Functioning Of Family System Research Articles

Is symptom outcome the whole story?—A multilevel meta-analysis of systemic therapy for adults including family system functioning

Objective Systemic Therapy conceives mental health symptoms in the context of social systems. Previous meta-analyses on Systemic Therapy focused on symptoms. This meta-analysis aims to focus on family system functioning while including all types of outcomes. Method We conducted a systematic literature research in multiple databases (PsycInfo, PubMed, Embase, Cochrane Central). We included RCT-studies on adults with psychiatric diagnoses, which compared Systemic Therapy with active psychosocial control. The literature research resulted in 171 coded effect sizes of 32 RCTs. We conducted a random-effects three-level meta-analysis. We categorized outcomes into symptoms of patients, family system functioning, further secondary outcomes of patients, and psychopathology of family members. Results The results show a small significant overall effect size of g = .30 (CI: .15–.45, p < .001, k = 171, s = 32) for all outcomes. Systemic Therapy revealed small effect sizes with regard to family system functioning (g = .34, z = 3.51, p = .0004, k = 26, s = 12), symptoms (g = .30, z = 3.74, p = .0002, k = 73, s = 29), and further secondary outcomes (g = .32, z = 3.83, p = .0001, k = 63, s = 19). The effect sizes for psychopathology of family system members were reported rarely (k = 9, s = 6). Conclusion This meta-analysis shows the potential relevance of investigating family system functioning as a primary outcome for Systemic Therapy.

Social Structures and Family Systems: An Analysis of Cultural Influences

Objective: This narrative review aims to dissect the complex interplay between cultural influences, social structures, and family systems, highlighting how cultural contexts shape and are shaped by social dynamics and family relationships. Methods and Materials: Utilizing a descriptive narrative review methodology, this article synthesizes a wide range of peer-reviewed literature from 2000 to 2023. It employs a comprehensive search strategy across multiple databases, focusing on works that explore the nexus of culture, social structures, and family systems. Findings: The review uncovers significant evidence of the profound impact of cultural norms and values on the formation and functioning of family systems within various social structures. It identifies key patterns of cultural influence across different societal contexts, emphasizing the diversity of family dynamics and social interactions shaped by cultural backgrounds. Conclusion: Recognizing and understanding the cultural underpinnings of social structures and family systems is crucial for developing culturally sensitive theoretical frameworks, effective practices, and inclusive policies. This review underscores the importance of interdisciplinary approaches and cultural competence in addressing the complexities of social and family dynamics in a globalized world.

The functioning of the family system and its relation to the psychological well-being of spouses in the context of their religious commitment

The article describes the functioning of family systems and its relation to the psychological well-being of spouses in the context of their religious commitment. The spouses play a very important role, as their mutual relationship affects the functioning the entire family system. Positive mental functioning, or the psychological well-being of husband and wife, can have an impact on these relationships. The aim of the study was to verify the connections between the functioning of the family and the psychological well-being of the spouses and to identify the predictors of the analyzed variables. The study included 130 married couples – an equal number of men and women making up 65 marriage systems bringing up school-age children. The following measures were used in the study: Family Assessment Scales (SOR) by Andrzej Margasiński (2013), based on the Polish adaptation of FACES IV – Flexibility and Cohesion Evaluation Scales by David H. Olson; Caroll Ryff’s Psychological Well-Being Scales, as adapted into Polish by Dominika Karaś and Jan Cieciuch (2017); and the Religious Commitment Inventory-10 (RCI-10-PL) by E. Worthington and colleagues, as adapted into Polish by Jarosław Polak and Damian Grabowski (2017). The analyses of the relationship between the variables shows that the more balanced and well-functioning the system is, the higher is the well-being perceived by the husband and wife. The crucial predictors of a “healthy” family include some dimensions of well-being: high self-acceptance, personal growth, and positive relations with others. Some differences in the analyzed variables between husbands and wives were also found.

Effectiveness of emergency department-based and initiated youth suicide prevention interventions: A systematic review.

This systematic review examined the effectiveness of Emergency Department-based and initiated youth suicide prevention interventions for suicide attempts, suicidal ideation, hospitalization, family system functioning, and other mental health symptoms. We searched five databases for randomized controlled trial (RCT) studies that examined Emergency Department-based and initiated suicide prevention interventions among youth aged 10 to 18 years old between May 2020 to June 2022. Using Cohen's d and 95% confidence interval as our standardised metrics, we followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) and Synthesis Without Meta-Analysis in Systematic Reviews (SWiM) guidelines when synthesizing, interpreting, and reporting the findings of this review. Five studies were included in this review. Findings were first synthesized according to the targeted population of the study intervention and this review's outcomes. Two interventions were effective for decreasing depressive symptoms, hospitalization recidivism, and/or increasing family empowerment. There were no interventions that reduced subsequent suicide attempts. A meta-analysis was not conducted due to the heterogeneity of the data. A need exists to develop and evaluate Emergency Department-based and initiated youth suicide prevention interventions that can be successfully and sustainably implemented in practice. Future research should focus on evaluating the components of interventions that effectively mitigate suicide risk among high-risk youth.

