Family Resilience Framework Research Articles

Family Resilience in Patients With Schizophrenia: Potential Influencing Factors and Mediating Effect.

To identify the determinants of family resilience in the recovery of individuals with schizophrenia using Walsh's family resilience framework. A cross-sectional study. In Northeast China, 403 patients diagnosed with schizophrenia were enrolled for this study, assessing family resilience, family communication, social support, illness knowledge, hope and family functioning. Regression analyses were conducted using SPSS 27.0, and mediation effects were examined using Mplus 7.0. Logistic regression showed that female gender and having a sibling as a caregiver were negatively associated with family resilience, while a higher educational level was positively associated. Mediation analysis showed that family functioning and hope levels mediated the impact of family communication, social support and disease knowledge on family resilience, confirming their crucial roles. Family functioning and hope are central in mediating the relationships between family communication, social support, illness knowledge and family resilience in families dealing with schizophrenia. The findings of this study enable psychiatric nurses and policymakers to devise intervention strategies that enhance family resilience among patients with schizophrenia, thereby facilitating their recovery and well-being. No patient or public engagement.

Understanding Family Resilience in Young-Onset Dementia: A Multiple Case Study.

Through the lens of family resilience, exploring the experiences of families in adapting to young-onset dementia. Qualitative multiple case study. This study examined the family as a single unit of analysis, focusing on a triad including a person with young-onset dementia, their spouse and their adult child. Three family triads were included. Data collection took place between April 20 and July 4, 2023, in South Korea. Data analysis involved a two-stage process, consisting of a directed content analysis based on the family resilience framework within cases, followed by a cross-case analysis to identify themes and unique patterns across cases. The study identified six key themes: (1) Stressors due to a young-onset dementia diagnosis, (2) perception of the young-onset dementia diagnosis, (3) degree of emotional connection, (4) coping approach to young-onset dementia, (5) availability and utilisation of external resources and (6) patterns of adaptation. Furthermore, our research uncovered the interplay between themes, and how adaptations patterns of families formed either resilient or non-resilient. Our triadic approach uncovered hidden family dynamics, emphasising family-centred care. This study provides insights into unique challenges and diverse adaptation processes, suggesting tailored interventions. This study emphasises the importance of family-centred care in young-onset dementia, recognising all family members as crucial clients. Also, we suggest that healthcare professionals should develop tailored treatment plans that reflect the unique needs of each family. This study presents the unique experiences of young-onset dementia families, laying the foundation for developing effective support strategies that reflect these insights. Additionally, we emphasise the utilisation of external resources and their existence, providing a comprehensive research direction. Our research follows the EQUATOR guidelines, specifically adhering to the COREQ guidelines. No Patient or Public Contribution.

Navigating Transnational Separation and Reunification: Resilience in Low-Income Chinese Immigrant Mothers

AbstractThe present study examines the experience of low-income Chinese immigrant mothers managing the reunification process with their young children after a prolonged transnational separation—either due to reverse migration separation (children born in the US but sent to live in China, then returned to the US later) or serial migration (the mother came to the US first, and the children followed years later). Grounded in a feminist family therapy and resilience framework, this qualitative study aims to understand the mothers’ experience through a strength-based perspective and a cultural lens. A phenomenological approach was used in this study to obtain qualitative data from interviews with nine Chinese immigrant mothers. Data were analyzed using the deductive approach of thematic analysis. Results highlighted mothers’ resilience in providing for the families’ needs, utilizing familial and community support, and their strategies to overcome adversities and parenting challenges. The participants demonstrate motivation to improve their children’s well-being by utilizing a range of public, school, and community resources and support from other Chinese parents. Areas where these mothers still needed support were also identified. Lastly, implications for clinical service with Chinese immigrant families are discussed.

Designing a resilience-based intervention program for children with cancer and their families: a study protocol.

