Family Systems Perspective Research Articles

Talking across generations: Family communication about BRCA1 and BRCA2 genetic cancer risk.

While family communication about a BRCA1 or BRCA2 (BRCA1/2) pathogenic variant can be a catalyst for the uptake of risk-reducing measures in young adults, disseminating information within families and across generations is complex. This study aimed to explore how young adults and their families communicate about a BRCA1/2 pathogenic variant, from a family systems perspective. In-depth family interviews and questionnaires (N=67 individuals; 21 families) were completed at four metropolitan and regional genetic clinics in Australia. Data involved thematic analysis and interpretation based on family systems theory, including the use of standardized measures. Six key themes were identified and explored: (1) Responsibility to protect, (2) "It's a woman's problem," (3) Family culture influences communication, (4) Adversarial growth and connection, (5) Key events can be relational turning points, and (6) Health professionals can help. Family identities were solidified through the incorporation of a pathogenic variant in family scripts, while members of the family who held differing views to their families expressed less agreeableness and openness to disseminate information. The collective family's experience and perspective toward a pathogenic variant can influence a young adult's decision-making about genetic testing, risk-management, and family planning. The utilization of family therapy skills in routine practice would be helpful in facilitating communication and the inclusion of standardized measures is beneficial to identify individuals needing ongoing psychological support. Understanding relationship difficulties that arise from family members holding divergent views can offer insight into future research inquiry and areas of further training and clinical support.

Trajectories of mother-child and father-child relationships across middle childhood and associations with depressive symptoms.

Using a family systems perspective, we examined the trajectories of father-child and mother-child closeness and conflict across Grades 1, 3, 4, 5, and 6, and their associations with child depressive symptoms across middle childhood among 685 families in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (SECCYD). Father-child and mother-child relationship conflict increased, whereas relationship closeness decreased from Grades 1 to 6. Girls with more slowly increasing father-child conflict, and more slowly decreasing father-child closeness, were at lower risk for depressive symptoms. Boys with more slowly increasing mother-child conflict were at lower risk for depressive symptoms. These findings highlight the important roles of both father-child and mother-child relationships in children's emotional adjustment during middle childhood.

Stepfamily Closeness and Depression Among American Indian Emerging Adults: A Structural Equation Modeling Approach

Stepfamilies are one of the fastest growing family structures among all racial groups in the United States. Stepfamily research among many racial groups, specifically American Indians, is virtually nonexistent. This is unfortunate, as American Indians are more likely to divorce and remarry compared with other populations. From a family systems perspective, this study examined whether retrospectively perceived closeness in three stepfamily relationships, namely child–residential biological parent, child–residential stepparent, and child–stepsibling, were negatively associated with depression scores in 226 American Indian emerging adults. A structural equation model showed that increased child–residential biological parent and child–stepsibling closeness predicted decreased depression scores, whereas child–residential stepparent closeness did not. We also found that depression scores significantly predicted retrospective perceptions of child–residential biological parent, child–residential stepparent, and child–stepsibling closeness. Findings encourage interventions that strengthen American Indian child–residential biological parent and child–stepsibling relationships, and underscore the need for further research that explores American Indian stepfamily relationships.

The Role of Grandparents in Supporting Families of Children with Autism Spectrum Disorders: A Family Systems Approach.

A family systems approach is required to identify the needs of families of children with autism. This paper explores how grandparents support children with autism and their parents using a family systems perspective. A thematic analysis of eighteen semi-structured interviews was conducted with participants from nine families, capturing experiences of both parents' and grandparents'. Themes identified were family recalibrating; strengthening the family system; and current needs and future concerns of grandparents. The views of families indicated the overwhelming need to acknowledge the grandparental role in supporting families that strengthen the family system by supporting the needs of a child with autism. Findings revealed that grandfathers have a calming role in these families where children have significant behavioural difficulties.

Parental Knowledge Discrepancies: Examining the Roles of Warmth and Self-Disclosure.

