Family Assessment: General Assessment Techniques

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Family AssessmentGeneral Assessment Techniques

• Dianna Spies Sorenson, Ph.D., RN, CNS

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Definition of Functional Families

• A functional family occurs as an open system
  where messages are both sent received. These
  messages are clear, precise, congruent within
  the context of the situation. Furthermore, a
  functional family provides nurturing among its
  members promotes a high degree of self-worth.

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Characteristics of Functional Families

• Smooth rhythm of interaction
• High spontaneous agreement
• Overall pattern of solving serious problems
• Parents use lt threats and acts of punishment
• Directions are clear
• Parents listen
• Provide a context of relief
• Interested in have time for children
• Parents dont feel guilty for stopping demanding
  behavior

• Parents are good role models
• Parents expect high quality efforts
• Children are able willing to meet parental
  expectations
• Parents let the kids do their own growing
• Children get along well help each other
• Parents as individuals are friendly relaxed
• Parents share common interests apart form the
  children

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Elements of Family Assessment

• Demographics
• composition
• history
• social class
• education
• vocation/profession
• housing
• clothing
• nutrition
• community
• social network

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Elements of Family Assessment

• Boundaries
• open/rigid
• internal alliances
• Roles
• complementarity
• evolution
• socialization
• Energy
• internal
• environmental

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Elements of Family Assessment

• Power
• influence opinion
• punishments/rewards
• physical
• who has power
• Change/Flexibility
• problem solving
• articulate needs
• outside assistance
• evaluate

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Elements of Family Assessment

• Communication
• accept responsibility for thoughts, feelings,
  actions
• clarity
• verbal skills
• talk for self
• talks to whom
• message completeness
• generalizations
• express thoughts/feelings
• validation
• feedback
• direct
• indirect
• receptivity to feedback
• complementarity

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Elements of Family Assessment

• Health Care Function
• beliefs
• knowledge
• life style
• prevention
• history
• utilization of health services
• power, energy, resources

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Elements of Family Assessment

• Coping Strategies
• stress/stressors
• defense mechanisms
• inner resources
• perceptions
• cohesiveness
• resiliency
• integration
• control
• spirituality
• External resources
• education
• social support
• health care services
• government assistance

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Elements of Family Assessment

• Strengths
• What are present?
• Awareness
• potential/latent
• How to develop

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Questioning

• Linear
• General
• Circular

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Circular Difference Question Explores
differences between people, relationships, time,
ideas, beliefs

• What was the best advice youve received?
• Who was the most skeptical about the advice?
• Who was the first to act on the advice?

• Cognitive
• Affective
• Behavioral

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Circular Behavioral Effect Question Explores
connections between the effect of one family
members behavior on another

• How do you make sense of Janes outburst?
• How do you feel when she does this in public?
• What do you do first to deal with the behavior?

• Cognitive
• Affective
• Behavioral

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Circular Hypothetical/Future Question Explores
family options alternatives or meanings in the
future

• Cognitive
• Affective
• Behavioral

• What do you think will happen if dads behavior
  doesnt change?
• If he continues to hit, who do you think will
  feel the most emotional pain?
• How much longer will you be able to tolerate
  living with him?

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Circular Triadic Question Question posed to a
3rd person about the relationship between two
other people

• How does mom know when to back off from nagging
  dad?
• How does dad feel when mom nags?
• What does dad need to do to get mom to stop
  nagging?

• Cognitive
• Affective
• Behavioral

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Tests

• Inventories
• Questionnaires

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Behavioral Observation

• Verbal
• nonverbal

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Exercises to Explore Beliefs/patterns of
Interaction

• Typical day
• Family floor plan
• Identify expectations
• Life style
• Photo album
• Success chart

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Sculpting

• Physical expression of the relationships among
  members

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Metaphorical Methods

• autobiographies
• composing stories
• diaries
• drawing
• dreams

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Behavioral Task Rx

• Prescribed during session
• Prescribed as home work

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Genogram/Ecogram

• Chart family constellation
• chart relationships

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Central Organizing Factors

• Symptom as a metaphor
• the word, phrase or caption
• what the practitioner feels wants to do
• the animal or object game or sculpture

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Central Organizing Factors

• tracking
• identifying priorities as organizing principles

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Central Organizing Factors

• Identify reciprocal role relationships
• look to the direction of the behavior then to
  the opposite