Family Systems Research Articles

Feasibility of a complex psychosocial intervention for families with parental cancer: acceptability, suitability, implementability, and perceived support

PurposeThis study aimed to assess the feasibility of a comprehensive psychosocial intervention for families coping with parental cancer.MethodsA quasi-experimental trial with intervention and control group, employing a mixed-methods approach, was conducted. A total of 472 families affected by parental cancer participated. The feasibility of the intervention was evaluated based on study monitoring measures (on-site visits, team supervision meeting observations, case conference observations, best practice workshops, coordinating information exchange between intervention sites, and reviewing intervention documentation), process evaluation (semi-structured interviews, focus group discussion) and survey data. Data analysis involved thematic coding and descriptive statistics.ResultsThe intervention was well-received by the participating families, with a high degree of acceptance observed. The feasibility of the intervention was found to be associated with specific dynamics within each family system and the motivation of the family members. The success of the intervention was described as dependent on the family-centered arrangement of the encounters, including factors such as frequency, duration, and mode, which greatly influenced its overall acceptability.ConclusionThe family-scout intervention demonstrates its feasibility as an effective intervention to reduce the burden experienced by families coping with parental cancer. Psychosocial oncology services should continue to develop and implement family-centered interventions to offer support to families during their cancer journey.Trial registrationClinicalTrials.gov, NCT04186923. Retrospectively registered on 4 December 2019.

Family Systems Dialectical Behavioral Therapy: A Proposed Clinical Synthesis

Dialectical behavioral therapy (DBT) has been well documented as an effective treatment for individuals with intense emotions. A comprehensive family model that addresses family systems utilizing DBT has yet to be developed. This article presents a model for DBT for a family system that goes beyond serving the individual and utilizing the family system for support. The theoretical concepts of DBT named “family systems (FS)DBT” are reviewed. The author reviews the current literature of DBT, how (FS)DBT addresses the dialectic of acceptance and change, how the complex model of individualized therapy such as DBT could be systematically applied to a complex and changing family system through psychoeducation, and the remaining phases of (FS)DBT. This proposed comprehensive model for doing (FS)DBT will have significant implications for clinicians working directly with complex FS that have multiple family members with intense emotions.

Navigating the Gap Between Correlational and Intervention Studies of Fatherhood and Children’s Development: A Family Systems Ecological Perspective

SYNOPSIS Objective. In fatherhood research, a large gap has emerged between correlation-based studies and the design of interventions to increase the quantity and quality of fathers’ involvement in their families. The correlational research suggests that all family members could benefit from fatherhood intervention designs that attempt to reduce risks and strengthen protective conditions in multiple family domains—an approach consistent with family systems theories and ecological theories of child development. But most fatherhood interventions have been designed solely for fathers and focus primarily on parenting. Even in rare instances in which both parents are included in a father-focused parenting intervention, the curriculum rarely attends to the quality of relationship between the co-parents, despite the fact that this relationship is a prime correlate and predictor of father involvement and father-child relationship quality. Design. This narrative review describes the current gap between multidimensional correlational studies of fathers and families and the restricted designs of most father involvement interventions. We describe a family systems ecological intervention approach to bringing the correlational and intervention streams of fatherhood research closer together. Results. Evidence from empirical studies of correlations between risk/protective factors and outcomes supports a family systems ecological model of five domains relevant for inclusion in fatherhood intervention curricula and measurement protocols. Evaluations of interventions based on these five domains show that when both parents participate, the interventions have greater impact than interventions directed only to fathers. Fathering is not simply behavior that occurs between a father and his child. In addition to the quality of his direct interaction with his child, fathering is a dynamic product of his well-being, the quality of the relationship between the co-parents, the transmission of behavioral patterns across generations, and the balance between outside-the-family stressors and the supports available to cope with them. Conclusions. This family systems ecological approach has implications for theory testing, future intervention research, and policy decisions about fatherhood services.

A Sibling's Intuition: The Role of Sibling Approval for Romantic Relationships

Research has shown that family and peer relationships have an impact on the stability and quality of one's romantic relationships. According to family systems theory, family dyads are likely to impact the stability of romantic dyads within a system. Yet, little is known if and how one's sibling will impact the development and maintenance of that relationship. Therefore, the goal of this study is to understand how approval of a sibling's romantic relationship impacts the quality of that relationship. Participants ( N = 168) and their siblings ( N = 118) were recruited to participate in an online survey, which included questions regarding their current and previous romantic relationships, if applicable, their relationship with their sibling, and their approval of their sibling's previous and/or current relationship(s). Data was analyzed using moderation analyses and actor–partner interdependence models. Although regression results showed no effects of sibling approval for relationship quality for either current or past relationships, the path analyses revealed that when participants approved their siblings’ relationship, the satisfaction increased, but when the siblings approved of the participant's relationship, the satisfaction trended downward. Path analyses also showed that approval did not predict the satisfaction of either participant's or sibling's last relationship. In both models, sibling and participant approval significantly predicted each other. Last, sibling closeness was not found to moderate any of these relationships. These results show that sibling approval plays a role in romantic relationships, but the impacts vary depending on relationship context.