Advances in pediatric oncology have significantly increased survival rates, yet have introduced challenges in managing long-term treatment side effects. This study process introduces an interdisciplinary clinical intervention program rooted in the family resilience framework, aimed at improving well-being across the cancer trajectory for children and their families, especially those in Canadian communities far from specialized oncology centers with limited access to resources. Employing an intervention mapping approach, this program collaboratively involves patients, families, professionals, and researchers. It aims to identify vulnerability factors, establish a logic model of change, and devise comprehensive strategies that include professional interventions alongside self-management tools. These strategies, tailored to address biopsychosocial and spiritual challenges, are adapted to the unique contexts of communities distant from specialized cancer treatment centers. A mixed-methods approach will evaluate program effectiveness. Anticipated outcomes include the empowerment of families with self-management tools and professional support, designed to mitigate biopsychosocial and spiritual complications. By addressing the specific needs and limitations of these communities, the program strives to improve the overall health and well-being of both undergoing treatment and survivorship phases. By focusing on comprehensive care that includes both professional interventions and self-management, this initiative marks a significant shift toward a holistic, family-centered approach in pediatric oncology care for remote communities. It underlines the necessity of accessible interventions that confront immediate and long-term challenges, aiming to elevate the standard of care by emphasizing resilience, professional support, and family empowerment in underserved areas.

Factors influencing postdeployment reintegration adjustment for U.S. service members and their spouses by spouse gender

ABSTRACT Research on spouses’ adjustment after military deployment has focused primarily on female spouses of male service members; little is known about how adjustment differs by gender. We used Walsh’s family resilience framework to examine communication, belief system, organizational factors, and other stressors, likely associated with postdeployment adjustment. Using Millennium Cohort Family Study data, logistic regressions assessed risk and protective factors on spouses’ and service members’ time to adjust, exploring whether spouse gender moderated their associations. Findings indicated that the association of (1) spouses’ perceptions of their own mental functioning with spouses’ and service members’ adjustment and (2) spouses’ mental readiness for deployment with service members’ adjustment both differed by spouse gender, with associations attenuated for male spouses and their service member partners. Other factors associated with family adjustment included the spouse’s satisfaction with communication, the extent to which the service member shared deployment experiences, the extent to which the spouse was bothered by deployment experiences, the spouse’s participation in postdeployment transition programs, the spouse’s informal support during deployment, and length of deployment. Results indicated shared and gender-specific risk and protective factors associated with spouse and service member adjustment, demonstrating the importance of tailored military family support programs addressing the needs of different populations of military spouses.

Community members as design partners: Codesign workshops of the families tackling tough times together program

AbstractObjectiveThis community‐engaged codesign project identified the changes needed to tailor a family resilience‐building program, the Families Tackling Tough Times Together (FT), into a community setting.BackgroundThere is a need for low‐burden resources to help families mitigate stressful times and build resilience. Guided by Walsh's family resilience framework, FT aims to improve families' ability to cope, recover, and build resilience. Due to the success of FT during the COVID‐19 pandemic, the program is now being modified to help families in the state of Indiana.MethodThree codesign workshops were held with community service providers (CSP) and families. Participants engaged with the FT materials and discussions related to program usability and feasibility. Data were analyzed using a rapid analysis approach.ResultsCSPs stated that FT program materials fit with their goals and workload. Families felt the FT program aligned with their personal needs and day‐to‐day lives. Challenges and concerns with the FT materials included activities that required additional resources or that may be intimidating for families to complete. Both CSPs and families provided helpful suggestions on how to modify the materials.ConclusionThe FT program was well received by participants and was viewed as a valuable addition to the services CSPs offer. Modifications will be made to the FT materials based on knowledge gained from the workshops.ImplicationsThis work highlights the collaborative nature of the codesign process as well as the insights gained from participants regarding the use of the FT materials by CSPs as part of their routine service delivery with families in the community.