Problematic media use in early childhood: The role of parent-child relationships and parental wellbeing in families in New Zealand and the United States

ABSTRACT Problematic media use (PMU) during early childhood has the potential to interfere with the healthy functioning of family systems and may be associated with significant long-term problems for the child. However, we know very little about what contributes to early childhood PMU, particularly in the family context. We examine parenting factors as correlates of child PMU in two studies, from two different countries, using two different methods. Study 1 (N = 93, Mage = 45.3 months, SD = 10.15, 58% males, 87% mothers) investigated the concurrent role of self-reported parental burnout and parent-child conflict and closeness as correlates of child PMU in an early childhood sample in New Zealand. Study 2 (N = 269, Mage = 41.17 months, SD = 3.06 months, 49% males, 95% mothers) investigated observed parental warmth and harsh criticism as predictors of concurrent and longitudinal PMU in an early childhood sample in the United States. Together, findings showed that in both countries approximately 22–25% of young children show symptoms of PMU. After controlling for parent’s PMU, parent-child conflict, warmth and parental burnout were not associated with child PMU. Low levels of parent-child closeness and parent’s use of harsh criticism were predictive of child PMU. The findings advance our understanding of some of the parenting factors that influence the development of PMU in young children.

Service dogs for autistic children and family system functioning: a constant comparative analysis.

Service dog placements for autistic children are growing in popularity, yet findings to date are mixed. Moreover, no study to date has examined these placements through the lens of a recognized theoretical model. The purpose of this study is twofold: to explore experiences reported by caretakers of autistic children involved in a service dog program, and to contextualize findings within an established theoretical framework. A total of n = 50 caretakers of autistic children (n = 38 with and n = 12 without a service dog) were recruited through the national non-profit service dog provider Canine Companions. Participants completed an online survey through Qualtrics which asked open-ended questions about their experiences, both negative and positive. Constant comparative analysis identified two high level themes, nested within a family systems approach framework: (1) Enhancing social functioning of the family system unit and (2) Fostering stability and strength within family system subunits. These themes interacted holistically to foster and reinforce family system resilience. Placements led to greater social inclusion for children and their families, acted as a highly individualized intervention, and decreased experiences of judgement and stigma. Perceived as members of the family, service dogs may coregulate with the autistic child and family members and can be a source of joyful connection within the family. Results highlighted the service dog's influence on the entire family (beyond the autistic child). Implications for service dog organizations suggest it may be helpful to account for family-wide impacts throughout the placement process. High standards on the part of provider organizations may minimize negatives, optimizing outcomes for both humans and canines. Ultimately, findings enrich our understanding of service dog interventions for autistic children.

Family Systems and Emotional Functioning in Deaf or Hard-of-Hearing Preschool Children.

This study examined how deaf or hard-of-hearing (DHH) and typically hearing (TH) children may differ in their family system and emotional functioning and examined the relations between family system and children’s emotional functioning. Parents of 106 DHH and 99 TH children (2–6 years) reported on family cohesion and adaptability, parental emotion communication, and their child’s emotional functioning. The DHH children were rated lower on family cohesion and positive emotion expression than the TH children. Higher levels of family cohesion related to more positive emotion expression in TH children but not in DHH children. For all children, higher levels of family cohesion related to fewer negative emotion expressions and more parental emotion communication related to more negative emotion expression. The results emphasize the importance of sharing leisure activities together and open communication within the family, which can support DHH and TH children’s experience of emotions and their expressions of them.

Causes and criteria of disharmonies in family system functioning

The article highlights the problem of finding the causes of disharmonies in marital relations and the criteria for the normal functioning of a family system. Dysfunction or disturbances of family functioning are such features of family life that complicate or hinder execution of family functions. A dysfunctional family in a broad sense means a system determining distortions of personal development and, therefore, maladaptive, deviant behaviour or neurotic disorders at one or more of the family members. The aim of the study is to identify the causes of disharmony in marital relations and the criteria for normal functioning of a family as a system. The empirical part of this study was devoted to determining the causes of such disharmonies in marital relationships that subsequently led to divorce. The study was conducted during the family counselling of married men, women and married couples who were in the process of divorce. The next criteria for normal family functioning have been determined: respect for differences; sincerity in expressing thoughts and feelings; dynamic relationships; role sharing; observance of personal boundaries; family openness; emotional and spiritual intimacy.

