Friedman Family Assessment Model Identifying data 1. Family name 2. Address & phone number 3.

Family composition (Genogram)

4. Type of family form 5. Cultural & ethnic background – extent of acculturation: a. Stated ethnic background b. Language spoken at home. Do all members speak English c. Country of origin, length of time in Canada, what generation are members in relation to immigrant status, family reason for immigrating d. Family social network from same ethnic group e. Family residence – ethnically homogeneous neighbourhood f. Religious, social, cultural, recreational, educational activities – within cultural group g. Dietary habits & dress – traditional or westernized h. Home decor – cultural influences i. Traditional or modern family roles & power j. The portions of community family frequents – territorial complex in ethnic community

k. Use of health care services & practitioners – folk practitioners, folk remedies, traditional health beliefs 1. Religious identification a. Family religion b. Members differ in their religious beliefs & practices c. How actively involved is family in church, temple, mosque or other religious organizations d. Religious practices does family engage in e. Religious beliefs & values are central in family life 1. Social class status – occupation, education, income a. Estimate family social class b. Economic status c. Who makes money d. Supplementary money or assistance – where from e. Does family think income is adequate – how are they managing financially 1. Social class mobility


Family Genogram .

Ecomap .

Family Ecomap .

Families present developmental stage .Developmental Stage & History of family 2.

loss 5. have left home – They have not started own family – The cornerstone for all successive stages to follow. unique health & health related behaviour. present relations with parents of parents 2 parent nuclear family career/life cycle stages: 9 stages Transitional stage – btw families (unattached young adult) – When individuals are in 20’s. financially independent. affects individuals choice of partner. Extent to which family is fulfilling developmental tasks appropriate for present developmental stage 4. Family history from inception thru present – includes: developmental history. health related events & experiences – divorce.3. past. when & how marriage occurs . death. Both parents family of origin – what family life was like.

combine resources.Families with preschool children – Oldest child 2. greater demands on their time – Must keep marriage alive & well . men struggle with attachment issues. communication ○ lack of info creates many problems which means couple can not plan stable lives Stage 2 . sexual differences & needs ○ Relating to family network. diet Stage 1 . demanding for parents. task of separating themselves & working out new relationships with family ○ Family planning – children/not & when. must accommodate each other. but not cut them off Developmental tasks: ○ Individual in nature ○ Coming to terms with family of origin ○ Form personal life goals & sense of self ○ Development of intimate relationships & establish self financially & productive member of society ○ Difficult stage ○ Experienced differently depending on gender: Men taught to pursue self identification thru self expression. family becomes a threesome. abuse.5 – 5 yrs old – 3-5 people. type of health care during prenatal time is crucial Health concerns: ○ Sexual & marital role adjustment. women with autonomy issues Health concerns ○ Personal & family ○ Birth control & family planning ○ STD’s ○ Accidents & suicide ○ Mental health problems . frequent-close-spaced pregnancies are bad ○ Maternity education for family. home visits for family after birth. Women taught to pursue self thru self sacrifice ○ Each has different identity issues to resolve.– Individual must separate self from family. family planning. satisfactory way to handle differences & conflicts.role shift as move from family to own home. must set a pattern of transactions & maintain them. neglect Stage 3 . become members of 3 families. learning to live together. inadequacy & disruption to marriage – Loss of personal freedom. accept development & growth of child ○ New communication patterns btw individuals when becoming parents. providing for each others needs.issues of separation from family ○ Lifestyles are not typically conducive to health promotion – drugs. infant care tasks. affects from separation from family. can lead to family crisis. family unit expands in fcns & responsibility ○ Changes family organization.Childbearing families – Birth of first child 30th month – Transition to parenthood is key. more complex & differentiated – Busy. wife & baby must learn new roles. infant care well baby care ○ Inaccessibility & inadequacy of child facilities for working mothers. making a permanent system – Stressful life transition – period of disequilibrium. alcohol.Beginning families/stage of marriage – Formation of the couple Developmental tasks: ○ Establishing satisfying marriage – preparing life together. ○ External Family relationships change – grandparents ○ Mother changes & adapts to parenthood faster than father ○ Parents learn meaning of baby’s cues. must re-establish personal & sexual needs Health concerns ○ Preparation for parenthood – family planning. less time for marriage – major stressor – There is little preparation for parenthood & many myths Developmental tasks: ○ Husband. new roles & fcns.