The Adoptee Consciousness Model: Integration with Family Counseling Theory and Practice

Transracial adult adoptee storylines are increasingly represented across media platforms, yet counseling practice guidelines for the population remain limited. The authors provide updated counseling strategies by applying the Adoptee Consciousness Model (ACM). Via a fictitious case study of one adult transracial adoptee, the authors integrate the ACM with three family systems theories. Recommendations for individual, couple, and family counselors and therapists are provided.

Parent–Child Relationship, Resilience Beliefs, Relationship Quality and Stress During the Pandemic in American Families: A Moderated Mediation Analysis

ABSTRACTThe study aims to investigate factors within the double ABC‐X model to explain parents' stress during the first wave of the COVID‐19 pandemic, with a focus on adaptive resources (i.e., parent–child relationship and relationship quality) and the moderating effect of appraisal (i.e., family resilience beliefs). Drawing on a sample of 1386 American parents, this study examines the moderated mediation effects to test the conditional indirect influence of a moderating variable (i.e., family resilience beliefs) on the relationship between a predictor (i.e., stressor pile‐up) and an outcome variable (i.e., stress) through potential mediators (i.e., family satisfaction and relationship quality). The results indicate that the relationship between stressor pile‐up and parent stress was mediated by both parent–child relationship and relationship quality. In addition, the direct association between the parent–child relationship and parent stress was moderated by family resilience beliefs. However, the moderation effects of family resilience beliefs on relationship quality and stress were not supported. Family resilience beliefs moderated the indirect effect of stressor pile‐up on parent stress through the parent–child relationship, but not through relationship quality. The study emphasized the contribution of stressors and adaptive resources in understanding parental adaptation and the role of the family system in maintaining well‐being during unprecedentedly challenging times.

The family and substance abuser in the mental health institution environment

Background: South African drug usage demographics are rare. Substance abuse disorder patients and their families have complex interactions. This study examines family members living with drug addict.Aim: The study seeks to investigate the experiences of family members living with a substance use disorder (SUD) individual.Setting: The research took place in a Gqeberha psychiatric facility. Low-income households were interviewed.Methods: This research is qualitative, exploratory, and descriptive study. Recorded and transcribed in-depth patient family interviews were collected. Qualitative thematic analysis was used to analyse data. The data themes were interpreted using family systems theory.Results: Each of the three main themes has subthemes. The first theme concerns family members’ inadequate comprehension of addiction. The subtheme explores family members’ denial and failure to recognize substance use disease symptoms. The second theme concerns variations in behaviour that challenge cultural norms. This subtheme addresses hallucinations, delusions, and fury in SUD patients. The third theme addresses the negative effects of drug use on families, potentially leading to divorce. This subtheme focuses on the family’s lack of awareness of resources that may have supported them and the SUD individual.Conclusion: Immediate family members are crucial to patient recovery. The family seemed to be struggling living with an SUD relative. Experts should help the family to manage the addict’s treatment. Healthcare education can help families cope with substance abusers.Contribution: This study will assist the nursing administration in discovering ways to help families manage a loved one with an SUD.

Vulnerability to incest – Findings from a comparative single-case study of the onset of intrafamilial child sexual abuse

Previous research about intrafamilial child sexual abuse was not able to identify specific risk factors that distinguish this unique subgroup from other sexual offending subgroups. In comparison to other groups of sexual offenders, men convicted of intrafamilial sexual child abuse (ICSA) are found to exhibit more similarities to non-offending fathers than extrafamilial sexual offenders. Consequently, the risk assessment of sexual recidivism among “incest offenders” lacks evidence-based evaluation criteria. Given the suggestion that family system factors should be included in research on the onset of ICSA, we employed the Vulnerability to Incest Model proposed by Trepper and Barrett (1989, https://doi.org/10.4324/9780203776605) in a qualitative single-case analysis. A comparative analysis of ten court evaluations of ICSA offenders revealed that all families in which ICSA has occurred demonstrated at least two vulnerability factors. The analyzed offenders exhibited comparable patterns of masculine sexual entitlement. The utility of this recently developed construct for sexual violence research is discussed and implications for further research proposed.