“We Want to Eat and be Healthy just like Everybody Else:” How Social Infrastructures Affect Nutrition Equity in a Racialized Urban Community in the United States

BackgroundFood security and nutrition equity, 2 social determinants of health, are impacted by the coronavirus disease 2019 (COVID-19) pandemic and the racialization of urban communities. Few studies to date have examined how the use of social infrastructures in the United States during COVID-19 affected the ability to achieve food security and nutrition equity. ObjectivesTo describe how the use of social infrastructures impacts food security and nutrition equity in a majority Black and urban community in the United States. MethodsSemistructured in-depth interviews were conducted with 40 low-income, urban, and predominately Black people living in Buffalo, New York in May–July 2022.A thematic analysis using a phronetic iterative approach informed by the Social Ecological Model, Walsh’s Family Resilience Framework, and a framework focused on the advancement of nutrition equity. ResultsWe identified 9 themes mapped across 3 interrelated domains that impact nutrition equity, including 1) meeting food needs with dignity, 2) supply and demand for fresh and healthy foods, and 3) community empowerment and food sovereignty. We found that people used coping strategies, such as food budgeting and cooking skills, paired with different social infrastructures to meet food needs. People commonly used the Supplemental Nutrition Assistance Program and food pantries to meet food needs over receiving support from family members or friends outside of the household. Poverty, challenges accessing and affording healthy food, and the inability to reciprocate support to others undermined the advancement of nutrition equity despite social infrastructures being available for use. Historical and ongoing acts of disempowerment and disinvestment also hindered the advancement of nutrition equity. ConclusionsSustained, community-led investment is needed to address structural inequities preventing the advancement of nutrition equity. Social infrastructures should be expanded to inclusively support low-income populations, so wealth generation is possible to address the root cause of food insecurity.

Family resilience of families with parental cancer and minor children: a qualitative analysis.

Estimated 50,000 minor children in Germany experience a newly diagnosed cancer in one of their parents every year. Family resilience has proven to be an important concept against life crises. However, little research exists regarding family resilience in the context of parental cancer with minor children. Based on the "Family Resilience Framework," the aim of the study is to investigate the processes of family resilience of affected families. In addition, we explore which combinations of promoting family resilience processes can be characterized. As part of the mixed-method quasi-experimental interventional study "F-SCOUT," a qualitative content analysis was used to analyze the documentation of the "Family-Scouts" (a fixed contact person who advises, accompanies, and supports the families). Documentation was performed by families' study inclusion (T0), after 3 months (T1) and 9 months (T2) concerning current family situation, organization of everyday life, emotional coping, open communication within the family, and planned tasks. The N = 73 families had between one and six children. In 58 (79%) families, the mother had cancer. In the course of the analysis, a category system with 10 main categories and 36 subcategories emerged. Family resilience processes were described to different extents. Combinations of categories promoting family resilience were characterized by the use of social resources, flexibility, economic resources, and open communication. The findings are consistent with existing assumptions about family resilience in terms of the importance of social resources, family cohesion, mutual support, flexibility, open communication, and psychological well-being. In contrast to the findings of previous research, spirituality, and collaborative problem-solving indicate less centrality here. In turn, the findings on economic resources and information-seeking provide a valuable addition to the family resilience literature in the context of parental cancer with minor children. ClinicalTrials.gov, identifier NCT04186923.

The relationship between family communication and family resilience in Chinese parents of depressed adolescents: a serial multiple mediation of social support and psychological resilience

BackgroundFamily resilience plays a crucial role in helping depressed adolescents overcome challenges. However, studies examining family resilience in depressed adolescents are currently scarce. This study, guided by the family resilience framework, aimed to investigate the serial-multiple mediation of social support and psychological resilience between family communication and family resilience in Chinese families of depressed adolescents.MethodsIn 229 parents of adolescents with major depressive disorder, 20.1% comprises of fathers, while 79.9% comprises of mothers. The mean age of depressed adolescents was 14.84 (±1.76) years, and the mean age of parents of these depressed adolescents was 43.24 (±4.67) years. The Family Resilience Assessment Scale (FRAS), the Psychological Resilience of Parents of Special Children Questionnaire, and the Social Support Rating Scale, Family Assessment Device (FAD) were used to collected data. Descriptive, univariate, and Pearson correlation analyses were used in preliminary analyses. To explore mediation, we employed a serial-multiple mediation model (PROCESS model 6).ResultsFamily communication was positively correlated with family resilience, social support, and psychological resilience. Mediation analysis revealed indirect effects of family communication on family resilience, which were mediated solely by either social support or psychological resilience, or through multiple mediation pathways involving both social support and psychological resilience.ConclusionsFamily communication positively and directly affects the family resilience of depressed adolescents, and a higher level of social support and psychological resilience can help improve family resilience. These findings not only provide empirical evidence supporting the family resilience framework but also have practical implications for future family interventions targeting depressed adolescents.

