Family Functioning in Families Affected by Parental Mental Illness: Parent, Child and Clinician Ratings

Family functioning is often impaired in families with a parent with mental illness and is linked to child mental health. This study aims to gain a better understanding of family functioning in affected families by comparing ratings among family members and by analyzing associations with clinician-rated family functioning. The cross-sectional sample comprised 210 families with ratings of 207 patients, 139 partners, and 100 children. Parents with a mental illness as well as their partners and children completed the German version of the Family Assessment Measure (FAM). Clinician ratings were obtained by the Global Assessment of Relational Functioning Scale (GARF). We conducted several mixed models to compare ratings of family functioning while accounting for family cluster. Family dysfunction was consistently elevated compared to a normative sample. On several domains, parents with a mental illness perceived family functioning to be worse compared to their partners and children. Partners and children did not differ in their perceptions of family functioning. Ratings of family members were moderately associated with clinician ratings. We discuss the importance of multi-informant assessment of family functioning and the implementation of family-based interventions for families with a parent with mental illness.

Psychosocial Interventions for Couples and Families Coping with Cancer

Couple therapy in cancer care delivers improvements in anxiety, depression, and marital satisfaction, with gains in communication and relational functioning. Women with breast cancer gain considerable benefit, whether through individual or group approaches to couple therapy. For men with prostate cancer, altered sexual functioning from prostate cancer treatment creates a more deleterious effect on couples. Psychoeducation, cognitive, and coping models of therapy (interventions with multiple components) deliver reliable effects, including in the setting of lung cancer. Use of telephone and web-based interventions is increasing. In advanced cancer, integrating a couple approach into the model of palliative care has benefits. Family-centered care can also increase knowledge of illness, caregiving, and coping and deliver small gains in relational functioning. Family therapy is worthwhile when a parent of dependent children is dying from cancer, in childhood and adolescent cancers, and when dysfunctional relationships add risk to bereavement outcome. Continuity of family-centered care from the palliative phase into bereavement has been shown to prevent prolonged grief disorder. Future research is needed to enhance approaches to family-centered care.

Organização familiar no contexto da infância com paralisia cerebral: um estudo de caso

Objetivo: avaliar a organização de uma família cadastrada em uma unidade de Estratégia Saúde da Família (ESF), para o cuidado de uma criança portadora de paralisia cerebral segundo o Modelo Calgary de Avaliação Familiar (MCAF). Método: estudo de caso com abordagem qualitativa realizado em uma ESF localizada em um município do norte de Minas Gerais, durante abril e maio de 2019. O sistema familiar foi descrito de acordo com o MCAF. Para avaliação da funcionalidade utilizou-se a escala Global Assessment of Relational Functioning (GARF). Para a coleta de dados, foi realizada uma entrevista semiestruturada durante uma visita domiciliar e leitura dos prontuários. Utilizou-se o software GenoPro® para confecção do genograma e ecomapa. Resultados: A família da paciente índice encontra-se simultaneamente nos seguintes estágios do ciclo de vida: família com filhos pequenos; família com crianças pré-escolares e família com crianças em idade escolar. De acordo com a escala GARF a família foi classificada como alto risco, com 15 pontos. Conclusão: A família estudada apresentou dificuldades de adaptação frente às demandas impostas pela condição de saúde da paciente índice. A utilização do MCAF viabilizou ao profissional responsável pela assistência familiar o conhecimento da sua dinâmica, além da identificação das necessidades vivenciadas e a formulação de estratégias de cuidado e enfrentamento. Ficou evidente que a desestruturação e a não adaptação às mudanças do sistema familiar interferiram diretamente na qualidade de vida de seus membros.

Adolescents’ representations of close relationships in the context of parental migration: an exploratory study from Ecuador

Purpose The purpose of this study is to examine the association between parental migration and adolescents’ styles of close relationships with parents, friends and romantic partners. Design/methodology/approach In total, 197 adolescents from Cuenca (Ecuador) participated in the study, of which 35% reported a background of parental migration. The Behavioral Systems Questionnaire was used to assess participants’ relational styles. Findings The study reveals that, although parental migration is associated with the development of lower secure styles for parents and friends, it is not associated with the development of insecure styles. Moreover, parental migration does not appear to be associated with the development of romantic styles. Based on the differential impact of the migration of one or two parents, the migration of two parents appeared to have a stronger association with lower secure styles. Originality/value The results are discussed in light of the socio-cultural context in which parental migration occurs in Ecuador, which may offer clue variables in shaping the relational styles of adolescents. The study addresses an important consequence of migration focusing on a scarce studies group, adolescents who stay in their home country while their parents migrate. Moreover, its main findings challenge the preconceptions that parent-child separations necessarily involve a direct negative impact on relational functioning.