Bilingualism – between Family and Educational System. Case Study – Romanian Nationality in Méhkerék

This study examines the linguistic and cultural dynamics of the Romanian-speaking community in Méhkerék, Hungary, focusing on the impact of bilingualism within families and educational settings. The research investigates how bilingual families influence their children's language use in various contexts, including school, society, and social interactions. Through a survey of 110 parents in the village, the study explores language preferences, the choice of bilingual or nationality schools, and the perceived advantages of bilingualism. Results show that while Romanian remains significant in family and cultural contexts, there is a notable shift towards Hungarian among younger generations. The findings highlight the importance of family-school collaboration in promoting and preserving bilingualism, as well as the cognitive, social, and educational benefits it offers. The study emphasizes the evolving role of bilingualism in maintaining cultural identity and fostering linguistic diversity.

Post-Partum Depression: A Case Study of the Wife of an Expatriate Pakistani

This study aims to explore the experience of post-partum depression in a woman that is the wife of an expatriate Pakistani. It probes into the psycho-social factor that boost the chances of past-partum depression among woman who gone through the c-section while giving birth to her 4th child in her husband’s absence while living in joint family system. This case study reported a woman with postpartum depression; facing psychosocial pressures while living in joint family system in rural area of Punjab. Edinburgh post-natal depression scale used to analyse her post-partum depression and DSM- V as the determinant of diagnostic criteria which revealed that psychosocial pressures, attachment issues and lack of social support made her vulnerable. Postpartum depression has varying symptoms and psycho-social factors irritating its symptoms.

"Grief Explodes all Relationships": Experiences of Grief and Coping Among Parents and Siblings Following the Death of a Child.

The death of a child is an intense loss for families, which impacts the wellbeing of parents, surviving siblings, and the family as a whole. This study expanded on existing literature by collecting qualitative accounts from bereaved parents and siblings about their experiences before, during, and after the death of a child in their family. In total, 15 participants from 9 families completed semi-structured interviews. Findings highlighted three periods of the grieving process, which were not linear but rather ongoing and often happening simultaneously: (1) Crisis; (2) Learning to cope; and (3) Establishment of a new equilibrium. Parents and siblings reported experiences unique to their role in the family and developmental stage, as well as shared experiences within the family system. Findings have implications for palliative care and bereavement professionals in terms of supporting parent, sibling, and family coping before, during, and after the death of a child.

Family belief system influences on COVID-19 vaccination decisions among First Nations Australians.

COVID-19 has changed the world in many ways, and while some families were divided by geographical distances and mandatory "stay-at-home" orders during lockdowns, others became fractured owing to decisions about vaccination. This novel exploratory qualitative study questions how family systems and COVID-19 attitudes influenced the vaccine decisions of 10 Australian First Nations individuals. Despite the significance of family in decision making, the advice of respected family members became insignificant when nonvaccination resulted in the undesirable consequences of coercive government mandates. The thematic analysis identifies themes of choice, repeated wrongs of the past, trust, relationships, isolation, and parenting anxiety. It also demonstrates the resiliency of First Nations families, evident in the creative ways family systems adapted during the pandemic. This study has implications for governments and health service planning toward community COVID-19 support systems in a postpandemic context and provides ideas for further research into First Nations service provision during health crises. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Narrative Accounts of Youth and Their Mothers With Chronic Headache: Application of a Socio-narratology Framework to Pain Narratives.

This study was the first to apply a socio-narratology framework to the narratives about child pain as told by youth with chronic pain and their parents, all of whom experience chronic headaches. Storytelling is a powerful social transaction that occurs within systems (eg, families, clinical encounters) and is both shaped by, and can shape, the pain experience. Narrative can be harnessed as a clinical tool to aid in the ability to listen, understand, and improve clinical encounters. Twenty-six youth (aged 11 to 18y) and their mothers, both with chronic headaches, recruited from a tertiary level pediatric pain clinic separately completed in-depth interviews about children's pain journey narratives. Data were analyzed using narrative analysis, which incorporated elements of socio-narratology to compare similarities and differences between and within dyads' narratives. Five narrative types were generated: (1) The trauma origin story-parents, but not youth, positing traumatic events as the causal link to children's pain; (2) mistreated by the medical system-neglect, harm, and broken promises resulting in learned hopelessness or relying on the family system; (3) the invalidated-invalidation of pain permeated youth's lives, with mothers as empathic buffers; (4) washed away by the pain-challenges perceived as insurmountable and letting the pain take over; and (5) taking power back from pain-youth's ability to live life and accomplish goals despite the pain. Findings support the clinical utility of narrative in pediatric pain, including both parents' and youths' narrative accounts to improve clinical encounters and cocreate more youth-centred, empowering narratives.