Understanding Transgender and Non-binary Youth Mental Health Through the Family Resilience Framework: A Literature Review

Understanding Transgender and Non-binary Youth Mental Health Through the Family Resilience Framework: A Literature Review

Investigating challenges and family resilience among Chinese families with cross‐boundary students: A multisystemic approach

AbstractTargeting families with cross‐boundary students (CBSs, 跨境学童) who travel daily between Mainland China and Hong Kong for schooling, this study aimed to identify (a) the challenges that CBS families experience in their daily lives, especially during and following the 2019–2020 Hong Kong protest, and (b) the key resources and the interactions of these recourses within and across family systems that strengthened family resilience. Data from semi‐structured interviews with 15 parents of CBS were analysed using thematic analysis, following Walsh's family resilience framework and multisystemic resilience views. The results showed that CBS families encountered three sources of challenges: contextual challenges, chronic family challenges and structural challenges. Despite challenges, we found that six types of resources interacted across multiple levels within and outside of the family: collectivist‐minded view of resilience, hope and perseverance, acceptance and strive, emotional regulation of self and others, family harmony and economic and instrumental supports. These resources helped CBS families maintain family functioning, alleviate situational stress and facilitate family transformation. This study produced new knowledge about CBS families. Findings suggest that fostering the resilience of CBS families relies as much on the families themselves as it does on other structural supports.

Fostering Low-Income Family Resilience: Findings from Walsh Family Resilience Framework in Tapos Depok, Indonesia

The family has a pivotal role in social development, as it represents the fundamental unit of society that contributes to achieving the Sustainable Development Goals (SDGs). Consequently, policies geared towards enhancing family well-being, such as poverty reduction, health, and education, are indispensable. Inevitably, families encounter challenges and difficulties, especially for poor household with limited capacity and resources to buffer from shocks. Nevertheless, some families are able to rebound quickly and learn from their struggles, a phenomenon known as resilience. Family resilience denotes a family's strength capacity to rebound from adversity and emerge stronger and more empowered. Using a depth interview method in Tapos, Depok, West Java, Indonesia, this study examines family resilience based on Froma Walsh's Key Processes, analyzing the strengths that enable families to overcome adversity. Participants were selected through purposive sampling, comprising two underprivileged families that receive government social assistance. Despite coming from impoverished backgrounds, these families possess resilience values that enable them to effectively fulfill their social roles and realize their aspirations. The findings reveal that family spirituality, adaptability, family connectedness, and communities support facilitate family members to grow and thrive despite adversity.

Family Resilience in the Context of Migration: Exploring the Lived Experience of Filipino Migrants' School-Going Older Adolescent Children

Using Froma Walsh's Family Resilience Framework, this study explored the experiences of overseas Filipino workers' (OFWs) families as narrated by adolescent children of migrant parents. Ten (10) Filipino college-level older adolescents (five were female) served as participants in an in-depth interview. Their narratives explored key family resilience processes using a Deductive Qualitative Analysis using various domains of family resilience (i.e., family belief system, communication processes, and organizational patterns). The study found that: (1) The family adjusts belief systems to accommodate unsettling realities of international labor migration; (2) Roles change in the family to compensate for responsibilities fulfilled by the parent before leaving for another country; and (3) Communication processes were strained, but family members serve as moderators to ease tensions and maintain a pre-migration relationship. This study concluded that the family resilience framework is a robust lens through which migrant families' experiences can be understood. Families generally exert effort to maintain homeostasis and cope with migration's psychological and social costs. A resilience-focused model for addressing psychosocial needs is proposed. Processes more apparent to the Filipino family and opportunities for future research are also discussed.

