1. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 0

2. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 1 Chapter 11 Families as Resources, Caregivers, and Collaborators

3. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 2 Parent Status in the Contemporary Family BIOLOGICAL TIE Both parents biologically related to the child One parent biologically related (artificial insemination, surrogate parenting, lesbian families, blended families) Neither parent biologically related (adoption) Biologically related grandparents fulfilling the parenting role

4. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 3 Parent Status in the Contemporary Family (cont.) MARITAL STATUS Single parent—By choice (child product of heterosexual union or insemination, due to adoption) or result of divorce Married parents—Both biological parents, one biological parent and one stepparent, or adoptive parents Cohabiting parents—Heterosexual, gay, or lesbian

5. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 4 Parent Status in the Contemporary Family (cont.) SEXUAL ORIENTATION Heterosexual Gay or lesbian

6. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 5 Parent Status in the Contemporary Family (cont.) GENDER ROLES/EMPLOYMENT STATUS Traditional Nontraditional

7. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 6 Characteristics of the Functional Family Completes important life cycle tasks Has the capacity to tolerate conflict and to adapt to adverse circumstances without long-term dysfunction or disintegration of family cohesion Emotional contact is maintained across generations and between family members without blurring necessary levels of authority. Overcloseness or fusion is avoided, and distance is not used to solve problems. Each twosome is expected to resolve problems between them.

8. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 7 Characteristics of the Functional Family (cont.) Differences between family members are encouraged. Children are expected to assume age-appropriate privileges negotiated with their parents. The preservation of a positive emotional climate is more highly valued than doing what “should” be done or what is “right.” Within each adult there is a balance of affective expression, careful rational thought, relationship focus, and care taking; each adult can selectively function in the respective modes. There is open communication and interaction among family members.

9. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 8 Determinations of Culture Within a Family The definition of family The beliefs governing family relationships The conflict and tensions present in a family and the adaptive or maladaptive responses to them The norms of a family How outside events are perceived and interpreted When, how, and what type of family interventions are most effective

10. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 9 Figure 11-2 Example of a family genogram.

11. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 10 Functions Measured by the Family APGAR Resources Decisions Nurturing Emotional experiences Time, space, and money

12. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 11 Competence Paradigm Focus is on growth-producing behaviors rather than on treatment of problems or prevention of negative outcomes Promotion and strengthening of individual and family functioning occurs by way of fostering prosocial, self- sustaining, and self-efficacious behaviors, and other adaptive behaviors Definition of the relationship between the help seeker and help giver embodies a cooperative partnership that assumes joint responsibility

13. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 12 Competence Paradigm (cont.) Encouragement of assistance that is in line with the family’s culture and congruent with the family’s appraisal of problems and needs Promotion of the family’s use of natural support networks

14. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 13 Components of a Comprehensive Family Psychoeducation Program Didactic—Provides information about mental illness and the mental health system Skill—Offers training in communication, conflict resolution, problem solving, assertiveness, behavioral management, and stress management Emotional—Provides opportunities for ventilation, sharing, and mobilizing resources Family process—Focuses on coping with mental illness and its sequelae for the family Social—Increases use of informal and formal support networks

15. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 14 Barriers to Family Involvement Professional bias against families based on past exposure to family systems theories that suggest families cause or perpetuate the illness Family attitudes that equate all family interventions with past, unwelcome experiences with family therapy Professional fears that an alliance with the family will endanger confidentiality and threaten the therapeutic alliance with the patient Administrative restraints in a managed-cost environment, where services to families (as nonpatients) receive the lowest priority

16. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 15 Family Involvement Competencies for Mental Health Professionals Develop a collaboration with the family. Offer information on mental illness. Enhance family communication and problem solving. Help with service system use. Help family members meet own needs. Address special issues concerning the patient. Address special issues concerning the family.