Families of people with Marfan syndrome. The relationship between the functioning of the family system and the life quality of the affected persons.

The purpose of the study was to analyze the functioning of afamily as perceived by a person with Marfan syndrome and to look for relationships between the characteristics of the system and the overall quality of life of the ill. Participants included 33 individuals with Marfan syndrome and 33 individuals without chronic illness. We used the Family Evaluation Scale - the Polish adaptation of the FACES-IVby D.H. Olson and the Satisfaction with Life Scale (SWLS) by Diener, Emmons, Larson and Griffin. People with Marfan syndrome perceive their families as significantly less coherent and significantly more disengaged than people without chronic illness. This family system of people with Marfan syndrome can be characterized by low scores on the "Cohesion" and "Flexibility" and high scores on the other four scales showing the level of imbalance of the family as a system, which makes this family profile similar to an ‛unbalanced' system. Life satisfaction of people with Marfan syndrome correlated positively with "Cohesion", "Flexibility" and "Family Satisfaction" as features of family system perceived by them. The obtained results confirm the importance of supporting families of people with Marfan syndrome and specialist help aimed at dealing with emotional burden related to the health of the patient.

Parentification Among Young Carers: A Concept Analysis.

There are approximately 1.4 million young carers in the United States alone. Being a young carer can result in parentification, a type of role reversal that occurs when children take on the roles and responsibilities of the adult. The purpose of this concept analysis is to provide a better understanding of the phenomenon of parentification among young carers through a description of its antecedents, attributes, and consequences using the steps of Rodgers' evolutionary method. The databases CINAHL, PubMed, PsycINFO, and Scopus were searched to identify 25 articles. The antecedents of the concept include the dependency of the care receiver and the child's adoption of a caregiving role. The attributes include fairness, obligation, resiliency, individuation, confidence in performing care tasks, cultural normalcy, family system functioning, support system, family resources, caregiver-care receiver relationship, and awareness of the child's needs. Parentification has both positive and negative consequences that impact the young carer. The antecedents, consequences, and identifiable attributes of the concept are presented through this work to provide a comprehensive picture of parentification among young carers. These findings showcase the multidimensional nature of parentification and the broad impact that it can have on young carers. While these findings do provide greater insight into young carers, the fact remains that little is known about this underserved and underacknowledged population. This concept analysis provides a foundation of understanding that specifies potential targets for intervention development, as well as modifiable outcomes, that can be explored through future research and intervention work.

Understanding Differential Effectiveness of Behavioral Parent Training from a Family Systems Perspective: Families Are Greater than “Some of Their Parts”

AbstractBehavioral parent training (BPT) is a theory‐driven, evidence‐based, and widely used intervention strategy for preventing and decreasing children's disruptive behavior problems, indirectly via improved parenting behavior. However, not all families benefit equally from BPT. To date, our knowledge of who benefits (and who does not) and our understanding of why some families benefit more than others is limited. An important challenge for research and practice is finding ways to tailor interventions to the needs of an individual family and increase their effectiveness. We put forwardfamily systems theoryas a tool to gain more insight into which families (do not) benefit from BPT and why. We synthesize the theoretical foundations and empirical support for the putative mechanisms through which the functioning of family systems may explain BPT effectiveness and propose ways in which family systems theory can help strengthen the design, implementation, and evaluation of BPT programs.

Family System Functioning in Caring for Thai Survivors with Severe Traumatic Brain Injury

Objective: This study aimed to describe family system functioning, in providing care for a family member, after surviving a severe traumatic brain injury (TBI).Material and Methods: A cross sectional survey, using a self-report questionnaire, was conducted with 77 family members; from 32 families, caring for survivors from one province in southern Thailand. Family system functioning was measured using the Family Assessment Measure III (FAM-III) General Scale, Thai version as well as a demographic questionnaire. Descriptive statistics were applied to analyze family functioning including means, standard deviation, percentage and T-scores.Results: The findings showed that the overall family system functioning existed within the moderate level (M=49.94, S.D. =8.99). The finding also indicated moderate levels of functioning within the FAM III subscales.Conclusion: The present findings provide evidence that family systems functioning was at a moderate level in those providing care for a family member who had sustained a severe TBI. This level of function might pose difficulty regarding ability of the family towards a variety of basic, developmental and crisis tasks. The investigation suggests a future study, complementing quantitative methods with qualitative approaches.

Family Health Leaders: Lessons on Living with Li-Fraumeni Syndrome across Generations.