Building family resilience: Qualitative perspectives from a multisite experimental study in intensive care units

AbstractObjectiveWe sought to explore how the family resilience framework may help us understand the relationship between patient‐ and family‐centered care interdisciplinary rounds and the stressors, resources, organizational, and systems context during critical illness of patients, their families, and the health care professionals providing the care in the intensive care unit.BackgroundFamily inclusion and engagement in patient‐ and family‐centered interdisciplinary rounds in the intensive care unit is a challenging and an under‐researched issue in critical care. Despite evidence that family presence can provide benefits to patients and family members, current literature still shows that family members are excluded.MethodWe examined qualitative data from patients, families, and health care professionals involved in a multisite experimental study using the family resilience framework, and Braun and Clarke's (2006) constructionist, contextualist approach to thematic analysis.ResultsWe learned that the participants' experiences and perception of family engagement during patient‐ and‐family‐centered care interdisciplinary rounds is centered around the family as the “synchronizer,” achieved with family acting as “moderator,” as an advocate, and as “therapeutic” that assisted the patients, family members, and health care professionals to be “feeling happy,” which also aided in providing “forewarning and mindfulness of the impermanence of life and imminence of death.”ImplicationsWe present and discuss our findings in the light of theoretical foundations and empirical support for the use of the Family Resilience Framework in critical care and propose how the framework can help implement policies and programs that will address the needs of patients and their families in this aspect of critical care.

Development and Validation of the Chinese Family Resilience Scale in Families in Hong Kong.

Family resilience is an important protective factor mitigating the negative impact of adversities on individuals and families. As there are very few validated measures of family resilience in the Chinese context, we have developed the Chinese Family Resilience Scale (C-FRS) based on the family resilience framework of Froma Walsh. In this paper, we outline the development and the validation of the C-FRS with reference to the socio-cultural context of Hong Kong. Based on content validation involving family experts, the initial 51 items were assessed in terms of their relevance, clarity, and representativeness. The results showed that these items possessed adequate content validity. In order to validate the 51-item measure, we examined its convergent validity, its factorial validity, and its internal consistency based on the responses of 1020 Chinese families (N = 2858 participants). After removing the items with unsatisfactory psychometric properties, we retained 35 items in the final scale. The results showed that the C-FRS scores were significantly related to family functioning, thus providing support for its convergent validity. This study also provided support for the conceptual model of Walsh (i.e., three high-order domains involving nine primary indicators). Most importantly, the measurement invariance tests showed that the dimensions of the C-FRS were invariant among fathers, mothers, and adolescent children. As the findings support the reliability and the validity of the 35-item C-FRS, we suggest that this measure can be objectively used to assess family resilience in Chinese communities.

Separate but not divided: Art-based inquiry on attachment and resiliency among displaced Puerto Rican families in Central Florida post Hurricane Maria

Hurricane Maria devastated Puerto Rico in September 2017. The destruction displaced and uprooted families. Combining the Person-Process-Place Attachment Framework and Walsh's Family Resilience Framework, we examined how families in migration negotiated cultural and geographical separation as a family resilience process. This study piloted an art-based inquiry method. Families co-created art postcards and posters prompted by themes. We conducted focus groups to discuss art pieces. Nine different Latino family units in central FL participated in the intervention and focus groups. Families expressed conflicted attachments through feelings about displacement in migration and those left behind due to opportunities in the new migration context. Through visual and verbal representations, they expressed a liminal tension in the process of relocation (detachment) with a family-driven resolve on resiliency (reattachment). Understanding the process of family separation and displacement has on resilience through attachment can lead to future development of family interventions and better understanding of how to foster resilience. Attachment theory and resiliency played key roles in the participating families' process of adaptation to new migration settings.

Emerging Ideas. Families Together: Supporting family resilience during the COVID‐19 pandemic

AbstractObjectiveThis study evaluated a rapidly developed program designed to support family resilience during the COVID‐19 pandemic.BackgroundGrounded in Walsh's family resilience framework, Families Tackling Tough Times Together (FT) disseminated weekly evidence‐informed content through a public Facebook group, partner organizations, and on a dedicated website.MethodFacebook and website analytics and weekly brief usage surveys (n with at least one = 74) documented program use, and pre‐ and post‐FT surveys (n with at least one = 49) assessed family connectedness, positive outlook, purpose in life, and stress.ResultsThe program was widely used and received favorable feedback. Participants reported less stress in weeks when they engaged in more program activities, and more family connectedness in weeks when they spent more time engaged in program materials. No significant changes were observed, however, in overall family resilience, self‐efficacy, family functioning, or stress.ConclusionThe FT program was widely used and appraised positively. Program involvement was favorably correlated with less stress and family connectedness within weeks, although long‐term changes post‐program were not observed.Implications for Emerging IdeasSocial media can be used as an effective mechanism for reaching families during times of adversity and provides preliminary data that can guide refinement of FT and other disaster‐responsive programs.

