Family systems theory views the family as a dynamic system where all members are interconnected. Key concepts include homeostasis, boundaries, roles, and coalitions. Assessing families using tools like genograms, lifelines, and ecomaps can provide insight into relationship patterns and influences on a patient's health. This helps family physicians understand the family context and apply a systemic approach.
2. What is a SYSTEM? An entity composed of discrete parts which are connected in such a way that a change in one part results in changes in all of the other parts
7. Rules Commonly agreed upon ways of dealing with each other, dealing with situations, and dealing with the external environment Overt Rules Covert Rules
8. Boundaries Special rules that govern the interactions between subsystems in the family Clear Rigid Diffuse
9. Elements of the Family System Roles Coalitions Power Structures
15. Family Map Application of Family Systems Concepts Characteristics : members Structure: boundaries, alliances, coalitions Process: enmeshment, disengagement Across time: intergenerational coalition
16. Circular Questions Series Questions Explores repetitive behavior “Who-does-what-and-when” Questions Explores different roles
17. Circular Questions “Closer-farther” Questions Explores emotional closeness and distance “Who agrees with whom” Questions Elicits information about coalitions
18. Family Map Symbols Functional relationship Enmeshed or over-involved relationship Dysfunctional relationship
27. APGAR A – adaptation Capability to utilize and share resources P – partnership Solving problems by communicating G – growth Freedom to grow and change A – affection Intimacy and emotional interaction in the family R – Resolve Commitment by other members to the family
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29. APGAR Scoring: Almost always – 2 Some of the time – 1 Hardly ever – 0 Total : 8-10 – highly functional 4-7 – moderately dysfunctional 0-3 – severely dysfunctional
30. Family Lifeline Family History Significant events that may have effect on a patient’s health
34. SCREEM Sources of help Barriers to patient care Relationships of health behavior, practices and utilization of health services
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36. Ecomap The ecomap is a “snapshot” of the patient within his/her family and social environment at a particular point in time
37. Ecomap Connects the environment outside of the family with the family members. Where is energy being directed and what is the nature of that exchange? What is the quality of that exchange?
38. Ecomap – Quality of Exchange The STRENGTH of the connection (Weak; tenuous/uncertain; Strong) The IMPACT of the connection (none; draining resources or energy; providing resources or energy) The QUALITY of the connection (Stressful; Not stressful)
39. Commonly Used Symbols Stressful, conflictual +++++++ relationship Tenuous and/or uncertain relationship - - - - - - - Positive relationship _________ or resource The direction of the giving & receiving exchange or a relationship or resource (also known as energy)
40. Interpretation Thicker (darker) lines mean stronger relationship Curvy or red lines mean that the system is a stressful relationship Arrows pointing to the patient mean that the system primarily influences the patient. Arrows pointing to the system mean that the patient primarily influences the system Arrows pointing both direction depicts a two direction flow of influence
41. Coffee Group Daycare Church Rotary Sister Clinic Px Parents ++++++++++++ Hospital Brothers Family