Discrepancies between parents' and adolescents' reports in parental knowledge of adolescents' daily activities and whereabouts are common and have implications for adolescents' well-being and school success. Grounded in a family systems perspective utilizing reports from parents and adolescents, the goal of this study was to explore the extent to which parent-adolescent warmth and adolescent self-disclosure could account for discrepancies in parental knowledge by testing the indirect effects linking warmth to discrepancies in parental knowledge via adolescent self-disclosure. Participants were early adolescents (N = 172; 53% female) and their parents (90% mothers). Adolescents (57% African American/Black, 18% multiracial, 17% White/Caucasian, 7% Hispanic/Latino and 1% Asian American) attended a Midwestern, Title 1, urban, public middle school. Using structural equation modeling, findings showed that parent-adolescent warmth significantly predicted adolescent self-disclosure, which in turn predicted fewer discrepancies in parental knowledge. The findings from this study help in understanding the factors that contribute to parental knowledge discrepancies and highlight potential targets for family interventions.

Using family circles to increase competency and confidence in social work

ABSTRACTThe family circle instrument is a self-constructed diagram that has been used by family physicians for more than 40 years to gather and assess information about patients’ family connections and relationships. Even though healthcare professionals have found the family circle instrument to be effective and easy to administer, the literature is silent on social workers’ use of this instrument to engage and assess individuals and families. This article describes the effectiveness of the family circle interviewing method in increasing the confidence and skill of graduate social work students in assessing families. The author also presents the results of an evaluative study that examined graduate social work students’ use of the family circle instrument. Graduate social work students received instruction on how to administer the family circle interview as a method of engaging and assessing families from a family systems perspective. Thus, a primary focus of this article is upon how using the family circle interview can promote competency and confidence among students to engage and assess families. A majority of the students that completed family circle instruction felt the instrument helped them understand families from a systems perspective and increased their confidence in their ability to assess families.

Influence of Parental Alcohol Dependence Symptoms and Parenting on Adolescent Risky Drinking and Conduct Problems: A Family Systems Perspective.

Parental alcohol problems are associated with adverse adolescent outcomes such as risky drinking and conduct problems. Important questions remain about the unique roles of fathers' and mothers' alcohol problems and differences and/or similarities in pathways of risk across ethnicity and gender. In this study, we used a family systems approach to consider spillover and crossover effects of fathers' and mothers' alcohol problems (number of alcohol dependence symptoms [ADS]) and parenting behaviors in relation to adolescents' risky drinking and conduct problems. The sample included 1,282 adolescents (aged 12 to 17) and their parents from the Collaborative Study on the Genetics of Alcoholism. Parents completed the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA), and adolescents completed an adolescent version of SSAGA. Data were analyzed using multivariate structural equationmodeling. Fathers' ADS count was associated with higher adolescent risky drinking and conduct problems indirectly via disruption to fathers' and mothers' positive parenting behaviors, whereas mothers' ADS count was not associated with adolescents' risky drinking and conduct problems directly or indirectly via positive parenting behaviors. No differences in these associations were found across ethnic background and offspring gender. Findings highlight the importance of considering the unique roles of fathers' and mothers' ADS in influencing family processes and adolescent outcomes.

The Enneagram: An Enhancement to Family Therapy

The enneagram (pronounced any-a-gram) is an ancient tool consisting of nine points depicting personality styles. It is a tool that can be integrated into different theoretical approaches. The enneagram is adaptable to the unique style of each client and can aid a counselor in conceptualizing a client or family. This manuscript includes the enneagram theory integrated within a family systems framework. To demonstrate the enneagram’s compatibility with family systems perspective, the enneagram is presented to facilitate therapy with a couple. A case study is provided to demonstrate the effectiveness of the enneagram as a tool to promote awareness in the counseling relationship.

Couples coping with sensory loss: A dyadic study of the roles of self- and perceived partner acceptance.