language.– – – Preschool children – learn independence. limit setting. responsibilities & problems ○ Stand firm against testing of limits ○ Balance freedom with responsibility. role renegotiation – Teen undergoes cognitive. sex. also teens more independent. autonomy & independence. rejection of values/lifestyle by parent & teen . self sufficient – schools foster this Adequate child care Single parent families – role strain Developmental tasks ○ Housing & space problems – parents need space. neglect. career.Families with school aged children – First born enters school full time 5 – 13 yrs – Families usually reach max number in this stage – Children & parents have own interests. children need to explore ○ Childproofing – accidents. organizational challenges. lack of warmth. falls. prevention ○ Husband assumes greater household roles ○ Multiple children strains the relationship more – personality changes. preparing children for new baby is key ○ Parents learn to separate from children & child from parents ○ Parents need outside interests & contacts Health concerns ○ Communicable diseases of children. also counselling & teaching Stage 5 .Families with teens (oldest child 13-20) – 13 -19 yrs of oldest child. burns. identity & biological changes Parental roles. home safety. activities. conversations ○ Many divorces occur at this time – weak marriage ties ○ Socializing children – developing self concepts. accept rejection ○ Set patterns of acceptance of self for teen ○ Parents feel in competition with social institutions ○ Parents unable to help teen with vocation plans ○ Immigrant families – generational clashes & value conflicts Developmental tasks ○ Balancing freedom & responsibility ○ Parents must change their relationships with child – from dependent to independent ○ Set up new roles & norms ○ Marital relationship – preoccupation with roles. when child leaves home – Loosening family ties to allow greater responsibility & freedom for teenager – Profound shift in relationship patterns across generations & is signalled by physical maturity – Most difficult stage – turmoil. kids. autonomy. rule changing. poison. satisfaction. takes on more self care ○ Integrating new children. accidents ○ Children’s contact with infection/disease – major problem ○ Marital relationship – strengthen & invigorate ○ Child abuse. responsibilities – Parent – finding fulfillment in rearing next generation & own growth – Children – developing sense of industry & ward of inferiority – Parents learn to deal with Childs separation – peer relationships & activities outside of home – Pressure to have children conform to community standards for children – achievement & productivity Developmental tasks: ○ Socializing children – promoting school achievement ○ Maintain satisfying marriage – diminishes at this stage Health concerns ○ Children’s handicaps crop up at this stage ○ Nurses fcn to watch for many problems that arise. so parents can pursue own interests ○ Communication problems – generation gap. communication problems ○ Preventions of major health problems Stage 4 .

multiple roles & relationships – leads to physical. distribution of power btw husband and wife. transportation. smoking & bad diet effects ○ Health promotion strategies. emotional. etc ○ Menopausal ○ Drinking.Families launching young adults – First child leaves home  empty nest – Economics force children to stay home longer – Reorganizing family into a unit & releasing mature children into world – Parents – early middle age. visiting. diminished masculinity. birth control. caring for them. drugs – parent generation – can have a toll – stress. alcohol. social isolation or – rewards & support ○ Problematic role – relating & assisting aging parents & other family members – care giving. generational squeeze. drive to get ahead in career. unemployment. alone now.○ Maintaining ethical & moral standards – teens searching for self Health concerns: ○ Health promotion – risk factors ○ Parents . STD’s ○ Strengthen & support marital relationship Stage 6 . financial. pregnancy. sense of themselves as failures in parenting and work Family developmental tasks ○ Women rechanneled energies from children. caught btw youth – elderly expectations Developmental tasks: ○ Launch oldest child & help younger children become independent ○ Parents have more time for other activities & relationships ○ Challenge to marital relationships ○ Women continue to be busy in their job & partner roles ○ Menopause ○ Men face developmental crisis. can be career peak or monotonous ○ More leisure activities ○ Preparation for retirement ○ Taking on healthier lifestyle. improving lifestyle – fear of getting illness ○ Find satisfying & meaningful relationships with children & their parents ○ Accepting & welcoming grandchildren – couples to continue to feel like a family ○ Grandparents are becoming the primary care givers – divorce. can be difficult. women do majority. sex education. loss of children. financial. marital problems ○ Strengthening of marital relationship. nursing home vs home Health concerns ○ Communication problems btw young adults and their parents ○ Role transitional problems for wife and husband ○ Caretaker concerns for aging parents ○ Emergence of chronic health conditions or predisposing factors – high BP.Risk of coronary heart disease. drug use. financial worries ○ Assisting aging and ill parents – calling. wellness lifestyle Stage 7 – Middle aged parents – When last child departs form home & ends with retirement/death – 45-65 yrs old – Changes in marital adjustment. renegotiate marital system Health concerns ○ Health promotion & needs . roles change – The prime of life – Marital & family satisfaction peaks – Greater economic security – Mutually enjoyable activities & companionship = marital satisfaction – Problems of aging. financial strain. sometimes middle age crisis ○ Redefining relationships with children ○ Women live healthier lifestyle ○ Men find frustrations & disappointment with work. vulnerable to ill health ○ Teens – accidents.

