Journal of Family Nursing

Volume 14 Number 1
February 2008 33-55
© 2008 Sage Publications
10.1177/1074840707312237
A Conceptual Review of http://jfn.sagepub.com
hosted at
Family Resilience Factors http://online.sagepub.com

Keri Black, MN, CFNP

Marie Lobo, PhD, RN, FAAN
University of New Mexico College of Nursing

Family resilience is the successful coping of family members under adversity

that enables them to flourish with warmth, support, and cohesion. An increas-
ingly important realm of family nursing practice is to identify, enhance, and
promote family resiliency. Based on a review of family research and concep-
tual literature, prominent factors of resilient families include: positive outlook,
spirituality, family member accord, flexibility, family communication, financial
management, family time, shared recreation, routines and rituals, and support
networks. A family resilience orientation, based on the conviction that all
families have inherent strengths and the potential for growth, provides the
family nurse with an opportunity to facilitate family protective and recovery
factors and to secure extrafamilial resources to help foster resilience.

Keywords: family; family health; family resilience; protective and recovery

factors

O ne of the enduring mysteries of family dynamics is why some families

continually live well together and respond positively to challenges,
whereas others in similar circumstances do not cope well. The successful
coping of families during life transitions, stress, or adversity has been described
as family resilience (McCubbin & McCubbin, 1988, 1996). The concept
of resilience was originally developed by studying the positive adaptation of
children under adverse circumstances (Rutter, 1987). Recently, its applica-
tion has been extended to the study of family systems (Allison et al., 2003;
Hanson, 2001a; McCubbin & McCubbin, 1996; Walsh, 1998, 2002).
This conceptual article reviews the literature on resilience at the family
level, with the identification of key factors often found in healthy families.
The review concludes with family nursing implications and suggestions

Authors’ Note: Please address all correspondence to Keri Black, MN, CFNP, 2121 Juan Tabo,
NE, Albuquerque, NM 87112; phone: 505-237-8816; fax: 505-237-8817; e-mail: Kblack@
salud.unm.edu.

33

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34 Journal of Family Nursing

how to obtain positive family outcomes. Inherent in the family resilience

model is a dual focus of building protective and recovery factors, in addition
to reducing ecological risks that threaten family functioning. Hanson (2001a)
has argued that an increasingly important realm of family nursing practice
is to identify, enhance, and promote family resiliency. This article describes
what is known, identifies conceptual gaps, and proposes how family resilience
can be used for family interventions.

Family and Family Health Definitions

For the purposes of this article, Hanson’s (2001b) definition of family will
be used: “Family refers to two or more individuals who depend on one
another for emotional, physical, and economical support. The members of the
family are self-defined” (p. 6). The health of a family is best described in
interactional traits for optimal growth, functioning, and well-being of the
family as a whole. Hanson (2001b) defined family health as “a dynamic
changing relative state of well-being which includes the biological, psycho-
logical, spiritual, sociological, and culture factors of the family systems” (p. 6).
Healthy families should not be assumed to be without problems, as no family
is problem-free. Crises challenge most families along the life cycle, ranging
from predictable developmental problems to sometimes catastrophic events
(McCubbin & McCubbin, 1993; Walsh, 1998).

Conceptualizing Family Resilience

Given that high functioning families also have crises, how can we best
understand what accounts for strong families? What are the family hall-
marks of success enabling families to flourish with warmth, support, and
cohesion, even under stressful events, whereas others succumb to crises?
Many family scientists are explaining the phenomenon of rising above chal-
lenges by the strength-based model of resilience; examining positive coping
factors rather than deficits. Consistent with a strengths approach and adapt-
ability, McCubbin and McCubbin (1988) defined family resilience as “char-
acteristics, dimensions, and properties of families which help families to be
resilient to disruption in the face of change and adaptive in the face of crisis
situations” (p. 247). It follows that healthy (strong) families may be explained
as sharing resilient processes in response to stress or change. CINAHL was
used for this literature review with the following search terms: resilience,

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 Black, Lobo / Conceptual Review of Family Resilience 35

family systems, family protective and recovery factors, and family resilience.
Family resilience clarifies why some families not only survive problems but
thrive and become stronger as a result.
The concept of resilience is becoming one of the most salient and chal-
lenging terms in contemporary psychology (Luthar, Cicchetti, & Becker,
2000; Masten, 2001; Von Eye & Schuster, 2000). The qualities of resilience
can be developed at any time of the family life cycle and are often enhanced
and refined through problem solving (Masten, 2001; McCubbin &
McCubbin, 1988; Rutter, 1999; Walsh, 1998, 2003b). Family interactions
and a general optimistic attitude are at the heart of weaving a strong and
unique tapestry of resilience as families continue to love and support each
other through normative and unexpected challenges.