Structural risks and family adjustment in midwestern Latine immigrant families: Extending the family stress model.

We tested an extended family stress model of economic hardship (FSM; Conger et al., 2010) incorporating structural risks (discrimination, immigration, and COVID-19 experiences) and qualitative data, to better understand the impact of culturally relevant experiences on family stress processes in rural, immigrant Latine families in the U.S. Midwest. Participants were Latine families (N = 307) with a child aged 10-15 (Mage = 12.21 years, 51.0% boys; 71.5% two parent; 93.1% of caregivers and 29% of youth born outside the United States) Mean household income was 25-30K and 65% of caregivers had less than a high school education. We tested a cross-sectional structural equation model in Mplus and analyzed qualitative interviews with a subsample of mother-youth dyads (n = 19). COVID-19 experiences predicted economic pressure, and both COVID-19 and discrimination experiences were linked to caregiver psychological distress. Consistent with the FSM, economic pressure predicted psychological distress, which was associated with interparental relationship problems and parenting. Parenting was associated with youth global health. Unexpectedly, interparental relationship problems to parenting were not significant. The indirect association linking COVID-19 experiences to youth global health via psychological distress and parenting was significant. Qualitative data revealed five themes demonstrating how structural and economic risks contributed to distress, conflict, and maladjustment within the family system. Culturally relevant structural risks exert a negative influence on family processes in rural Latine immigrant families through contributing to economic pressures and parental distress. The additional impact of these experiences should be considered when addressing the FSM in Latine populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Influence of Social Activities on Delayed Memory in Older Adults: A Cross-Cultural Study

This study investigated the impact of social activities on delayed memory among older adults, framed within Social Support Theory and Social Gerontology. By comparing Chinese and American populations, we aim to fill a gap in the cross-cultural research on this topic. Using data from the China Health and Retirement Longitudinal Study and the U.S. Health and Retirement Study, we employed quantitative analysis with Stata 18.0. We discovered that social activities like internet use, card games, and volunteer work significantly enhance delayed memory across both cultures. However, cultural differences influence the types of social activities that are more prevalent in each context and affect the degree of their impact on cognitive health. In China, card games had a stronger effect on delayed memory, while in the United States, volunteer work and internet use exerted a more pronounced impact. These findings highlight the importance of culturally tailored interventions and the combined role of family and community support systems in promoting cognitive health among older adults.

Family system and problematic technology usage

Abstract Technology plays a dual role in human life, offering both beneficial and adverse effects. McDaniel and Coyne defined “technoference” as recurring interruptions in relationships due to technology use, leading to conflicts, decreased relationship and life satisfaction, and depressive symptoms. Systems theory suggests that technology fundamentally alters family dynamics, shifting from personal connections to isolation within households. The structural family perspective notes that technology often lacks established roles and boundaries. Approximately three out of four families seeking help at tertiary care centers report interpersonal issues related to technology use. This paper uses a case illustration to apply family systems theory in conceptualizing and planning interventions for problematic technology usage. It emphasizes that many effective intervention packages, primarily developed in Western contexts, can be adapted to foster healthy technology use and improve interpersonal relationships in Indian families.

Disclosure dilemma: Revealing biological paternity to family and others after unexpected direct‐to‐consumer genetic results

AbstractObjectiveThis study explores the experiences of direct‐to‐consumer (DTC) genetic test results of recipients who learn of unexpected biological paternity, not parent expected (NPE). We characterize the process of disclosing NPE discoveries, as well as the benefits and the repercussions of such disclosures on individuals, families, and others.BackgroundThe popularity of DTC genetic testing is increasing. Consequently, many discover unexpected information about their ancestry, heritage, and paternity.MethodsThis qualitative study used an inductive thematic analysis of in‐depth interviews with adults (n = 27; aged 40–70) who received DTC genetic test results revealing unexpected biological paternity.ResultsThe NPE disclosure dilemma encompasses uncertainty about narrating their discovery; gauging the dispositions of others; wondering what repercussions may arise; and managing feelings about stigma, betrayal, and anger. Culture, history, and family dynamics are vital in navigating disclosures. A desire to understand their origins, connect with new genetic families, and validate their sense of self is essential. Biological connections of kinship remain important arbiters of relatedness for many individuals.ConclusionDisclosure of NPE discoveries differs from other stigmatized identities because the secret belongs to someone else; thus, self‐disclosure affects the entire family system.ImplicationsDrawing on family systems theory and disclosure processes model, our findings provide insights into the intricate dynamics inherent in NPE disclosure.

