Family%20Issues%20in%20Rehabilitation

1
Family Issues in Rehabilitation

• What is the family? Who is the family?
• Impact on the family?
• Functional/dysfunctional adjustment
• Assessing families
• Treatment considerations

2
Learning Objectives

• To increase awareness of students about the ways
  in which disability in one family member can
  impact all family members.
• 2. To increase knowledge and awareness of
  students about the strategies that can be used
  with clients and their relatives that may be
  helpful and facilitative of the entire
  rehabilitation process.
•  

3
What is the Family?

• A social group in which people learn to love,
  care for others, and get their own needs met.
• The functioning of this primary social group
  affects the manner in which the individuals
  within it develop and grow.

4
Who is the Family?

• Nuclear
• Extended
• Step-family
• Single-parent
• Blended
• Cohabitation
• Foster Family
• Adoptive Family
• Guardianship

5
The Family as a System

• System a group of interacting interrelated or
  interdependent elements forming or regarded as
  forming a collective entity.
• Functions separately and in reliance on and
  influenced by the interrelated interaction or
  functioning of the other elements within the
  system

6
Family System like a Mobile

• Demonstration of Family as a System
• Healthy connection to each other
• Balance or Homeostatis
• Interdependency
• Disruption
• Differentiation versus fusion or symbiosis

7
ILLNESS AND FAMILY IMPACT

• Daily routines
• Care giving responsibilities
• Emotional reaction
• New ways of independence
• Energy to maintain normal life

8
Functional Family Characteristics

• Respect for each other
• Enjoy each other's company
• Adapt to change flexible
• Sense of hopefulness

9
Dysfunctional Family Characteristics

• Unresolved power issues
• Avoid responsibility for self
• Many family myths and secrets
• Members less differentiated, more
• enmeshed
• Stereotypical roles
• Closed communication
• Denial of feelings
• Misinterpretation of events

10
Family Dynamics

• Mood
• Seating position
• Speaking
• Coalitions
• Conflicts resolved
• Power
• Previous crises
• View of problem

11
Informational Areas During Intake

• Family composition
• Family response to illness/disability
• Current knowledge/information needs
• Services needed
• Family strengths

12
Family Strengths

• Listening Skills
• Shared Reality
• Shift Roles
• Problem-solve
• Care for self and others
• Focus on present

13
Family Strengths-continued

• Support one another
• Open communication
• Sense of belonging
• Hopefulness
• Change is possible

14
Case Study

• Woman, 42 years old, diagnosed two years ago with
• Multiple Sclerosis. She lives with her husband
  (age 44)
• for the past 17 years, two children (ages16 and
  12 years
• old), and her biological mother. The patient's
  mother
• has been living with her daughter's family for
  the past
• four years since her husband died. Patient takes
  care
• of home and assumes major responsibility of
  raising
• both children and, when necessary, her mother.
• Husband has been working as an architect for the
  past
• 20 years. Current complaints includes numbness
  and
• twitching of both legs as well as general
  weakness and
• fatigue.

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Case Study Questions

• 1. What do you need to know about this family?
• 2. What are some basic questions that you might
  want to raise in the first intake session?
• 3. Who would you want to interview during the
  intake?
• 4. What services might you provide?

16
Case Management Considerations

• Cultural Uniqueness
• Respect for homeostasis
• Support groups
• Communication styles
• Schedule disruption
• Interventions
• Client permission and trust issue
• Mistrust and psychological adjustment

17
References

• Curtis, O. (1999). Chemical Dependency A Family
  Affair. New
• York Brooks Cole Publishing.
• Roessler, R. Rubin, S. (1998). Case Management
  and
• Rehabilitation Counseling Procedures and
  Techniques.
• Austin, Tx Pro-Ed Publishers.