Running Head: FINAL INTERVIEW 1

Final Interview Assessment: Smith Family

Katie Neddo

Brigham Young University-Idaho

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Final Interview Assessment

Introduction

I am going to be using this paper to discuss a family stressor and how it relates to family

stress models. I will be using a family from my hometown who have dealt with a young daughter

being diagnosed with type 1 diabetes. I have interviewed the parents prior to gain insight into

how it affected their family unit, as well as the individuals in the family, and how they coped

with it in the various stages they have gone through. The interview went well as they seemed

eager to share their story. The family consists of two parents with five children. The oldest two

are boys and the youngest three are girls ranging from the ages of fifteen to four. The child who

has been diagnosed is child number four. I will be using the name Emma to conceal her identity

and Smith for the family name. Emma was six years old when she was diagnosed and is

currently seven, it has been a little over a year since her diagnosis.

The Crisis

The Smith family realized something was wrong with Emma around the beginning of

2018. Emma started to show some symptoms of the diabetes, but the family didn’t recognize

what it was yet. Emma started to have a lot of fatigue, she was taking more naps than usual and

wasn’t as energetic as her siblings; she also started to have an extreme thirst and wanted water

and juice all the time. This also led to excessive urination and occasionally bedwetting when she

was previously well past that stage of childhood. Another major concern was Emma’s weight

loss, her eating habits had grown but she wasn’t gaining any weight and was even losing some.

With many other symptoms, that they didn’t recognize at the time, the parents were starting to

get worried. After a couple of months, they decided to take her to the doctors and had come

home without any real answers. The parents decided if the doctor thinks she is fine then they
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should stick to their regular routine and see if things get any better. Around the beginning of

November, the parents realized things weren’t getting better and were starting to discuss what

they should do next when hardship became worse. Emma was at school on November nineteenth

when she started to feel nausea and was sent to the nurse’s office, it was in the office that she

passed out and her mother was called. When her mother arrived, she decided to take her to the

hospital, and they found out she had blood sugar levels over 1000 which is extremely dangerous.

After several days in the hospital what they suspected was confirmed, Emma had type one

diabetes.

There was a big adjustment period as the family had to address each family member's

feelings while trying to learn about this complicated diagnosis. After gaining an abundance of

information about type one diabetes, Emma was released from the hospital the day before

Thanksgiving. The family then went on a small trip, they had been planning to visit family after

the doctor’s approval. The family wanted to try to keep things as normal as possible for all the

children to try to disrupt their normal routine as little as possible. The family was starting to get

used to Emma having daily shots and finger pricks that were extremely taxing on her. Emma also

had frequent mood swings and the whole family, especially the mother, had difficulty adjusting

to this as she was normally a very happy girl. After six months Emma received an insulin pump

so that she would no longer have to receive injections, and this seemed to relieve a lot of

pressure and tension in the family. The family had a hard time dealing with the diagnosis in the

first few months but seemed to recover rather quickly and by one year they had all seemed to

have adjusted rather well.

Family Stress Model: Hill’s Truncated Roller Coaster

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I would like to start by talking about Hill’s Truncated roller coaster and how it applies to

this family and how it could be helpful to them. Williams (2013) discusses Ruben Hill’s theory

about the roller coaster each family member goes through in a stressor or crisis. Hill believed

that every family member went through their own variation of shock, disorganization, recovery,

and adjustment[ CITATION Mic \l 1033 ]. Williams (2013) goes on to explain Hill’s theory

about how a family crisis tends to be followed by several smaller crises over time as the family is

trying to recover.

The Smith family started to have their first crisis when Emma started to have symptoms

over the course of several months and wasn’t receiving any answers, this was the buildup. Then

the biggest crisis hit when Emma was hospitalized, the whole family was dealing with emotional

turmoil, but the parents were still dealing with everyday life. With four other children to care for

it was very hard to balance time with Emma who needed lots of attention and the other children.

The other children in the family started to feel left behind and were starting to act out when their

parents left them with their grandparents for several days, this is the next crisis the parents had to

deal with. After Emma was out of the hospital, she had a hard time dealing with needles and

receiving several injections a day would often end in tears, yet another hardship. One of the final

stressors this family had to go through was the medical bills. Although it wasn’t an extreme

amount, it was overwhelming enough that they have had to cut back on a lot of things since it

happened. This can and has led to many smaller issues.

You can see in the Smith family Hill’s truncated roller coaster and the effect it can have

on the family when the trials never seem to end. I think that introducing this family to Hill’s

Model could help them to see the ripple effect one event can have over time. Hill had five

different response patterns a family has when they face a crisis [ CITATION Mic \l 1033 ].
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These five response patterns could be insightful to the Smith family when facing the subsequent

trials that come with an initial stressor. The family can see the response patterns and how it

affects their overall level of resilience and unity in the family. Insight into what is happening can

help the family come to terms with what they are facing and have a more positive attitude in the

face of these trials. However, another great model that would help this family to not just

understand what they are going through, but also make changes for the better would be Cognitive

Behavioral Therapy.

