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PubMed1998

Family functioning and parent general health in families of adolescents with major depressive disorder.

Family functioning and parent mental health in families of adolescents with major depressive disorder (n = 61) were compared with a community control sample (n = 34) using the McMaster Family Assessment Device (FAD) and the General Health Questionnaire (GHQ). Mean FAD and GHQ scores for clinic families were significantly worse than controls. 56% of clinic and 29% of control families met operational criteria for current dysfunction. In the clinic group family dysfunction was associated with the additive effects of comorbid Oppositional Defiant disorder in the adolescent and mother's current poor mental health, while father's current mental health had no associations with family functioning.

Adolescent↗
PubMed2001

Family psychology and family therapy in Japan.

The development of family psychology and family therapy in Japan has occurred mostly since the 1980s. This development was originally activated by the major social issue in contemporary Japan of school refusal, in which more than 127,000 children either overtly refuse to or claim that they cannot go to school. From a family perspective, this problem is analyzed as it relates to the confusion that children experience from unbalanced and unclear boundaries in family relations or "membranes." An approach to family therapy that adapts systems theory and integrates a clay sculpting medium has been developed to work with Japanese families confronting this problem. The design and implementation of preventative family psychology programs applied at the community level are also an important part of the future development in these fields.

Family↗
PubMed1989

The development of structural complexity in the child's concept of family: the effect of cognitive stage, sex, and intactness of family.

Twenty-eight boys and 28 girls at each of the Piagetian preoperational, concrete operational, and formal operational cognitive stages were given an interview focusing on their concepts of family. Half of each group were from intact families, and half were from divorced families. Interviews were scored for two structural aspects of the concept of family: conceptual level, and use of dimensions that structure the concept. The complexity of children's concepts was strongly related to cognitive stage and, to a lesser degree, to sex. Frequency of use of concept dimensions was strongly affected by general developmental level, though not specifically cognitive stage, and by intactness of family, but to a lesser degree by sex. Specific information is provided on the effect of these factors on perceptions of family composition, parental roles, and breadth of family activities.

Adolescent↗
PubMedDate not supplied

A prospective study of the effects of marital status and family relations on young children's adjustment among African American and European American families.

The present study investigated the effects of divorce and family relations on young children's development prospectively, using an ethnically diverse sample of approximately 300 low-income families. We also were able to examine the moderating effects of ethnicity on child adjustment in always two-parent, to-be-divorced, already-divorced, and always single-parent families. Results indicated that to-be-divorced European American and African American families demonstrated higher rates of preschool-age behavior problems, and already-divorced families showed similar trends. Parental conflict and behavior problems accounted for predivorce differences in child behavior problems, whereas rejecting parenting accounted for differences in problem behavior between always single-parent and always two-parent families. The results are discussed in terms of the importance of ethnicity in influencing young, low-income children's adjustment to different family structures.

Adolescent↗
PubMed1979

Family awareness for nonclinicians: participation in a simulated family as a teaching technique.

This paper describes a course in family theory geared to "well" family members that combines didactic and experiential teaching techniques. A key feature of the course is that students participate in a simulated family for twelve weeks. Family therapists are skilled at using techniques that powerfully dramatize family process; they can provide a needed and useful service to the community by teaching the dynamics of families functioning to people who have a personal or professional interest in learning more about families.

Awareness↗
PubMed1984

Family organization as an ecology of ideas: an alternative to the reification of family systems.

The argument of this paper is that current structuralist and quasi-organismic models of family organization are descriptions masquerading as explanations. They correctly assert, but do not account for, the fact that the behavior of each member of a family is related to that of every other member. An adequate account must begin by assuming that people behave according to how they define the situations in which they are actors, and that such definitions of the situation are generalizations learned through repeated interaction with others. Family organization is regarded within this framework as the outcome of an evolutionary process by which some ideas are encouraged or confirmed and others suffer a kind of death or extinction, so that the ideas of each family member lead him or her to behave in ways that confirm or support the ideas of every other family member. That is what is meant by the slogan "family organization as an ecology of ideas." This view of family organization requires a demystified account of resistance in psychotherapy, a bare outline of which is provided in the previous section. The overall conception of the psychotherapeutic process presented here is closest to that of the Palo Alto Brief Therapy Project, though I offer as a conjecture that the effective operations of all the psychotherapies can be explained within this framework.

Communication↗
PubMed1985

The Beavers-Timberlawn model of family competence and the circumplex model of family adaptability and cohesion: separate, but equal?

An empirical examination of the association between instruments measuring the Beavers-Timberlawn Model of family competence and the Circumplex Model of adaptability and cohesion is presented. Even when triangulated measures were utilized to control for the divergent methods of data collection traditionally employed to operationalize these models of family health, family competence as measured by the Beavers-Timberlawn Family Evaluation Scales was either minimally (mothers) or not associated at all (fathers and children) with balanced and thereby optimal dimensions of adaptability and cohesion as measured by the Family Adaptability and Cohesion Evaluation Scales. Methodological and substantive explanations for the surprising lack of association between measures of these two prominent family assessment models are explored and short- and long-range implications for the growth and practice of family therapy are discussed.