History of the Concept of Resilience

Positive, strengthening adaptive outcomes in response to adversity have
a long and renowned history. Evidence shows that since the 1970s, many
children raised in high-risk environments did not mirror their deprived envi-
ronments, but rather thrived and grew up to become productive and loving
individuals (Luthar et al., 2000). Although many deprived or traumatized
children became blocked from growth or trapped in a victim position, Rutter
(1987) noted that about half of children exposed to high-risk circumstances
overcame them, were able to lead loving and productive lives, and went on
to raise their own children well.
Research on resilience expanded to include various ages and disadvan-
taged states, such as poverty and violence (Luthar, 1999; Rutter, 1987),
maltreatment (Cicchetti & Rogosch, 1997), chronic illness (McCubbin,
Balling, Possin, Frierdich, & Bryne, 2002; White, Richter, Koeckeritz,
Munch, & Walter, 2004), and catastrophic life events (Clay, 2002). Early
efforts to describe resilience focused on personal qualities of resilient indi-
viduals, such as autonomy and self-esteem (Masten, 2001).

Family Resilience
With the evolving concept of family resilience, the focus is shifting away
from identifying individual personality factors toward the crucial influence
of positive relationships with family, kin, and mentors. Family resilience
examines the product of family relationships (Patterson, 2002). Luthar and
colleagues (2000) argued that the dynamic process of resilience is best under-
stood through the context of a broader, interrelational framework. A family

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36 Journal of Family Nursing

resilience perspective recognizes parental strengths, family dynamics, inter-

relationships, and the social milieu. This strength-based approach considers
family stresses and challenges not as damaging but rather as opportunities
for fostering healing and growth (McCubbin & McCubbin, 1988, 1996;
Walsh, 2003b).
All families encounter problems, or stressors. “A stressor is a demand
placed on the family that produces, or has the potential to produce, changes
in the family system” (McCubbin & McCubbin, 1993, p. 28). The problem,
demand, or loss has the possibility to either weaken family functioning and
relationships or, conversely, strengthen the family as the stressor is subdued
with unified action and commitment. Resilient families are strengthened
through the use of resilience factors (protective and recovery) in these
circumstances.
McCubbin and McCubbin (1993) identified both protective and recovery
factors that work synergistically and interchangeably to respond success-
fully to crises and challenges. Protective factors facilitate adjustment, or the
ability to maintain integrity and functioning, and to fulfill developmental
tasks. When the family is challenged, recovery factors are called upon to
promote the ability to adapt, or rebound, in crisis. In addition to the perceived
severity of stressors, a “pile-up” of stressors can tax family protective and
recovery factors, with the family relying on some more than others during
various family cycle situations (McCubbin & McCubbin, 1993).
Family resilience entails more than surviving a crisis, but also offers
the potential for growth out of adversity. Weathering a crisis together, a family
can emerge more loving, stronger, and more resourceful in meeting future
challenges (Walsh, 1998; White et al., 2004). The developmental progression
of resilience often emerges with changing life circumstances and new stressors
(Luthar et al., 2000; McCubbin et al., 2002). “The phenomenon of resilience
requires attention to a range of possible psychological outcomes and not just
a focus on an unusually positive one or on super-normal functioning” (Rutter,
1999, p. 120). A repertoire of possible coping factors is exchanged in resilient
families. There are times when family demands exceed the family’s capa-
bilities. When these imbalances exist, some capabilities may supersede others
toward regaining equilibrium. Of course, some family processes fail to adapt
with poor immediate and long-term outcomes (Patterson, 2002).

Family Cultural Considerations

Cultural ideals must be considered in examining families. McAdoo (1999)
described the complex interaction that occurs within family constellations

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 Black, Lobo / Conceptual Review of Family Resilience 37

as family ethnicity. Ethnicity is a family’s collective identification from the

totality of ancestry and cultural characteristics. Despite wide variations in
family structure, rituals, and practices, there appears to be common factors
among cultures and ethnic groups in characterizing resilient families
(Patterson, 2002). The importance of family, with emphasis on kin relation-
ships, striving for satisfying parent-child relationships, family members
meeting each others’ needs, and the family as a source of comfort and secu-
rity, have been found to be similar worldwide (DeFrain, 1999; McAdoo,
1999; Parke, 2000).