Family Stress Model: Cognitive Behavioral Therapy

The family stress model I feel that can be the most beneficial in changing a family’s

outlook and therefore their resilience is cognitive behavioral therapy or CBT. CBT is based on

the idea “I think therefore I fear”[ CITATION Dav07 \l 1033 ]. Studies have shown that CBT is

more effective long term without medications than with them [ CITATION Dav07 \l 1033 ]. This

is because CBT gives patients skills that help them to overcome anxieties and this is a skill that

lasts with the patient [ CITATION Dav07 \l 1033 ]. This is like the popular quote said to be from

many different people “If you give a man a fish you feed him for a day if you teach a man to fish

you feed him for a lifetime”. If you give families dealing with crisis the tools in the form of

CBT, they will be able to deal with crises for a lifetime. Burns (2007) explained that anxiety

comes from cognitive distortions or different types of lies we think about; most of the time this

happens without us realizing it. He then gives us tools to overcome those distortions by using

three different models: The cognitive model, the exposure model, and the hidden emotion model

[ CITATION Dav07 \l 1033 ]. The model I would like to focus on is the cognitive model; in this

model, one can recognize that our thoughts are what direct how we feel and in turn if we change

our negative thoughts to neutral/positive ones we can change our negative feelings to
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neutral/positive feelings. Each member of the Smith family dealt with a lot of unpleasant feelings

over the course of this crisis. If the family were to understand the components of CBT and more

specifically the cognitive model it may help them to learn how to change their emotions and help

the family to grow closer in this hardship rather than further away. I would suggest the Smith

family particularly help Emma to understand the basic components of the cognitive model so she

can start to recognize her thoughts and emotions better. This would not only help her deal with

the extreme emotions she is going through because of the crisis, but it is also a good technique

for children to learn and practice over time to help them to be more self-aware as they become

adults.

Changes in family function over time

As stated in the model overviews and analysis the Smith family dealt with a significant

amount of emotions in every member of the family unit for several months after the diagnosis.

The other four children were of particular concern because they were receiving a lot less

attention from their parents as Emma required more. They also received less attention because

there wasn’t as much money to go out and spend on each of the children as this was easier

before. The parents were also dealing with significant stress as they tried to balance time with

each of their children, giving Emma the attention she needed, work and school schedules, paying

medical expenses, as well as still finding time to spend with each other. Emma, of course, had

her own difficulties, one of the biggest being her mood swings. For several months as the parents

were trying to learn about insulin and how much to administer, Emma would suffer mood swings

if their calculations were off and she wasn’t getting the correct amount of insulin. She also took

some time to overcome her negative relationship with needles.

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All of the members of this family unit were going through various difficulties and

emotions while having to learn how to come together as a family and grow in their resilience.

They felt in the first few weeks that they weren’t doing well in their communication and this

caused a lot of unnecessary suffering. After feeling the dip in their resilience and closeness as a

family the parents started to take more action in resolving this issue which I will talk about more

in the next section of this paper. After Emma received her insulin pump the strong emotions

started to wane as many of their largest struggles were behind them.

Coping Strategies and Resources for the Family

The Smith family struggled for the first six months, but they relied heavily on religious

teachings and found comfort in taking their hardships to God. The family coped by attending

religious services weekly and praying and reading the scriptures as a family every day. They

used several more religious practices to cope such as fasting, going to the temple, and asking

members of their faith for their prayers. The family now says that they are much closer and

stronger than before and contribute that to their unwavering faith.

The family also had many resources at their disposal that contributed to helping the

family cope. The Smiths asked the children’s grandparents to help watch the other children when

they were busy with Emma, they also had friends of the family help in taking the children to

school when they were unable. Their church provided meals for the time that Emma was in the

hospital. The parents joined a Facebook group for parents of children with type one diabetes that

helped them to receive answers to the many questions they had in the beginning as well as

finding a community of support for those that understood what they were dealing with.

Summary and Conclusion

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The Smith family suffered through a lot of hardship for most of 2018 as they tried to

figure out what was wrong with their daughter and then facing a diagnosis that affected every

member of the family. Before the diagnosis, the parent’s relationship started to face some strain,

but the family unit remained unchanged. After the diagnosis, the parents felt more relief as they

could finally put a name to the issues Emma was dealing with and had a clear plan to face them.

However, the family unit started to face more hardship as all the children learned to cope with

what their sister was facing and still having to ask to have their needs met. After a few months of

learning how to care for Emma, the parents started to have more time for the family, and they

started to grow closer again. Overall, the family suffered through a lot but feel that they are

stronger than ever and are grateful for the opportunity to get to know each of their children better

through this trial.

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References

Burns, D. D. (2007). When panic attacks. New York: Three Rivers Press.

Williams, M. D. (2013). Family Stress and Coping. Rexburg: Brigham Young University-Idaho.