Adaptation, Psychological↗
PubMed1987

Professional politics and the concepts of family therapy, family consultation, and systems consultation.

At a time when an increasing number of professionals are calling themselves "family therapists," many teachers and theorists in this field are troubled that the term "family therapy" no longer adequately characterizes the concepts or activities of the field. Recently, clinical, political, and economic circumstances have emerged that suggest the need for alternatives to the role of "family therapist." By adding the roles of family consultant and systems consultant, we can open up new options for ourselves and our clients. During initial contacts with families, agencies, and other professionals, we can heighten our therapeutic potential by proceeding with consultative stocktaking, not starting with therapy. Family consultation also can assist in redirecting therapy when a new problem or an impasse develops, in focusing on competency rather than on pathology, and in engaging constructively with families that have a physically or mentally ill member.

Adolescent↗
PubMed1992

Connectedness versus separateness: applicability of family therapy to Japanese families.

This article, a product of the two authors' multicultural experiences, contrasts British and Japanese families in order to examine the applicability of the Western model of family therapy to Japanese families and therapists. Areas where the Western model is incompatible are identified, and modifications to fit the Japanese indigenous model are suggested. The most significant difference in value systems between the two cultures is the Japanese preference for connectedness. The Japanese person is seen as a part of the embedded interconnectedness of relationships, whereas British norms prioritize separateness and clear boundaries in relationships, individuality, and autonomy. This value orientation is manifested in the Japanese language, hierarchical nature of the family structure, the family life cycle, and the implicit communication style. Systemic thinking, which deals with the pattern of relationships, is valid for all families regardless of cultural differences. But therapists should note that the preferred direction of change for Japanese families in therapy, is toward a process of integration--how a person can be effectively integrated into the given system--rather than a process of differentiation. An authoritative therapist style, the use of individual sessions, silence, and other nonverbal techniques are relevant to bringing about the desired change toward better integration of the individual with his or her networks.

Adolescent↗
PubMed1999

Surviving cancer competently intervention program (SCCIP): a cognitive-behavioral and family therapy intervention for adolescent survivors of childhood cancer and their families.

Psychological reactions to having had childhood cancer often continue after treatment ends, for survivors and their parents. Based on our previous research, we developed an intervention program for adolescent survivors of childhood cancer, their parents, and siblings. Surviving Cancer Competently: An Intervention Program--SCCIP--is a one-day family group intervention that combines cognitive-behavioral and family therapy approaches. The goals of SCCIP are to reduce symptoms of distress and to improve family functioning and development. SCCIP is described and data from a pilot study of 19 families are presented. Program evaluation data indicated that all family members found SCCIP helpful. Standardized measures administered before the intervention and again at 6 months after SCCIP showed that symptoms of posttraumatic stress and anxiety decreased. Changes in family functioning were more difficult to discern. Overall, the results were promising with regard to the feasibility of the program and its potential for reducing symptoms of distress for all family members.

Adaptation, Psychological↗
PubMed2002

A hereditary disorder in the family and the family life cycle: Huntington disease as a paradigm.

The implications of predictive DNA-testing for Huntington's Disease (HD) for the transitions in the family life cycle are described. HD is a hereditary disorder leading to personality changes, uncontrollable movements, cognitive impairment, and ultimately death in mostly adults. People at risk have the possibility to detect whether or not they carry the disease provoking-gene, but no treatment is available. In this article, we will highlight the complex implications of pre-symptomatic testing by describing six different cases, interpreted by following the theoretical framework of Carter and McGoldrick (see pp. 684). HD interferes strongly with the "normal" transitions in the life cycle. It is not so much the test result itself that may be disrupting, but the changed expectations and possibilities for the future. As a family disease, HD forces its members to cope, one way or another, with disturbing events and untimely deaths. Some families are able to make some transitions, while becoming blocked at other transition points; this may differ between families. Being able to cope with HD in the family for a certain time does not necessarily imply that problems will never occur. Because any family member may eventually need help, it is important to then help the family discover what hinders them from making the transition to the next life stage, and to resolve these issues so that they can move on.

Adaptation, Psychological↗
PubMed2002

Impact of a family information leaflet on effectiveness of information provided to family members of intensive care unit patients: a multicenter, prospective, randomized, controlled trial.