Hearing-, vision-, and dual-sensory loss have been linked to relational and psychological distress among adults with sensory loss (AWSLs) and their spouses. Regardless, research on factors associated with couples' adjustment is lacking. This study examined the stability and strength of associations between self-acceptance of sensory loss, perceived partner acceptance of sensory loss, and relationship satisfaction and psychological distress among AWSLs and their spouses over time. A total of 122 AWSLs and their spouses completed an online survey at two time points over a 6-month period. A multigroup (i.e., time 1 and time 2) actor-partner interdependence model assessed the stability and strength of actor and partner effects of self-acceptance and perceived partner acceptance on each partner's relationship satisfaction and psychological distress over time. No moderation by time was identified, indicating stability in associations over the 6-month period. Overall, both actor and partner effects were evident. Specifically, self-acceptance among AWSLs was inversely associated with own psychological distress and the relationship satisfaction of spouses. Self-acceptance by spouses was inversely associated with the psychological distress of AWSLs and spouses. Perception of spouse acceptance by AWSLs was positively associated with own and spouse relationship satisfaction. Interventions targeting acceptance that incorporate a family systems perspective may be beneficial in alleviating psychological and relational distress among couples coping with sensory loss. Statement of contribution What is already known on this subject? The experience of hearing and/or vision loss has been linked to heightened distress both psychologically and within intimate relationships. Prior research has demonstrated a link between an individual's ability to accept their sensory loss and healthier well-being. What does this study add? This is the first dyadic study of sensory loss acceptance and its link to relationship satisfaction and distress. Acceptance operates interpersonally protecting against distress for those with sensory loss and their spouses. Perceiving that one's spouse accepts the sensory loss is important for both partner's relationship satisfaction.

Exposing the role of coparenting and parenting for adolescent personal identity processes

In line with a family systems perspective, this study examined the association between two aspects of family climate, that of coparenting (cooperation, triangulation) and parenting (autonomy support, dependency-oriented and achievement-oriented psychological control) and their relation to adolescent personal identity formation (commitment making, identification with commitment, exploration in breadth, exploration in depth, ruminative exploration, reconsideration of commitment). Using structural equation modeling (SEM), we tested the hypothesis that coparenting would be associated with adolescent identity formation via parenting. Cross-sectional self-report data were collected from 1,105 Swiss adolescents (aged 13–18 years; 51% female). SEM revealed associations between coparental cooperation and more adaptive identity formation via parental autonomy support. Conversely, coparental triangulation was associated with maladaptive identity dimensions via parental dependency-oriented psychological control. These associations were not moderated by age, gender, or family structure.

Family Relationships and Youth Sport: Influence of Siblings and Parents on Youth's Participation, Interests, and Skills

Taking a family systems perspective, the present study investigated how older siblings’ and parents’ (mothers’ and fathers’) interests, skills, and participation in sports predicted younger siblings’ attitudes and behaviors in those same domains. Testing social learning principles, we further examined whether family members’ influence was stronger when they shared warmer relationships and siblings shared the same gender. Participants included mothers, fathers, and adolescent-aged first and second-born siblings from 197 maritally intact families. Families participated in home interviews as well as a series of 7 nightly phone calls during which participants reported on their daily activities. Across dependent variables, results revealed that parents’ and (with one exception) older siblings’ qualities were predictive of younger siblings’ interests, skills, and participation in sports. Inconsistent with hypotheses, however, family members’ influence was not moderated by relational warmth. Discussion highlights the need to examine the socialization processes by which siblings shape each other’s sport-related attitudes and activities.

The Role of Parental Posttraumatic Stress, Marital Adjustment, and Dyadic Self-Disclosure in Intergenerational Transmission of Trauma: A Family System Approach.

Research indicates that posttraumatic stress symptoms (PTSS) induced by war trauma may be transmitted to veterans' wives and offspring (secondary traumatic stress; STS). However, the interplay between family members' characteristics has not been accounted for in such processes. Taking a family systems perspective, we examine the contributions of fathers' PTSS, mothers' STS, marital adjustment, and self-disclosure of both parents to offspring's STS and test whether marital quality applies as a mechanism of parent-child transmission. Combat veterans and former prisoners of war (N=123), their spouses, and adult offspring were investigated in a multiple-step mediation analysis. The results highlight the mother's crucial role in trauma transmission and suggest that strengthening the marital relationship may buffer the transmission of fathers' PTSS to offspring.