Childhood Trauma, Perceived Social Support, and Post-Partum Depression among Newly Married Women after Miscarriage

The study examined childhood trauma, perceived social support, and postpartum depression in married women with first-time miscarriages. After reviewing the literature, these hypotheses were formed. 1).Childhood trauma, perceived social support, and postpartum depression are significantly associated with newly married women with first miscarriage. 2)Early trauma and support networks are two major contributors to the new-onset maternal depression in newly married women experiencing a first perinatal loss. 3). There are significant family system differences in early trauma, support networks, and new-onset maternal depression for newly married women experiencing a first perinatal loss. The research has surveyed 250 newly married females in the b/t age group of 18–35 years after their first loss event. The sample includes public and private hospitals in Lahore and Faisalabad. Calculations were done according to the psychological measures: 1)Childhood Trauma Questionnaire 2)Perceived Social Support, and 3) Edinburgh Postnatal Depression Scale. Data analysis was done through SPSS.

Exploring the Association between Sexual Orientation Beliefs and Ambivalent Sexism in Young Adults

This paper investigated the association between sexual orientation beliefs and ambivalent sexism in young adults. It was hypothesized that sexual orientation beliefs would correlate with and predicate ambivalent sexism, while there would be significant sociodemographic differences across the study variables. Selecting a cross-sectional (correlation) approach, a non-probability convenient sample of 221 young adults (Mage = 24.84, SDage = 5.82) was recruited. After filling out a detailed sociodemographic information sheet, the participants responded to original (English) versions of the Sexual Orientation Beliefs Scale (Arseneau et al., 2013) and the Ambivalent Sexism Inventory (Glick & Fiske, 1996). The analysis revealed that all sub-scales of the Sexual Orientation Beliefs Scale (discreetness, naturalness, informativeness and homogeneity) had positive correlations with hostile sexism and benevolent sexism. Moreover, discreetness, informativeness, and homogeneity beliefs predicted hostile sexism, while only the homogeneity belief predicted benevolent sexism. The socio-demographic variables of age and education emerged as significant correlates. Muslims held stronger ambivalent sexism than non-Muslims but no difference was found in sexual orientation beliefs. Hostile sexism was higher in men and those from a nuclear family system. Benevolent sexism was higher in unemployed and non-heterosexual individuals. Lastly, the discreetness belief was stronger in men and heterosexuals. This study would be a valuable addition to the academic scholarship as it provided insights into the indigenous patterns of sexual orientation beliefs and their relationship with specific forms of sexism.

Testing a family system-based intervention (ENTREN-F Programme) for a paediatric obesity sample by a randomized controlled trial

This study evaluated the effectiveness of ‘ENTREN-F’ –a multi-component, family system-based intervention-for managing paediatric obesity at National Health Primary Care. A 3-arm, parallel-design, single-blinded randomized controlled trial (RCT), 165 families were randomized: Arm 1) ENTREN-F(n = 62) is a 12-week cognitive-behavioural intervention (CBT) family system-based programme, addressing lifestyle changes, children's emotional and social development and the family system, Arm 2) ‘ENTREN’ (n = 52) is a CBT family-based programme for children and parents, not addressing the family system, and Arm 3) Control group (CG) (n = 51) covers individual behavioural monitoring. All children were clinical interviewed to assess a diagnosis. Their effectiveness was assessed against six-month changes in children's body mass index (BMI) z-score, children's psychological well-being, levels of expressed maternal emotion, depression symptoms, parental feeding practices, levels of physical activity and sedentary lifestyles. The maintenance of the changes was evaluated for two years. High-attendance rates for ENTREN-F (72.6% vs. 66% vs. 33%, respectively) indicated its greater acceptance. After programme completion, the BMI z-score reduced by .5 points in almost 50% ENTREN-F (n = 22/45), 21.9% ENTREN (n = 7/32) and 11.8% (n = 2/17) CG participants. There were no significant differences between the three trial arms for anthropometric, psychological, or family-related measures. At the two-year follow-up, both ENTREN-F and ENTREN showed similar long-term effectiveness without between-group differences, and weight trajectories were favourable. ENTREN-F appears effective for childhood obesity management; however, the COVID-19 pandemic limited the sample size. Also, the tendency towards multiple differences in child and family outcomes could not be statistically shown. It also provides further evidence of the role of psychological and family-related factors that may underlie the origin and maintenance of weight gain.