Helping Families Change: From Clinical Interventions to Population-Based Strategies

Abstract

The family provides the fi rst, and most important, social, emotional, interpersonal, economic, and cultural context for human development and, as a result, family relationships have a profound infl uence on the well-being of children and parents. The parent-child relationship has a pervasive infl uence on the psychological, physical, social, and economic well-being of children. Disturbed interpersonal relationships within the family are generic risk factors and positive interpersonal relationships are protective factors that are related to a wide variety of mental health problems from infancy to old age (Sanders, 1995). Many signifi cant mental health, social, and economic problems are linked to disturbances in family functioning and the breakdown of family relationships (Chamberlain & Patterson, 1995; Patterson, 1982; Sanders & Duncan, 1995). Epidemiological studies indicate that family risk factors such as poor parenting, family confl ict, and marriage breakdown strongly infl uence children’s development (e.g., Cummings & Davies, 1994; Dryfoos, 1990; Robins, 1991). Specifi cally, a lack of a warm positive relationship with parents; insecure attachment, harsh, infl exible, rigid, or inconsistent discipline practices; inadequate supervision of and involvement with children; marital confl ict and breakdown; and parental psychopathology (particularly maternal depression) increase the risk that children develop major behavioral and emotional problems, including substance abuse, antisocial behavior and juvenile crime (e.g., Coie, 1996; Loeber & Farrington, 1998).