Mothers', fathers', and siblings' perceptions of parents' differential treatment of siblings: Links with family relationship qualities

A family systems perspective directs attention to the potentially different experiences and perspectives of family members. This study examined parents' differential treatment (PDT) of siblings, discrepancies between parent and youth reports of PDT, and their links with relationships between adolescents and their mothers and fathers across three years. Participants were first- (Time 1 M age = 15.71, SD = 1.07) and secondborn (Time 1 M age = 13.18, SD = 1.29) siblings from 381, predominately white, working and middle class families. Analyses revealed that siblings' perceptions of being favored predicted less conflict with and greater warmth from both mothers and fathers, primarily for secondborn adolescents. Larger discrepancies between maternal and youth reports of differential affection were linked to more maternal conflict and less warmth for firstborns. These findings may suggest a hierarchy within families: parents may serve as referents for firstborns and firstborns as referents for secondborns.

子どもの発達と母子関係・夫婦関係 : 幼児を持つ家族について

子どもの発達と母子関係・夫婦関係 : 幼児を持つ家族について

School Counselors’ Perceptions of Family Systems Perspectives

School counselors traditionally have been trained in individual models and often lack the training in a family systems perspective that is necessary to provide a comprehensive school counseling program. One project 10 years ago empirically studied school counselors’™ perceptions of the importance of utilizing a family systems perspective when working with children and families. The present study updated this information, and determined how prepared and competent they felt, and how frequently they use a family systems perspective. A total of 657 school counselors completed 56 online questions about a family systems approach, including its importance, their preparedness, rating of their own competency, frequency of use, how they learned about family systems, and barriers might prevent use. Less than half (39%) reported taking a course in family systems, but more than half (87%) said that such a course should be required. They used family systems daily or at least several times per week. Overall, the more methods they used to learn about family systems, the more important they rated it, the more prepared and competent they rated themselves, and the more frequently they used this approach. Many (79%) responded to the open-ended question about barriers and often mentioned barriers such as lack of training (23%), lack of parental involvement (18%), and time (18%). In both quantitative and qualitative data, most school counselors recognized the importance of requiring a family systems course in their training curriculum. Lack of this kind of course may be leaving counselors unprepared to respond to student needs.

Cancer Risk Information Sharing: The Experience of Individuals Receiving Genetic Counseling for BRCA1/2 Mutations

Genetic counseling and testing for familial cancer is a unique context for the communication of risk information in the family. This study utilized a theoretical framework based on the family systems perspective to understand intrafamilial cancer risk communication patterns in the Ashkenazi Jewish population. Individuals (n = 120) at an elevated risk for BRCA1/2 mutations were included. Change in communication patterns over time was assessed using McNemar tests. Associations with communication patterns were assessed with multivariable logistic regression. Overall, the proportion of participants encouraged by others significantly (p < .001) increased from before to after genetic counseling. A higher proportion of participants were encouraged by female family members compared with male family members. Participants who were older, had no personal history of cancer, and had a higher cancer risk perception were more likely to be encouraged by others for genetic testing. Participant’s intent to encourage family members for genetic testing from before counseling to after receipt of genetic test results decreased by 16.7%. Participants who had no personal history of cancer and had informative test results for a BRCA1/2 mutation were more likely to encourage other family members for genetic testing. In addition, qualitative findings suggested that closeness among family members, concern for family, especially future generations, and cognizance about cancer risk facilitate information sharing and encouragement for genetic testing. Our findings indicate that intrafamilial cancer risk communication varies with the structure of family relationships and that genetic counseling can play an important role in improving intrafamilial cancer risk communication.

