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Calgary family assessment intervention model
Calgary family assessment intervention model
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The Calgary Family Assessment and Intervention Model is broken down into three categories: Structural (family composition, race, social class), developmental (stages, tasks, attachments) and functional (activities of daily living, communications, beliefs) (Kaakinen et al., 2015). This assessment is used for outpatients and community based patients. It is a multidimensional approach to assessing a family’s structure, function, affective and behavioral components (Kaakinen et al., 2015). The purpose of this assessment and intervention is to promote health changes that improve family stability or maintain family stability. The assessment is also used to identify how one family member can affect all family members. When assessing Bernetta Bold,
I would like to address her mental health issue of being isolated and possible depression related to her husband’s death. It is important to address how her mental health status is impacting the family unit, and how the rest of the family is coping in relation to this issue as well as their communication patterns. Another key factor to look at would be the extent of her relationship with her children now in comparison to before the passing of her husband. This could determine the functionality of the family unit.. The loss of a significant other in the older adult years can exacerbate depression symptoms. To preserve the quality of life and reduce the risk of the problem becoming chronic it is important to thoroughly assess how the patient is coping with these significant life changes (Sikorski et al., 2014).
The movie utilized for this assignment was What’s Eating Gilbert Grape. This movie explored the life of the Grape family consisting of Gilbert, Ellen, Arnie, Bonnie and Amy. (Hallström, Blomquist, Matalon, Ohlsson, Teper 1993). The movie reveals the struggles that the family face while raising Arnie who had a chronic mental illness (Hallström et al., 1993). This paper will discuss the priority concerns and corresponding interventions that are pertinent for the Grape family based on thorough use of the Calgary family assessment model. The focus of this papers assessment on the family will be on the functional aspect; however the structural and developmental aspects have been assessed.
Family therapy is often needed when families go through transitions such as separations between parents and divorce. According to research, “the power of family therapy derives from bringing parents and children together to transform their interactions” (Nichols, & Davis, p.18), as problems need to be addressed at their source. The children who are the most vulnerable, when parents decide to separate, exhibit symptoms which are exaggerations of their parent’s problems (Nichols, & Davis, p.18). Frank and Walt Berkman are the examples of how children cope and adapt to the stressors of family separations such as marital separations and
Mental illness can have a tremendous effect on not only the individual suffering, but to their family. "Mental illness often has a ‘ripple effect’ on families, creating tension, uncertainty, troubled emotions and big changes in how people live their lives" ("Families and friends"). A family member who suffers from a mental illness can have a great impact on numerous physical, psychological and social aspects of the family. Creating nursing priorities can help to create developmental and behavioral functions of a family to help the family bond and cope with a mental illness. The film “What’s Eating Gilbert Grape” by Lasse Hallstrom, portrays a family who struggle to cope with the enormous impact that a mentally challenged child “Arnie” can have on a family. Although the whole family is involved in Arnie’s care, it is clear that Gilbert, Arnie’s older brother, takes on the primary giver role. Throughout the movie, many scenes tend to dramatically show the amount of stress, frustration, aggression, and separation on the family that is ultimately created from Arnies mental illness. In this paper we are going to discuss the impact of chronic illness on the grape family, two family centered priorities we have chosen using the Calgary Family Assessment Model and one nursing intervention for each priority using the Calgary Family Intervention Model.
Structured Family Therapy (SFT) refers the mere undesignated rules that structure how a family interacts with one another (Walsh, 2010). The family unit is composed of systems or parts, and the parts must be unified to compile a whole unit to create homeostasis (Broderick, 1993). SFT therapy is warranted when dysfunction enters the family unit, and creates a deficiency of adaption by the individual which disrupts the family structure (Boyle, 2000). The family structure is composed of major components such as: subsystems, executive authority, boundaries, rules, roles, alliances, triangles, flexibility, and communication (Walsh,
Structural therapy focuses on the family as a whole. It is concerned about how the issues effect the family relationships and connections. This theory concentrates on how well the understanding is amongst the family members and counselor. The members of the family are prompted to understand how the issues were created, where did the issues come from, when the issues started effecting their family, and what the family needs to overcome their issues. Its focus is to help others understand and improve negative behavior. The structural therapy concentrates on the interaction and boundaries of families with separating the whole family into smaller groups. The subsystems will create a clearer understanding of what issues are hurting their family environment (Gladding, S. T. 2010). The counselor is concerned about the members interaction because this reveals how strong the relationships and connections are in the home. The boundaries are important because they create an understanding that there are limits and order, and the boundaries can be diffused, rigid, or clear (Gladding, S. T. 2010). The counselor is expected to identify techniques so members can understand which boundaries are clear, positive, and healthy (Gladding, S. T. 2010).
Friedman Family Assessment Method is a very helpful tool for assessing a family. It assesses the social, spiritual, physical, and psychological, among other aspects of a family. Analysis of the assessment data using the Friedman model, allow nurses to develop a plan to improve family health and to live a healthy life. The assessment of the Smith’ family was a great experience as it exposes one to different aspects of community health.
