The comprehensive treatment of schizophrenics.
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Biomedical subjects
Publications and source records attributed to S Fleck.
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The author proposes a general systems approach to the examination and understanding of family functioning. Scrutinizing the family as an open system with 1) evolutionary goals and tangible tasks, 2) a need for "semipermeable" boundaries, 3) cultural and subcultural communication modes, 4) leadership effectiveness, and 5) the nature and age-appropriateness of the affective bonds will enable clinical judgements about family functioning that indicate general system competencies and defects. Such a framework may also lead to a typology of family process because the major functions of the family as a system (creation, nurturance, enculturation, and guidance of the young into adulthood) can be evaluated regardless of symptoms or diagnoses.
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Unified health and primary care services must focus on family health and the family as the clinical unit. Understanding the family as the basic social system and assessing its functioning from the standpoints of evolutionary family tasks, family health behavior and family coping capacities are as important as is knowledge of body systems and their functional evaluation, and of social and ecological systems which also can be pathogenic for individuals or families. The concept of psychosomatic medicine must include familio-somatic and somato-familial medicine. Families are involved in the pathogenicity of some diseases and psychiatric disorders, and in the treatment and management of all chronic disease. Coping with dying patients and mourning are also basic family tasks. Only unified clinical services, whether hospitals or health stations, can render realistic care and relate to the many relevant systems in the community, beginning with the patient's family. Clinicians must evaluate these systems as to their wholesome or unwholesome impact on a particular health issue or problem, seeking corrective as well as preventive measures.
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