MARRIAGE AND DISSOLUTION AMONG WOMEN'S COHABITATIONS: VARIATIONS BY STEPFAMILY STATUS AND SHARED CHILDBEARING.

Cohabiting unions increasingly involve children, either born during the union and/or from prior relationships (i.e., stepchildren). Drawing from arguments about the institutionalization of cohabitation and stepfamilies as well as the family systems perspective, this paper examines dissolution and marriage risks among women's cohabiting unions by stepfamily status, configuration (which partner has children) and shared intended and unintended fertility using the 2006-2013 National Survey of Family Growth. A minority (32%) of 1st cohabitations, but the majority of 2nd (65%) and 3rd (75%) cohabitations, are stepfamilies. Stepfamily cohabitations are less likely to transition to marriage compared to non-stepfamily unions, especially among complex stepfamilies (both partners have children), but neither stepfamily status nor configuration affect dissolution. Shared intended and unintended births are associated with dissolution and marriage risks but largely only for non-stepfamily cohabitations, suggesting that shared childbearing is only indicative of the institutionalization for cohabitations that are not stepfamilies.

Applying a family systems lens to proxy decision making in clinical practice and research.

When patients are incapacitated and face serious illness, family members must make medical decisions for the patient. Medical decision sciences give only modest attention to the relationships among patients and their family members, including impact that these relationships have on the decision-making process. A review of the literature reveals little effort to systematically apply a theoretical framework to the role of family interactions in proxy decision making. A family systems perspective can provide a useful lens through which to understand the dynamics of proxy decision making. This article considers the mutual impact of family systems on the processes and outcomes of proxy decision making. The article first reviews medical decision science's evolution and focus on proxy decision making and then reviews a family systems approach, giving particular attention to Rolland's Family Systems Illness Model. A case illustrates how clinical practice and how research would benefit from bringing family systems thinking to proxy decisions. We recommend including a family systems approach in medical decision science research and clinical practices around proxy decisions making. We propose that clinical decisions could be less conflicted and less emotionally troubling for families and clinicians if family systems approaches were included. This perspective opens new directions for research and novel approaches to clinical care. (PsycINFO Database Record

Parent-child relationship quality and family transmission of parent posttraumatic stress disorder symptoms and child externalizing and internalizing symptoms following fathers' exposure to combat trauma.

Transactional cascades among child internalizing and externalizing symptoms, and fathers' and mothers' posttraumatic stress disorder (PTSD) symptoms were examined in a sample of families with a male parent who had been deployed to recent military conflicts in the Middle East. The role of parents' positive engagement and coercive interaction with their child, and family members' emotion regulation were tested as processes linking cascades of parent and child symptoms. A subsample of 183 families with deployed fathers and nondeployed mothers and their 4- to 13-year-old children who participated in a randomized control trial intervention (After Deployment: Adaptive Parenting Tools) were assessed at baseline prior to intervention, and at 12 and 24 months after baseline, using parent reports of their own and their child's symptoms. Parents' observed behavior during interaction with their children was coded using a multimethod approach at each assessment point. Reciprocal cascades among fathers' and mothers' PTSD symptoms, and child internalizing and externalizing symptoms, were observed. Fathers' and mothers' positive engagement during parent-child interaction linked their PTSD symptoms and their child's internalizing symptoms. Fathers' and mothers' coercive behavior toward their child linked their PTSD symptoms and their child's externalizing symptoms. Each family member's capacity for emotion regulation was associated with his or her adjustment problems at baseline. Implications for intervention, and for research using longitudinal models and a family-systems perspective of co-occurrence and cascades of symptoms across family members are described.

Alexander, P. C. (2015). Intergenerational cycles of trauma and violence: an attachment and family systems perspective. New York, NY: W.W. Norton &amp; Company, 370 pp. $39.95.

Alexander, P. C. (2015). Intergenerational cycles of trauma and violence: an attachment and family systems perspective. New York, NY: W.W. Norton &amp; Company, 370 pp. $39.95.