Prominent Family Resilience Factors

Individual families, regardless of ethnic status, differ highly in how they

experience family strengths, setbacks, and the perceived severity of risk.
There is no universal list of key, effective protective and recovery factors,
but a review of recent research and literature recognizes recurrent and
prominent attributes among resilient, healthy families. These factors include:
a positive outlook, spirituality, family member accord, flexibility, communi-
cation, financial management, time together, mutual recreational interests,
routines and rituals, and social support (see Table 1).

Positive Outlook
An optimistic confidence in overcoming odds lies at the heart of
resilience. Rutter (1987) identified an approaching style to new situations
and a sense of humor as important features in viewing crises as meaningful
or comprehensible. The importance of optimism was emphasized again by
Rutter in 1993:

Almost certainly, it is not that there is one “right” way of thinking about
things, or one optimal style of coping. Rather, what seems important is to
approach life’s challenges with a positive frame of mind, a confidence that
one can deal with the situation, and a repertoire of approaches. (p. 630)

Bradbury and Karney (2004) reported that displays of positive emotions

(such as affection, humor, offering positive solutions, and accepting sugges-
tions) were more influential in marital satisfaction than problem solving or
communication. Hope for the future was found to foster resilience, measured
by the avoidance of risky behaviors, among 443 impoverished inner-city

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38 Journal of Family Nursing

Table 1
Resilient Family Prominent Protective and
Recovery Factor Characteristics
Resilience Factor Family Characteristic

Positive outlook Confidence and optimism; repertoire of approaches; sense

Spirituality
Family member accord
Flexibility
Family communication
Financial management
Family time
Shared recreation
Routines and rituals
Support network
of humor
Shared interval value system that gives meaning to stressors
Cohesion; nurturance; authoritative discipline; avoidance of
hostile parental conflict
Stable family roles with situational and developmental
adjustments
Clarity, open emotional expression, and collaborative problem
solving
Sound money management, family warmth despite financial
problems
Makes the most of togetherness with daily tasks
Develops child social and cognitive skills; cohesion and
adaptability
Embedded activities that promote close family relationships;
maintenance even during family crisis
Individual, familial, and community networks to share resources;
especially important for families in poverty

black female adolescents and to thwart risk-taking behaviors in Aronowitz

and Morrison-Beedy’s (2004) study.
Affirming strengths and possibilities, maintaining courage and hope, and
remaining optimistic have been shown to be effective methods of coping for
families (McCreary & Dancy, 2004; Orthner, Jones-Sanpei, & Williamson,
2004; White et al., 2004). Maintaining a positive outlook does not mean
that negative behaviors are ignored, but rather that various viewpoints and
each member’s opinions are examined to identify underlying problems,
always augmenting positive aspects (Conger & Conger, 2002; Leon, 2003;
Lindsey & Mize, 2001). For example, moving to a new area could be seen
as a burden for some families and met with resistance. For families with a
positive outlook, the relocation could be seen as a welcome challenge and
an opportunity to interact with new people and locations.

Spirituality
A shared belief system of hope and triumph enables families to make
sense of crisis or change. When confronted with problems, many families

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 Black, Lobo / Conceptual Review of Family Resilience 39

foster an optimistic attitude with spirituality, seeking purpose in faith. Many

fundamental family beliefs are founded in religion and spirituality (Marks,
2004; McAdoo, 1999). A meta-analysis of family spirituality studies indi-
cates that religion is a prominent factor in the family, with 95% of parents
reporting a religious affiliation (Mahoney, Pargament, Tarakeshwar, &
Swank, 2001). Spirituality may or may not be religion-based (Tanyi, 2006),
but whatever the spiritual orientation, families associated with a shared
internal value system that provides meaning tend to feel a connection with
the family, community, and universe (Marks, 2004; Walsh, 1998).
Spirituality has been found to be an essential factor of resilience, as it
provides families with the ability to unite, understand, and overcome stress-
ful situations (DeFrain, 1999). For example, White and colleagues (2004)
found that whereas patients with end-stage renal disease and their families
expressed spirituality in differing ways, it was an important factor in family
resilience. Additionally, membership in a church is often an avenue to gain
supportive networks for family members (Mahoney et al., 2001; Marks,
2004; McCubbin & McCubbin, 1988; Tanyi, 2006; Walsh, 1998). Data from
a random sampling of 621 U.S. counties revealed that religious couples had
lower divorce rates that couples without a religious faith (Mullins, Brackett,
Bogie, & Pruett, 2004). Rew, Wong, and Sternglanz (2004) reported that
children, regardless of ethnicity, who frequently prayed experienced higher
levels of social connectedness and positive health behaviors than children
who did not regularly pray. Spirituality and religious beliefs appear to serve
as powerful protectors often embraced by resilient families.