Li-Fraumeni Syndrome (LFS) is a hereditary disorder that confers an approximately 90% lifetime risk of cancer and requires comprehensive lifetime cancer screening. We explored healthcare roles for managing LFS-related cancer risks and treatments that were assumed by parents, adolescents, and adult children. Semi-structured interviews were conducted with 23 families. Family groupings were comprised of 2-5 members, with the younger generation in each family ranging in age from 7 to 40years. Using grounded theory methods, we conducted open and focused coding of interview transcript content. Family members described how the role of health leader was implemented in their family, as well as factors such as maturation of a child or death of a member that determined who assumed particular roles and how these roles shifted over time. They often expressed collective responsibility for helping relatives understand LFS and implement appropriate cancer risk management. Members demonstrated their health role by attending others' medical appointments for support or information gathering. The health leader role was intergenerational and provided the family necessary support in navigating complicated healthcare decisions. Our findings provide insight into healthcare providers regarding how LFS patients and their relatives develop unique medical decision-making and caring roles influenced by the hereditary nature of LFS, and how these roles change over time. Providers who are attuned to family role dynamics may be better able to meet relatives' psychosocial and medical needs by understanding how living with LFS influences the family system's functioning and facilitating members' support for each other.

Associations between family cohesion, adaptability, and functioning of patients with bipolar disorder with clinical syndromes in Hebei, China

ObjectiveWe aimed to investigate the symptoms of inpatients with bipolar disorder (BD) in different types of families, and to explore the correlations between family coherence, family adaptability, and family functioning among inpatients with BD.MethodsInpatients with BD in Hebei, China (n = 61; mean age = 33.85±10.54; 39 males) participated in this study. Participants’ symptoms were evaluated using the Bech–Rafaelsen Mania Scale (BRMS) and Hamilton Depression Rating Scale (HDRS) at weeks 1, 4, and 8 after their admission to the hospital. Participants’ family type was assessed using the Family Adaptability and Cohesion Scale II–Chinese Version. Family functioning was assessed using Family Assessment Device.ResultsParticipants were classified into three family types: balanced (n = 13), mid-range (n = 28), and extreme (n = 20). BRMS scores improved over time in patients from all three family types. Improvement was slightly better with the balanced than the extreme family type. HDRS scores showed an improving trend over time, although this was not significant. Family coherence, adaptability, and functioning were mutually correlated.ConclusionThe family system and family functioning are important factors that clinicians should keep in mind when treating people with BD.

Internalizing and externalizing behaviors in chronically ill adolescents in the context of family system functioning

BackgroundDiagnosis of chronic illness, which constitutes a life-threatening situation such as in Marfan syndrome or dis-ease with periods of remission and severity such as in juvenile idiopathic arthritis (JIA), leads to problems with the functioning of the adolescent and the whole family system. Therefore the aim of the study was to determine the differences in severity of internalizing and externalizing problems and in the perception of the family sys-tem between adolescents with Marfan syndrome, with JIA, and without chronic disease, as well as to determine whether characteristics of the family system are associated with externalizing and internalizing behaviors in those groups.Participants and procedureThe study involved three groups of adolescents: 1) with Marfan syndrome (n = 25), 2) with JIA (n = 29), and 3) without chronic illness (n = 20). We used the adolescent version of the Child Behavior Checklist (CBCL) Youth Self-Report (YSR) and the Family Assessment Scale.ResultsOur results indicated that adolescents with Marfan syndrome have similar scores compared to adolescents without illness on all subscales concerning both internalizing and externalizing behaviors, as well as the family system’s characteristics. Compared to adolescents with JIA, adolescents with Marfan syndrome had lower scores on externalization symptoms and Attention Problems and they also perceive their families as less bal-anced. Additionally, in the perception of adolescents with Marfan syndrome and with JIA the weaker the family bond, the stronger the intensity of externalizing behaviors.ConclusionsAlthough in the light of our novel research, adolescents with Marfan syndrome do not present behavioral prob-lems different from healthy peers, it is worth continuing such research in order to verify the results. Adolescents with JIA present more externalizing behaviors than peers without chronic illness, which is consistent with some previous research. Research on families of an adolescent child with Marfan and JIA are quite novel and they should be continued.

