Family Based Intervention: How to Assessment

and Practice in Hospital Setting

Assoc.Prof.Dr. Saovakon Virasiri

PhD, APN, NP,
Director of Family Nurse Practitioner Program: Faculty of Nursing, Khon Kaen University
 Situation/life Alcoholic person/ *Receiving therapy
style/function/ Addiction/ *Behaviors and
reactions
attachment/family Family *Expectations
interaction/ role/Problem *Health
vulnerable/ solving/caring//mo (Abuser/Family
dification/ members)
unexpected event
management *Resources
 How to assess family with person using Amphetamine during therapy in hospital
basis
Key point: How to understand family function, relationships, management and
expectation
1. Family function and process: behaviors/actions/interaction/coping…..6 functional
aspects
How to solve family conflict/difference/communication/monitoring and
controlling/solving problems…current and the past
2. Emotional expression to family member/situation
caring behavior/connectedness/emotional distance
3. Family structure/family system
Role/Rule/Expectation/subsystem (parents-child/Husband-
wife/Mother-son
4. Problems/background of the problems***
-Severity and impact/complication/How to fix it?...outcomes
-Motivation of the focused member and family
5. Family strength and supportive systems
-Family problem solving ability
-Supportive system (person/economy/community/instrument/emotion/information)
-Goal of change
-Family support (parental support/relatives...)
-Attachment/Relationships/communication…family role/key person...
-Safety and security in the family
-Family characteristics: Leadership/competency/positive interaction/emotional
expression/trust/coping skill/risk factors/poverty/violence/education
(Saovakon Virasiri ( 2019) modified from Rick A. Myer1, R. Craig Williams, Melinda Haley, Jamie N. Brownfield, Kelley B. McNicols, and
Nickole Pribozie. 2014. Crisis Intervention With Families: Assessing Changes in Family Characteristics. The Family Journal: Counseling and
Therapy for Couples and Families, 22(2) 179-185)
Model of family adaptation: family with addiction adolescents
Perception/feeling/
Expectations (C)

Addiction
Function Problem health/behavio
Stressors Vulner and family solving
ability/ relationshi /coping rs/family
(A)
risk ps (T) (PSC) function and
(V) health

Supportive in-outside
family (B)
 Family Health Assessment: crisis situation
• Genogram/Structure and
function/Attachment/Resources/Eco-map …
“quick interview” 15 mins
• Therapeutic communication : listening, support, showing
compassion, emphasizing strengths, not focus weakness
• Therapeutic questions: Who, how, what, when, where, why,
whom
• Seeking family strength more than weakness and problems
for developing new ideas and abilities
Family Genogram

liver cancer brain tumor

60 54

64 60 58 56 54 52
61

21 21

3,4
Family Attacment and Ecomap
Deaf ear man

Farm
Neighbor

54 61

21 21
Community
network
3,4
Office

Exercise
network

Temple
Data management and analysis: Example

Conflict
Not talking with openly/not express feeling
Not seeking knowledge
Guilty/self blaming
*Ineffective coping (individual and family)

Not function/not providing care Over protection

Inferiority/frustrate/sad
Inappropriate care and management
• Conflict/Family violence
• Lack of skills: supporting/caring/decreasing
Example: Family nursing
suffering diagnosis
• Lack of skill for helping the child quitting from
substance abuse
• Ineffective communication among family members
• Ineffective family support: emotional and providing
care
• Ineffective problem solving
• Family dysfunction: not fathering/not working
• Stress from role overload/conflict
• Role overload/role strain
• Ineffective parenting
 What is the essential family
intervention? And How?
*Family counselling
*Supporting family
(Emotion/Information/Caring/helping/morale/seekin
g effective resources)
*Therapeutic communication
*Symptom management
How about your goal of working as family
nurse?