Family Member Accord

The premise of the systems approach to families is that the whole and its
parts must be connected and content for both to continue. A family system
works when its members feel good about the family, their needs are being
met, and the development of relationships flows smoothly (Olson, 2000).
Family cohesion enhances family confidence that problems are comprehen-
sible, manageable, meaningful, and that higher levels of reorganization and
adjustment are reached after the crisis (McCubbin et al., 2002; Walsh, 1998).
Well-functioning family members tend to interact on a daily basis with
nurturance and compliments, and they reinforce each others’ efforts (Walsh,
2003a). The comfort and security of a resilient home may be seen as a pro-
tective and secure base for all family members (Bowlby, 1982). In times of
crisis, the family’s pulling together and turning to each other for support has
been found to be one of the most important recovery factors in resilience

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40 Journal of Family Nursing

(Conger & Elder, 1994; McCreary & Dancy, 2004; Orthner et al., 2004;
White et al., 2004).
Children seem to do better when there is a fit between the temperament,
personality, and needs of the children and the style of parenting they receive.
This fit is best achieved when parents assume loving and leadership roles
(Pruett, Williams, Insabella, & Little, 2003). Discipline in resilient families
tends to be authoritative and predictable, with mutual respect for all family
members. An authoritative parenting style is characterized as warm and affec-
tionate, clear and firm about expectations, yet not too rigid. Consistently
practiced, this type of parenting and discipline has been found to achieve
positive child outcomes, such as perseverance, better school outcomes, and
the development of resilience into adulthood (Conger & Conger, 2002;
Luthar, 1999; Masten, 2001). Conversely, too-strong parental control, or
an authoritarian style, has been associated with poor child outcomes, such
as behavioral problems, poor academic achievement, and less initiative
(Lindsey & Mize, 2001; Morris et al., 2002).
The American Academy of Pediatrics Task Force on the Family Report
(AAP, 2003) concluded that children do best economically, socially, spiri-
tually, and psychologically when raised by two married parents who love
and respect each other. In two-parent families, the tone for family harmony
is most often set by the degree of marital accord (Walsh, 1998, 2002).
Transcending economic or other hardships, spouses who are supportive,
warm, and caring instill a sense of security, self-worth, and confidence in
all family members (Conger & Conger, 2002; Orthner et al., 2004).
Children do not need to suffer when parents face relationship conflict or
separation. When spousal conflict is handled away from children, children
from separated homes have been found not to differ from those whose
parents had little or no conflict (Golby & Bretherton, 1999; Kelly & Emery,
2003). The avoidance of hostile or angry parenting under the strain of eco-
nomic hardship reduced externalizing and internalizing child behaviors,
according to Conger and Conger’s (2002) 10-year longitudinal study of 558
poor Midwestern youth and their families.
On the other hand, maladjustment outcomes, such as substance abuse and
behavioral problems, have been well documented when children are exposed
to intense marital conflict, particularly when parents use their children to
express anger (Hipke, Wolchik, Sandler, & Braver, 2002; Lindsey & Mize,
2001; Peris & Emery, 2004; Pruett et al., 2003). Children often learn how to
handle conflict from observing their parents. When disputes are handled in a
civil and cordial manner that ensures mutual respect, children can model
peaceful negotiation skills throughout their lives, an added factor toward
fostering resilience.

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 Black, Lobo / Conceptual Review of Family Resilience 41

Marital dissolution is a reality, yet children can do well if a secure and

loving atmosphere is maintained. Refuting claims that divorce irreparably
damages children, Kelly and Emery’s (2003) literature review concluded
that more than 75% of children showed healthy postdivorce development,
dependent on the continuity of supportive love and protection from intense
family conflict. When conflicts did occur, respect was maintained, and
reconciliation after the crisis reestablished security.
The AAP (2003) argues that many of the psychological problems children
from divorced families face are largely due to the absence of a supportive
father figure. Fathers are often absent in single-parent and divorced homes,
but their continual involvement has been shown to be a powerful buffering
influence on their children’s well-being. When fathers provide a visible and
nurturing presence in their children’s lives, the children have better emotional
and social outcomes and are more likely to have stronger coping and adapta-
tion skills, show better problem-solving skills, stay in school longer, have
longer lasting relationships, and have higher work productivity (Peris &
Emery, 2004; Pruett et al., 2003). The protective and recovery factors of both
supportive mothers and fathers are vital in promoting family resilience,
whether the family is intact, separated, or divorced.