condition of home – predictor of persons wellbeing. menopause Stage 8 – Families in retirement and old age – Retirement of one or both spouses. healthy. assisted living facilities. goals. relocation is traumatic ○ Adjusting to reduced income ○ Maintaining marital relationships ○ Adjusting to loss of spouse ○ Maintaining intergenerational ties ○ Continuing to make sense of one existence – life review and integration Health concerns ○ Increasing functional disabilities ○ Mobility impairment ○ Chronic illness ○ Diminished physical vigour and function ○ Long term care services ○ Care giving ○ Social isolation ○ Grief/depression ○ Cognitive impairment Environmental Data 1. productivity • Health – decline physical. elderly has doubled in population – More people survive longer due to improved health care and disease prevention – Some are miserable. aging parents. money. depends on financial. burdened. spouse • Work – retirement. grandchildren ○ Caregiver concerns. health status Societies attitude ○ Aging is viewed as a decline. assisting with aging parents ○ Physiological changes. satisfaction. disease is perceived as the norm. new generation of old people – educated. others are happy. social support. institutional setting • Social – death of sibling. dependency • Housing – move to smaller home. mental. location of home. energies ○ Retirement yrs – quarter of persons life Developmental tasks ○ Maintaining satisfying living arrangements – move out. loss of work role. lifestyle changes. ends with death – 65 yrs and up. thru loss of spouse. cognitive fcns ○ Retirement – life cycle turning point – loss of status. active. society doesn’t allow elderly to be productive – affects elderly’s self image ○ Attitudes are changing. friend. reorientation of values. affluent Losses ○ Stressors/losses: • Economic – reduced income.○ Marital relationship ○ Communication with children. negative connotation. in-laws. Characteristics of Home .

adequacy of refrigeration d. Paint – flaking. does family rent or own b. lead poisoning h. rooming house. Sleeping arrangements – adequate for members. vermin (interior). number of rooms. living room. how they are furnished. Homes condition – interior & exterior. sanitation. old paint. room uses. Homes safety hazards – presence or absence k. adequate light – artificial/daylight. Territorial unit – family comfortable driving out of neighbourhood to use resources & services i. Kitchen – assess water supply. types of rooms – bedroom. ventilation. condition and adequacy of furniture. Cleanliness & sanitation – hygiene & cleanliness practices. relationship. how members feel about privacy j. heat. do members share towels. water supply.a. Waste & garbage disposal – adequate . considering age. railings in adequate condition c. infestations. presence of towels & soap. Privacy arrangements. grab bars in tub e. Bathrooms – sanitation. Dwelling type – home. toilet facilities. special needs f. sanitation problems due to pets g. apartment. stairs. floors.

community – rural. Physical characteristics of immediate neighbourhood & larger community – type of neighbourhood. combined residential & industrial. hospitals. Availability of public transport – how accessible – distance. hours to family g. Families geographic mobility a. trash. density of population. agrarian. Demographic characteristics of neighbourhood & community – social class & ethnic characteristics of residents. types of dwellings – residential. sanitation of streets. How long family lived in area b. counselling. is home adequate for their needs 1. dilapidated. urban. social service agencies – welfare. Recreational facilities f. recent demographic changes in neighbourhood c. Family history of geographical mobility . busing & integration problems e. noise. emergency facilities. presence & type of industry. air. condition of dwellings & streets – kept up.l. Health & basic services available in neighbourhood & community – marketing facilities – food. family church/temple d. intercity. water pollution problems b. drugs. Characteristics of neighbourhood & larger community a. home – cleanliness. Satisfaction/dissatisfaction with housing arrangements. garbage collected. employment. Accessibility of schools & condition. industrial. safety problems 1. suitability. Laundromat – if needed. occupations & interests of families. deteriorating. revitalized. health agencies – clinics. Incidence of crime. clothes. suburban.

How family views community Family structure . Who in family uses what community services b. Family associations & transactions with community a. Family aware of community services relevant to needs – transportation e. How often does members use these services c. Where did family move or migrate 1. organizations from whom receives assistance or relates f. Family feel about groups.c. Family territorial patterns – communities or areas frequented d.