Economic Hardships and Intergenerational Support among Families in Internally Displaced Persons (IDP) Camps in Jos, Nigeria

ABSTRACT Plateau State, Nigeria has experienced multiple ethnoreligious crises including devastating changes to traditional herder–farmer clashes in rural areas. Destruction of lives and property of rural autochthons in crises locations led to internal displacements from their ancestral homes. Families flee to safety, sheltering in makeshift camps under compromising conditions with few basic resources and lost livelihoods. We studied the lived experiences of internally displaced persons (IDP) in a camp, the nature of intergenerational exchange among family members and how the family structure has been affected and thrives in crisis situations. The family resilience framework and the life course theory were employed to understand constraints and agency of displaced families. Qualitative research methods were used to study IDPs living in the Geo-Sciences Camp in Jos. Two focus group discussions (FGDs) were conducted in Hausa with adult female and male occupants, interviews with key informants and observations. FGD transcripts were translated to English, coded and analysed thematically. We found that the conflict had inflicted severe poverty on IDPs. They lost most material possessions, sources of livelihood and became dependent on charity to meet their basic needs. Marital relationships and gender roles changed. Parenting roles were affected in duties of provision, nurture and discipline. Critical aspects of family life were managed by ill-trained volunteers, with major support coming from international non-governmental organisations (INGOs)/non-governmental organisations (NGOs), charitable/faith-based organizations and the public with little government presence. Recommendations include reorganisation of IDP camps prioritising family spaces, robust trauma care services and more proactive governance of IDPs to restore them to secured communities.

Exposing the Mythology of Balance and the Ecology of Graduate Student Mother Resilience in COVID-19

While the COVID-19 pandemic has amplified the once marginalized conversation of academia’s gendered imbalance of opportunity, discussion of its impact on graduate student mothers has remained absent. Resilience has been cited as key to overcoming in the pandemic era with little discussion of how its conceptualization continues to marginalize females in the academy. Our phenomenological study explores graduate student mothers’ conceptualizations of balance, failure, success, and resilience using a family resilience framework which acknowledges the multiple identities to which they may avow and contexts in which they may operate. Employing an ecological conceptual framework, we engaged nine graduate student mothers and their children in focus groups and analyzed data using a constructivist grounded theory approach. Our research found that many graduate student mothers’ definitions of success led them to delay qualifying exams and comps during the pandemic. Our exploration of the ecology of our participants’ resilience during quarantine begins the generation of a new graduate student mother resilience theory in which the ability to overcome adversity is rooted in celebration, gratitude, collaborative problem-solving, connection, and flexibility. We recommend continued development of this new theory and provide insight into the supports higher education can offer to address the leaky academic pipeline.

Combining Family Systems Approaches to Address BIPOC Families' Racial Trauma Amidst the Global Pandemic.

The ACE study (Felitti et al., 1998) led to the recognition of the prevalence and impact of trauma. However, since the ACE study sample was mostly white and middle class, the Philadelphia task force implemented their own study to account for trauma of a more diverse sample. A result of the study was a list of evidence-based treatments to be utilized with BIPOC populations. Of the evidence-based treatments was, ecosystemic structural family therapy (ESFT). A similar effective approach is the family resilience framework. When combined, the approaches can be effective with BIPOC families during the global pandemic and racial trauma, something not typically at the forefront of family counseling goals. In this article, I explain the four steps family counselors should follow when combining the approaches to better approach and treat racial trauma while also partaking in effective advocacy to enhance family resilience of BIPOC families. A case study is provided for family counselors to understand how to effectively utilize this combined approach.