Comprehension and satisfaction are relevant criteria for evaluating the effectiveness of information provided to family members of intensive care unit (ICU) patients. We performed a prospective randomized trial in 34 French ICUs to compare comprehension of diagnosis, prognosis, treatment, and satisfaction with information provided by ICU caregivers, in ICU patient family representatives who did (n = 87) or did not (n = 88) receive a family information leaflet (FIL) in addition to standard information. An FIL designed specifically for this study was delivered at the first visit of the family representative: it provided general information on the ICU and hospital, the name of the ICU physician caring for the patient, a diagram of a typical ICU room with the names of all the devices, and a glossary of 12 terms commonly used in ICUs. Characteristics of the ICUs, patients, and family representatives were similar in the two groups. The FIL reduced the proportion of family members with poor comprehension from 40.9% to 11.5% (p < 0.0001). In the representatives with good comprehension, the FIL was associated with significantly better satisfaction (21 [18 to 24, quartiles] versus 27 [24 to 29, quartiles], p = 0.01). These results indicate that ICU caregivers should consider using an FIL to improve the effectiveness of the information they impart to families.

Aged↗
PubMedDate not supplied

Family distress in palliative medicine: a pilot study of the family APGAR scale.

The family is essential to patients with advanced cancer. Family and caregiver distress, however, can impair optimal care and support of the patient. A five-item questionnaire, the Family APGAR Scale, was evaluated to determine family functioning levels of selected patients. The APGAR Scale has five components for measuring family functioning: Adaptation, Partnership, Growth, Affection, and Resolve. Fifty consecutive patients admitted to a palliative medicine inpatient unit were reviewed for a pilot study. Eligibility requirements included admission to the unit for the first time, and the ability to speak English and give informed consent. Fifteen patients and 11 primary caregivers participated. Despite the small sample, some significant family functioning issues were identifed. Completing the study later with a larger sample will provide information that will help the multidisciplinary team better meet the needs of both patient and family.

Adult↗
PubMed2003

Familial resemblance for muscle phenotypes in the HERITAGE Family Study.

INTRODUCTION/PURPOSE: We hypothesized that skeletal muscle histological and biochemical phenotypes aggregate within families. METHODS: Nineteen families (78 Caucasians) from the HERITAGE Family Study participated in the study. Proportions and areas of Type I, IIA, and IIX muscle fibers, capillary density, and maximal enzyme activities were determined in biopsy samples from the vastus lateralis obtained in the sedentary state and after a 20-wk endurance-training program. RESULTS: In the sedentary state, there was evidence for familial resemblance for Type I fiber area (P = 0.007), number of capillaries around Type I and Type IIA fibers (P = 0.04), and Type I and IIA fiber areas per capillary (P = 0.01 and P = 0.04, respectively). Significant familial aggregation (0.05>P > 0.0001) was observed for maximal activities of enzymes of the energy production pathways. With regard to the training response, significant familial aggregation (0.05 > P < 0.0001) was observed for maximal activities of enzymes of the energy production pathways. CONCLUSION: These data provide evidence of familial aggregation for enzyme activities of the main energy metabolism pathways of the skeletal muscle in the sedentary state and in response to regular exercise.

Adaptation, Physiological↗
PubMed1994

Effect of family group psychotherapy on alcoholic families.

We examined the effect of family group psychotherapy on 14 alcoholic families. Family group psychotherapy helped alcoholic families be aware of their anxiety and conflict and enabled them to share their feelings with a group. Alexithymia for a cognitive-affective disturbance significantly decreased after group psychotherapy. Moreover, participation in family group psychotherapy over six months increased family cohesion and allowed anxiety and conflict to be more easily expressed within the family.

Adult↗
PubMedDate not supplied

Family systems and family therapy of substance abuse: an overview of two decades of research and clinical experience.

Substantial recent progress has been made in the study of family systems and in the field of family therapy. The gradual application of these new technologies to the field of substance abuse is discussed. A shift has occurred toward quantitative assessment of the three generational systems of the substance abuser as well as inclusion of that entire system in the family therapy. Family therapy treatment methods have been developed to motivate substance abusers, detoxify them, and work with the family when the identified patient is not involved in treatment and to restructure the entire family. The field of family therapy evaluation is in its infancy but plans are underway for elaborate scientific investigation of efficacy.

Alcoholism↗
PubMed1992

Family therapy for Dutch drug users: the relationship between family functioning and success.

This article reports treatment outcome in families with drug problems after a family therapy intervention. An attempt is made to determine what changes occur in family functioning in the course of treatment with family therapy, and how these changes relate to prolonged abstinence and improvement in social functioning in drug misusers. The results indicate that, overall, most families, one year after the start of family therapy, changed in the predicted direction as determined by an observation instrument. Furthermore, success in treatment for the drug misuser was most likely to occur in families in which the parents communicated with each other in a predominantly negative way at the beginning of therapy, and when, in the course of therapy, a significant change occurred toward a more positive supportive manner of communicating.

Adult↗
PubMed1998

Family pattern and family care in Greenland.

Information on household and family patterns from the 1993-94 Health Interview Survey in Greenland is described. The average size of households is 3.5, and almost three-fourths of the Greenlandic population live in families with children. The pattern of these families with children covers a variety of single-parent families (6% of the total Greenlandic population), nuclear families (42%), extended families (14%), and other types of families (11%).

Adult↗