Degree members use assumptions & judgemental statements in interaction. What are areas closed off to discussion that are important issue of family wellness or adequate fcning g. Are msgs congruent in content & instruction – observations of nonverbal msgs. msgs sent appropriate for developmental stage of members d. How emotional – affective msgs conveyed in family & within family subsystems. How frequent are emotional messages conveyed. patterning of transmitting important msgs. in what manner. b. Interact in offensive manner to messages. what extent members use clarification & qualification in interacting. c. What is frequency & quality of communication in communication network & familial sets of relationships. if not who manifests what kind of incongruency e. member elicit & respond favourably to feed back or do they discourage feedback & exploration of an issue.1. How well members listen & attend when communicating. intermediary exist. Types of dsyfncal process seen in family communication patterns f. Who talks. How do these affect family communication patterns: – Context. Communication patterns a. How firmly & clearly members state their needs & feelings. After observing family as whole & set of relationships – how is fcnal & dysfcnal communication patterns used – diagram & give examples. Members seek validation from each other. situation – Family life cycle stage . What types of emotions are transmitted in family subsystems – negative or positive or both. Frequency of disqualification utilitized.

decides how money is spent. Specific techniques utilized for making decisions in family & extent they are utilized – consensus. family power can be assessed. compromising. wins b. how does family make decisions Power bases – the various bases/sources of power are legitimate power/authority. decides on changes in job/residence. de facto. decides on how to spend evening. What bases of power do family members make decisions – variables affecting power c. and variation of helpless power. referent power. expert power/resources power. coercive power. Recognizing existence of variables helps assessor interpret family behaviour. disciplines/decides on child’s activities Decision making process a. pays bills. tension management power b. Power structure Power outcomes a. Who makes what decisions – last say. How important are decisions/issues to family: specific questions: – Who budgets.– – – – – Family cultural background Gender differences in family Family form Family socioeconomic status Family unique miniculture 1. affective power. what friends/relatives to visit. accommodation-bargaining. reward power. informational power – direct/indirect. power hierarchy: – Type of family form – Formation of coalition . coercion.

Determine overall power pattern – broad open ended questions of spouse & children: – Who has last say. Deduce family power as dominated by husband/wife. child. automatic. makes decision about important issues – – – – – – Who is really in charge & why Who runs family Who wins important arguments/issues Who wins in disagreements Who gets way when spouses/parents disagree Are members satisfied with how decisions made & who makes them – present power structure . who is it b. chaos.– – – – – Family communication network Gender differences Age & family life cycle factors Cultural & interpersonal factors Social class Overall family system & subsystem power a. grandparent – is it egalitarian-syncratic. family power continuum used for visual presentation of analysis Family power continuum – if dominance found. leadershipless.

who gave feelings & values about growth. If informal roles are dysfcnal. Who plays them & how frequently or consistent are they enacted. Cultural influences – role structure affected by ethnic & religious background . Purpose of informal covert roles serve g. roles & communication techniques c. How competently members feel they perform their roles d. covertly playing roles different from their position f. Role structure Formal role structure a. Impact of persons who play these roles Analysis of role models – when role problems are present b. Describe how each member carries out their roles b. what were they like d. Social class influences – social class background influence formal & informal roles f. new experiences. Any flexibility in roles when needed Informal role structure e. Informal roles that are dysfcnal to family or member in long run h. Who acted as role model for mates in roles as parents & marital partners. Who are models that influence members in early life. who modeled these for them Variables affecting role structure e. Are these roles acceptable & consistent with member expectations – any role strain or conflict c.1. Informal or covert roles exist. What formal position &roles do each members fulfill.

reallocation of roles/tasks. Extent there is congruence btw family values & members values .g. health problems affected roles. member who is sick – reaction to his/her loss of role Family Values 1. ethnic group with whom they identify or both: – Productivity vs individual achievement – – – – – – – – – Individualism Materialism vs the consumption ethic The work ethic Education Equality Progress and mastery over the environment Future time orientation Efficiency. member adjusted to new roles. conflicts. Developmental & life cycle stage influences – are roles developmentally appropriate h. practicality Quality of life and maintaining health Disparity in value system a. families reference group. Extent there is congruence btw family values & family reference group and interacting systems like educational & health care systems & wider community b. evidence of role stress. orderliness. Situational events – members health status changes. Use of compare & contrast method is suggested with values of either dominant culture.

Values conscious /unconscious e. cultural background & degree of acculturation. How important identified values to family – rank in order of family values d. Value conflicts within family f. suburban influence family values g. urban.Family values c. generational differences. geographical setting – rural. Family values affect health status of family . Family social class.

Family Functions .

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