Family in later life

9. Family influence on health and impact on illness
Genetic influence
Crucial in child development
Infectious disease spreads in the family
Family factors affect morbidity and mortality
The family is important in recovery from illness

10. Tools for Family assessment
Family Genogram
Family APGAR
Family Circle Technique
SCREEM
Minuchin’s Family Map
Family Lifeline

11. Family Genogram
Uses:
Quick overview of the interrelationships between family members
As a way of looking at the family medical and psychosocial problems
Tool for understanding the multigenerational family systems

13. Family APGAR
Five item questionnaire designed to elicit the patient’s perception of the current state of his family relationships
Adaptation-capability of the family to utilize and share inherent resources
Partnership-sharing of decision making
Growth- physical and emotional growth
Affection- how emotions like love, anger, hatred are shared between members
Resolve- refers to how time, space and money are shared

14. Medical factors affecting health
Family Circle Technique
SCREEM
Social
Cultural
Religious
Economic
Educational
Medical factors affecting health
Brief, graphic method for disclosing, gathering, and discussing family dynamics as discussed by one or more family members

15. Family Health Care Plan
Process which encompasses diagnostic, preventive, curative, and rehabilitative approach for whole family