Teenage motherhood and the evaluation of relationships in the family of origin in mothers in their early adulthood

BackgroundThe objective of this study was to evaluate the relationships in the family of origin in a sample of mothers who had their first child as teenagers (off-time motherhood). We also sought to answer the following question: are there any differences in the evaluation of relationships between mothers who gave birth to their first child in their teens and those who had their first baby during women’s best fertility age (on-time motherhood)? For women, the optimum reproductive age is anywhere between 20 and 30 years of age.Participants and procedureThe study looked at 60 mothers, including 30 off-time mothering and 30 on-time mothering. Two research tools were used in the study: an own survey and the SOR test by Margasiński (a Polish adaptation of the Flexibility and Cohesion Evaluation Scales).ResultsThe results of the research showed significant differences in how family life was assessed by the two groups regarding cohesion and communication. Moreover, teenage mothers’ families of origin are characterised by unbalanced cohesion which manifests itself as extreme cohesion (enmeshed relationships) and higher inter-family communication satisfaction when compared to mothers who had a baby at the optimum age of 20-29.ConclusionsIntergeneration issues are a vital research problem. One of those is how experiences from one’s family of origin shape the way one builds a partnership in one’s family of procreation – which later translates into rela-tionships with one’s children. The results of the present study are the first step in a research project on the psy-chological functioning of family systems of mothers who gave birth as teenagers. Later, relationships in fami-lies of origin and families of procreation of teenage mothers will be examined.

The imprint of trauma on family relationships: an enquiry into what may trouble a ‘troubled family’ and its implications for whole-family services

For some families facing complex difficulties, an underlying issue can be the impact of traumatic experiences, such as child abuse or domestic violence. While the impact of trauma on individuals is relatively well understood, its impact on the functioning of family or relational systems is less well theorised. This article takes forward the development of an original theoretical framework by which to understand both the impact of trauma at a collective level and the resources that people may need in order for them to overcome its legacy – building principally building on concepts of family schema and recovery capital. This discussion is grounded in the practice context of whole-family support and decision-making services, and is explored through an analysis of narrative data obtained as part of a wider national study into whole-family approaches.

Identification of the main problems in social work with low-income families

Family is a basic social group, which influences one‘s life in all its stages. Through optimal fulfilment of functions which are imposed by society, it creates a safe environment for survival and development of family members. It is an essential factor in socializing and significantly affects the social functioning of its members. The family is also a dynamic system whose functioning operates a number of internal but also external factors. One of these factors is family income. The aim of our study is to investigate which dimensions and aspects of family functioning are threatened by living below the breadline. For assessing individual dimension of family functioning we used the Family Assessment Device (FAD). Quantitative analysis showed disruption of the functioning of the family system in all dimensions. The greatest family disruption was found in dimensions of role, behaviour control and affective involvement.Poverty is a social problem that negatively affects all dimensions of family system functioning. In order to provide effective help and intervention to the family, it is essential that the social worker is able to correctly identify problem areas and appropriately choose methods and procedures aimed at restoration of family functioning.

The Impact of Poverty on the Family System Functioning

This study aims to examine how life in poverty affects the functioning of family system. We focused on family functioning in the dimensions based on McMaster model. We employed The Family Assessment Device.The result shows that there is an association between poverty and disrupted family functioning. Family functioning in different dimensions is in the range of “unhealthy”, mainly in communication, behaviour control and family role. Family stress caused by problems with the fulfilment of the family economic function, affects the way parents fulfill their parental role.We consider it necessary to focus on effective interventions to help families living in poverty in the restoration of family functioning in different dimensions.

Functionality of Family Relationships and Parenting Style in Families of Adolescents with Substance Abuse Problems

In this paper we considered family functioning from a systemic perspective, while we try to point out the relationship between patterns of family functioning, parenting style of the parents and adolescents’ addiction diseases. The research was conducted with the aim to determine a correlation between a functionality of family systems, parenting style of parents and presence of adolescents’ substance abuse problems (alcoholism and drug addiction). A FACES III (Olson, Portner & Levi,1985) and EMBU (Arrindell, 2005) scales were used in order to establish patterns of family functioning and of parenting style of the parents. Two groups of adolescents were examined: 50 adolescents with addiction diseases (alcoholism and drug addiction) who had ambulance or hospital treatment at the Clinic for Mental Health Protection in Nis and 50 adolescents who do not have any problems with addiction. The results of the research showed that there are statistically significant differences between these two groups: in terms of the patterns of family functioning, it could be noted that the patterns of disengaged family functioning, parenting style based on rejection and overprotecting and a significant presence of incomplete family systems were much more dominant for adolescents with addiction diseases. Also, results showed that there is a correlation between family functioning, parenting style and the presence of addiction diseases which shows the need of family support in order to accomplish adequately parenting function. In organizing certain interventions in the family system it is important to have in mind that separately focused interventions which are directed towards parenting, have short-dated effects and that influences directed towards the functioning of the whole family system are much more adequate, which is actually our approach in this paper.