Rebecca Sposato MS, RN

All happy families are alike, every unhappy family is unhappy in it own way -Leo

Tolstoy, Anna Karenina

Family FunctionsManagement: decision makers, allocate

resources Boundaries

Clear: understood rolesDiffuse: roles are blurredRigid or disengaged: too tight, not flexible

Communication: direct, true or manipulativeEmotional-supportive: accepted and helpedSocialization: getting along to prepare for

society

Maladaptive CommunicationManipulating - Distracting – promote side issuesGeneralizing – ‘always’ and ‘never’Blaming/ScapegoatingPlacating – efforts for short term peace

Doublebinds – either/or ‘s are both bad

Frameworks of Family TherapyStrategic ModelAssumes that changing any single

element in the family system will bring about change in the entire system

Structural Model Explains family problems from

perspective of dysfunctional boundary and role structure

Working with the familyThe family as a system – takes focus off

of individual and onto the interpersonal actions of the family

The identified patient – ‘the problem,’ bears the families symptoms

Family triangles – third person is drawn into conflict between 2 people

Nuclear family emotional system – behaviors and emotions are not confined to one person but flow to all family members

Goals of TherapyReduce dysfunctional behavior

resolve/reduce conflicts

Mobilize family resources

encourage adaptive family problem-solving behaviors,

improve family’s communication skills

Goals of TherapyHeighten awareness and

sensitivity to other family members’ emotional needs

Strengthen family’s ability to cope with major life

Improve integration of family system into societal system

ImplementationDetermine short-term and long

term needsFamily therapy

TraditionalPsychoeducationalSelf-help groups

Case managementPharmacological interventions