[01.18] FCM - Approach to Families with Sick Members V2.pdf

A family system

What operates through transactional patterns and the establishment of repeated behaviors?

Interconnected and interdependent

How are individuals described within a family system?

Understand the family system

What must a physician do to understand an individual within a family, according to the system approach?

Circular changes

What term describes a system where a change in one member leads to changes in all other members?

Homeostasis

What is the family’s tendency to resist change and maintain a state of equilibrium?

Step up to keep the family functioning

What happens in a family system if one member is unable to perform their specific role?

Salvador Minuchin

Who pioneered the structural approach to family systems?

Hierarchy, roles, subsystems, and boundaries

What four elements must a family structure possess to effectively adapt to stressors?

Structures

What are behavioral patterns that are repeated over and over again within a family?

Rules

What are commonly agreed-upon ways of dealing with each other, situations, and the external environment?

Overt rules

What are rules that are explicitly stated, such as a written code of conduct?

Covert rules

What are implied rules, such as a specific seating arrangement at the dinner table?

Boundaries

What are the special rules that govern interactions between subsystems in the family?

Subsystems

What are subgroups within a family that are often separated by a significant period of time?

Roles

What is the term for a specific function assigned to a family member?

Coalitions

What are informal groupings within the family consisting of people who usually side with each other?

Power structures

What refers to the decision-makers in the family, such as the parental generation or primary breadwinner?

Circular questions

What type of questions are used to determine structures and elements in a family system?

Series questions

Which circular questions explore repetitive behavior?

Who-does-what-and-when questions

Which circular questions are used to explore different roles?

Closer-farther questions

Which circular questions explore emotional closeness and distance?

Who agrees with whom questions

Which circular questions elicit information about coalitions?

Family Map

What tool is used to reflect family psychodynamics, including relationship and interaction patterns?

Therapeutic allies

What can a physician identify by looking at interaction patterns on a family map?

Characteristics, structure, process, and across time

What are the four categories included in a family map?

St. FFRRED

What mnemonic is used to remember the different family assessment tools?

Genogram

What tool is used to assess family structure and member details?

Family APGAR

What tool is used to assess family functionality?

Family Lifeline

What tool is used to assess family flexibility by looking at stressors through time?

Family Map and Circular Questions

What two tools are used to assess resonance in a family?

SCREEM and Ecomap

What two tools assess the ecological context or external family resources?

Family Life Cycle

What tool helps the physician assess concerns by providing a chronologically oriented sequence of events?

Two parallel lines

On a family map, what symbol represents a functional relationship?

Three parallel lines

What symbol represents an enmeshed or over-involved relationship?

Break in the line

What symbol represents a dysfunctional relationship?

Jagged or dashed line

What symbol represents clear boundaries?

Solid line

What symbol represents rigid boundaries?

Dotted line

What symbol represents diffuse boundaries?

Bracket

What symbol represents a coalition or alliance?

Predictable

How are the stages and associated problems of the family life cycle generally characterized?

Oscillate

What do connections between family members do as the family moves from one stage of the life cycle to the next?

Unattached young adult

What is the first stage of the family life cycle mentioned?

Newly married couple

What stage follows the unattached young adult stage?

Family with young children

What stage follows the newly married couple stage?

Family with adolescents

What stage follows the family with young children stage?

Launching family

What stage follows the family with adolescents stage?

Family in later years

What is the final stage of the family life cycle mentioned?

Centripetal period

What period in the family life cycle means that family members are pulled into the system?

Mobilize family members

What is easier to do during a centripetal period when a member gets sick?

Birth of a new infant

What is a specific example of a centripetal event in the family life cycle?

Centrifugal period

What period in the family life cycle features a tendency for members to move out of the system?

Increasing independence in adolescents

What is an example of a centrifugal period?

Transition points

At what specific times is family stress considered to be at its greatest?

Horizontal stressors

What types of stressors are commonly seen in life transitions?

Developmental, transitional, and unpredictable

What are the three subtypes of horizontal stressors?

Vertical stressors

What types of stressors come from the community or culture, including generational issues?

Generational, attitudinal, expectations, taboos, and stigmas

What are five subtypes of vertical stressors?

Indian or Chinese families

Which cultural examples are used to show challenging transitions when horizontal and vertical stressors meet?

Intrafamilial factors

What category of coping factors includes the family life cycle stage and degree of functionality?

Extrafamilial factors

What category of coping factors includes illness typology and the stigma associated with disease?

Typology of illness

What concept shows that illness characteristics influence the adjustment a family must make?

Gradual

What type of illness onset allows a family time to prepare and adjust?

Acute

What type of illness onset, such as an accident or sudden stroke, likely causes coping problems?

Incapacitation

What characteristic of an illness impacts the different roles and functions of family members?

Illness Timeline

What tool gives an idea of concerns based on whether an illness is in a crisis, chronic, or terminal phase?

Family Illness Trajectory

What depicts the normal course of the psychosocial aspects of a disease for a patient and family?

Onset, Impact, Major Therapeutic Efforts, and Recovery

What are the four stages of the Family Illness Trajectory?

Catharsis-Education-Action

What model can be used to explore fears and uncertainties regarding an illness?

Family Lifeline

What tool helps assess how the family has coped with different stressors through time?

Supportive, Educative, and Problem-solving

What are the three broad categories of intervention strategies?

Supportive approach

Which intervention approach provides opportunities for members to share feelings?

Educative approach

Which approach targets health beliefs and behaviors resulting from misperceptions?

Sharing unwanted information

What action in the educative approach is noted for not increasing understanding?

Problem-solving approach

Which approach assists with immediate problems or referrals to support groups?

Levels of Family Involvement

What did Doherty and Baird establish in 1987 to guide the depth of interaction with families?

Level 1

Which level involves minimal family involvement?

Individual patient

What is the primary focus of treatment at Level 1 of family involvement?

Medico-legal issues

What is the primary reason the family is involved at Level 1?

Level 2

Which level involves ongoing medical information and advice?

Health education

What is the focus at Level 2 of involvement?

Cognitive

What is the primary nature of the doctor's role at Level 2?

Level 3

Which level involves the provision of emotional support?

Probes deeper into the emotional impact

What does a doctor do at Level 3 in addition to health education?

CEA framework

What health counseling framework is an example of a Level 3 intervention?

Level 4

Which level involves systematic assessment and planned intervention?

Family dynamics

What does the doctor systematically assess at Level 4?

Breaking coalitions

What is an example of a structural intervention performed at Level 4?

Triangulation

What family dynamic might a doctor try to identify and address at Level 4?

Level 5

Which level involves family therapy?

Specialty training

What is required for a doctor to perform Level 5 interventions?

Dysfunctional families with deep issues

For whom is Level 5 intervention primarily reserved?

Intergenerational abuse or addictions

What are two examples of deep-seated issues requiring Level 5 therapy?

Level 3

By year levels eight and nine, which level of intervention should a physician be able to provide?

Level 4

Which higher level of intervention is also possible for physicians who assess if families hinder healing?

Active and supportive allies

What is the goal of empowering families during the patient care process?

Deliberate choice

How is the depth of family involvement described in the summary?

Transactional patterns

According to Minuchin, through what patterns does a family operate?

Hierarchy and boundaries

What must a family structure have to adapt, according to the structural approach?

Agreed-upon ways of dealing with each other

How are rules defined within the family system?

Explicitly stated rules

What are overt rules?