The Calgary Family Assessment Model (CFAM) is a well-known comprehensive and multidimensional template used by nurses to assess families. CFAM begins by having the nurse visit with the family and gain insight on the family’s functioning at a particular point in time. Interviewing the family allows the nurse to assess and identify potential issues. Furthermore, the CFAM consists of three main assessment categories, known as structural, developmental, and functional. Each of these categories contains several subcategories that allow the nurse to examine all aspects of a family’s functioning. The goal of the CFAM is for the nurse to openly discuss family issues, provide insight to families from an outside perspective and guide them towards their own problem solving tactics. CFAM allows families and nurse to develop a plan of care that is mutually agreed upon. The following paper illustrates a family assessment completed using the CFAM and applies nursing diagnoses and interventions relevant to the family’s current issues (Wright & Leahey, 2013).
According to Richard Charles (2001) “the effectiveness of family systems theory rests not much on empirical research but on clinical reports of positive treatment outcomes, the personal benefits experienced by the families that underwent this kind of treatment, and the elegance of Bowen’s theory” (p. 279). Bowen’s family systems theory views the family as an emotional unit and is a theory of human behavior. Systems thinking is used to describe the complex interactions in the unit. However, the client’s ability to differentiate himself/herself from the family of origin is the basis for Bowen’s family systems theory. In addition, the primary focus for growth within the emotional system is differentiation of self.
Kaakinen, Gedaly-Duff, Coehlo & Hanson, (2010) report family is the biggest resource for managing care of individuals with chronic illness; family members are the main caregivers and provide necessary continuity of care. Therefore, it is important for health care providers to develop models of care based on an understanding what families are going through (Eggenberger, Meiers, Krumwiede, Bliesmer, & Earle, 2011). The family I chose to interview is in the middle of a transition in family dynamics. I used the family as a system approach as well as a structure-function theoretical framework to the effects of the changes in dynamic function. Additionally, the combinations of genogram, ecomap, adaptations of the Friedman Family Assessment model as well as Wright & Leahey’s 15 minute family interview were utilized.
Structural Family Therapy offers a framework that provides order and meaning within the family connections (Nichols, 2013). Divorce for a family is considered a significant transition for all parties involved. When counseling a family going through divorce the structural family therapist’s job is to build an alliance with the family and obtain information about the structure. The structure of the family consists of the roles, interactions, organization, and hierarchy. Family therapy yields the belief that changing the organization of the family leads to change in the individual members. The structural family therapist often will try to become part of the family to gain a perspective of their issues as whole so not to place the focus on one individual. Joining is an empathetic approach in helping families explain and break down their individual stories without uncomfortable challenge or unnecessary confrontation (Nichols, 2013). It is important to note that family dysfunction that often leads to divorce is not attributed to one individual, but the entire family system. In structural family therapy, part of dealing with the issue of divorce in the family is to focus on the interactions between all the family members both positive and negative. Through these interactions the therapist can discover where the conflicts arise, which will in turn help the therapist understand how these negative interaction affect the family. Family therapy in these cases allows for repair of long-standing interactional patterns in which divorce is just one of a series of ongoing transactions that are disruptive to the child’s development (Kaplan, 1977, p.75). The structural family therapist often has the family play out these family interactions via enactments so that he can get a firsthand look at maladaptive patterns, roles, and
Corey states (2012), “attempts at change are best facilitated by working with and considering the family or set of relationships as a whole. Therefore, a treatment approach that comprehensively addresses the family as well as the “identified” client is required. Because a family is an interactional unit, it has its own set of unique traits. It is not possible to accurately assess an individual’s concern without observing the interaction of the other family members, as well as the broader contexts in which the person and the family live”.
A systems based treatment plan is necessary when working with this family and a systemic assessment is needed to accomplish this. “A systemic assessment will typically reveal that marital and/or parenting issues are contributing to the presenting problem” (Gehart, p. 37, 2016). The therapist will start by using a genogram. A genogram was used to analyze the Andersen family, as it is a structured way of collecting information about the family. It allows the therapist to gather details and “identifies not only problematic intergenerational patterns, but also alternate ways for relating and handling problems” (Gehart, 2014, p. 237). A genogram is a visual representation of the family and their history that will display
intervention. Families in Society. Vol. 88, pg. 42. Proquest Direct database. Retrieved February 25, 2015.
Family health assessment is a process of getting information from the family about health promotion and disease-prevention activities. Family assessment includes nurse’s perceptions about family constitution, norms, standards, theoretical knowledge, and communication abilities. Marjorie Gordon (1987) proposed eleven functional health patterns as a guide for establishing a comprehensive nursing data base. These functional health patterns (2007) help organize basic family assessment information (Friedman et al., 2003) (Edelman & Mandle, 2010, p. 173-177).Eleven health functions are as follows. Health perception and / or health management pattern, nutritional pattern, elimination pattern, activity/exercise pattern, cognitive/perceptual pattern, sleep/rest pattern, self-perception and self-concept pattern, role/relationship pattern, sexuality/reproductive pattern, coping/stress tolerance pattern, and value/belief...
Family therapy is an important way of solving problems affecting family members. It demands the participation of the entire family in some of the sessions. Though working with the Kline family will present is set of challenges, the challenges are not unique and are part and parcel of counselling.