family assessment and interventions - lecture 2 - exam 1

family

All the descendants of a common ancestor.

A group of individuals living under one roof and usually under one head

A group consisting of parents and children living together in a household

The basic unit in society traditionally (?) consisting of two parents rearing their children

- also: any of various social units differing from but regarded as equivalent to the traditional family (e.g., a single-parent family)

family

Defined by reciprocal relationships in which persons are committed to one another

Protect

Provide

Preserve

nursing diagnoses related to family

nursing diagnoses related to family

incorporating the family into the patient's care plan

Research indicates that ....... helps promotes positive outcomes. Families are sometimes more reliable informants than the patients.

benefits of family involvement

Joint Commission requirement

Education of the family is criterion for accreditation.

65% of those with mental illness live with their families.

Family Support

is one of the strongest predictors of recovery for persons with SMI

Bias against families

Sometimes viewed as part of problem, especially if history of ineffective collaboration

barriers to family involvement

bias against families

Unhealthy family dynamics/functioning

Ethical concerns that alliance with family will endanger confidentiality and threaten therapeutic alliance with patient

Administrative/insurance restraints, where services to families (as non-patients) receive lowest priority

heredity and environment

Families are at risk for mental illness based on ..

stress in the environment

Spouses escape the heredity factor, but at risk due to..

modeling

loudest person in the house is heard vs talking civilly

largest

Families are the ________ group of caregivers for the mentally ill.

Families

nourish each other physically, mentally, emotionally, and spiritually. Families exist so that human beings can develop and thrive.

harm individual family members.

A family system is dysfunctional when it fails to perform it's necessary functions and starts to ...

Single Parent Family

Children living with a single adult of any gender.

Unmarried Biological or Adoptive Family

Children living with two unmarried parents who are the biological/adoptive parents to all the family's children.

Nuclear Family/traditional family

Children living with two parents who are married to each and are each the biological or adoptive parents to all the children in the family

Blended Family

Children living with one biological/adoptive parent and that parent's spouse.

Cohabitating Family

Children living with one biological/adoptive parent and that parent's unmarried partner.

Extended Family

Children living with at least one biological/adoptive parent and at least one related nonparent adult such as grandparent or adult sibling

Multi-parent Family

Children living with and who have more than two adoptive/biological parents

"Other" Family

Children living with related or unrelated adults who are not biological or adoptive parents. This includes children living with grandparents and foster families

family

Bear in mind, "_______" is a self-defined concept. Your clients may identify various kinship networks as family, including unrelated friends and housemates. Also, not all families include children.

functioning in other intimate relationships, the workplace, culture, and society in general

A healthy family provides its members with tools to guide effective functioning within the family and extends to....

Management activities

Boundary delineation

Communication patterns

Emotional support

Socialization

These tools are acquired through activities associated with family life and include:

Management activities

Boundary delineation

Communication patterns

Emotional support

Socialization

Management activities

includes rule-making, planning, allocation of financial and other resources

Boundary delineation

organizing family members into a hierarchy; developing member roles.

Communication patterns

Are messages being communicated in a clear and comprehensible way? Is assertiveness valued or aggression/passivity?

Emotional support

Are emotional needs met in healthy and role-appropriate ways?

Socialization

What kind of socialization occurs among family members and between the family and the outside world?

characteristics of functional families

Complete life tasks

Capacity to tolerate conflict and adapt

Emotional contact is intergenerational

Fusion or over-closeness is avoided

Dyad solves internal problems

Differentiation

There are age-appropriate responsibilities

Positive emotional climate

Open communication and interactions

helicopter parent

the label used for parents who hover over their emerging adult children

disengaged parent

parents who are low in both demandingness and responsiveness

Triangulation

Indirect communication through a 3rd party; may occur when tension increases within dyad

Enmeshment

Overly close generations with poor lines of authority

Role reversal

e.g., Children raising children with ineffective parents in the home

normal modes of being

Addictions, lying, violence, or emotional abuse, neglect as ...

Scapegoating

A less powerful family member is blamed for another family member's distress.

Manipulating

Using dishonesty to support one's agenda

Distracting

Introducing irrelevant details into problematic issues in order to avoid functional problem solving and conflict resolution

Generalizing

Using global statements ("always" and "never") instead of dealing with specific problems and areas of conflict

Blaming

Attributing failure, error, or negative consequences to others in order to deflect the focus from oneself

Placating

Taking responsibility (even if not truly responsible) in order to keep the peace at all costs

Diffuse boundaries

obscure family roles, lines of authority and lead to enmeshment (over-involvement; over-concern for others leads to loss of autonomous development and/or role reversal)

Rigid boundaries

exist when rules and roles are completely inflexible; leads to isolation

Codependent

Excessively reliant on another person for one's own sense of identity

Enabler

family member who helps make it possible for another to engage in self-destructive behavior

Scapegoat

family member who receives blame for something they are not fully culpable for (displacement)

Perfect Child

perceived to have no problems and utilized by family as an ideal representation; hero

Lost Child

an overlooked family member who tends who tends to avoid conflicts and self-isolate.

Self-Assessment

Biases regarding family structure

Transference and counter-transference

genogram

information about relationships and interactions between family members, while a family tree only depicts lineage.

SO MUCH MORE INFO THAN A FAMILY TREE

nursing interventions

nursing interventions

nursing interventions

nursing interventions

Psychoeducation

teach the family about the client's illness, prodromal symptoms, and treatment rationales. Use psychoeducation as a stepping stone to involving the family in Relapse Prevention Planning.

Family Teaching

Psychoeducation

Anticipatory guidance

Coping skills

Medication adherence

community resources

Caregiver support groups (look to advocacy groups like NAMI or hospital-affiliated groups)

Respite care

Personal care attendants and Medicaid waiver programs

c. Generalizing

A nurse visits a client at his home to discuss the client's concerns regarding medication side effects. During the course of the conversation, his mother interjects that the client never washes the dishes after he cooks something. This is an example of

a. Placating

b. Blaming

c. Generalizing

d. Distracting