Flexibility
Flexibility refers to a family’s ability to rebound and reorganize in the
event of challenges while maintaining a sense of continuity (McCubbin &
McCubbin, 1988). Mutuality is best achieved when family members possess
a clear sense of themselves, both within and outside the context of family.
In other words, members identify a connection with the family as well as
differentiation from the family.
According to Olson (2000), families tend to prefer stable and orderly
patterns, yet function best when a balance is achieved between moderate
amounts of structure and flexibility. A moderately structured relationship
has a democratic, egalitarian leadership, with negotiations from all members.
Family roles are stable, yet allow for role sharing. Family rules are age appro-
priate, acknowledged, and predictably enforced. It is common for most
families to resist change or loss, yet resilient families do not view the change
with helplessness; rather, roles are reorganized and changes are viewed
optimistically as venues to build a new equilibrium (Conger & Elder, 1994;
Orthner et al., 2004; Walsh, 2002; White et al., 2004).
Dysfunctional parents, in comparison, tend to operate at the extremes of
being either overly rigid or chaotically unstructured. Walsh (1998) observed

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42 Journal of Family Nursing

that rigidly enmeshed, or fused, families view member independence as

threats to the family system. Strict limits are placed on their children’s
expressions or ventures outside the family. Not only do enmeshed families
have difficulty handling stress, but the children tend to have internalizing
disorders when attempting to seek productive lives outside the family.
At the other extreme, disengaged families view the sum of the family as
less than the parts. Members of disengaged families tend to drift off on their
own and are unable to find mutual support from the family. Within a chaotic
family environment of an imbalance of either overindulgence or neglect,
difficulty in limit setting and discipline exists. Rules and roles are inflexi-
ble and unpredictable. Role confusion only worsens with crisis situations,
and the family is set up for repeated disappointments (Walsh, 1998).
A meta-analysis examining children from these families have shown them to
exhibit externalizing problems, such as antisocial behaviors and aggression
(Rothbaum & Weisz, 1994). In contrast, healthy families learn to adjust and
shift the balance of connectedness and separateness through the family life
cycle to meet the ever-changing developmental needs.

Family Communication
Harmonious communication is the essence of how families create a shared
sense of meaning, develop coping strategies, and maintain agreement and
balance (DeFrain, 1999). Three important aspects of communication have
been noted by Walsh (1998) for family resilience: clarity, open emotional
expression, and collaborative problem solving. Clarity of communication
implies clear and consistent messages. Communication in healthy families
has been shown to be direct, clear, honest, and specific (Lindsey & Mize,
2001). Members are able to distinguish facts from opinion and seriousness
from humor. Unclear communication or ambiguity can breed confusion and
misunderstanding, thus establishing mistrust and insecurity.
Open emotional sharing is expressed in well-functioning families through
behavior, tone, words, availability, and communication patterns. A climate
of mutual trust prevails when family members feel free to express their
feelings without judgment or shame. Conversely, patterns of destructive
communication are often characterized with withdrawal, unresolved anger,
and a higher incidence of divorce (Stanley, Markman, & Whitton, 2002).
Unspoken tensions are often bred by attempts to protect one another from
painful or threatening information, such as through secrecy or silence.
Walsh (1998) observed, “When families don’t function well, ambivalent
feelings are often not acknowledged or owned” (p. 111). Conversely, the

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 Black, Lobo / Conceptual Review of Family Resilience 43

reassurance of empathetic truth-telling and sensitive disclosure renders

problem solving more comprehensible and manageable.
Resilient families are not immune to negative emotions or anger, but they
attempt to listen, understand, and respect the reasons for negative emotions
(Golby & Bretherton, 1999). Finkenauer, Engles, Branje, and Meeus (2004)
found that Dutch children who disclose sensitive information about them-
selves, past events, and future plans with a parent, typically the mother, report
higher family satisfaction. On the other hand, parents who consider their
children their equals and confide secretive or highly personal information,
known as parentification, overly burden their children.
Problems and crises are inherent in all families. The ability to collabora-
tively solve problems and conflicts well has been shown to be a key factor
in resilient families. The problem is recognized and communicated openly
with all involved. In well-functioning families, parents act as coordinators,
bringing out others’ ideas, expressing their own, and encouraging all family
members’ opinions (Lindsey & Mize, 2001; Mederer, 1999). Approximately
one-third of low-income families studied by Orthner and colleagues (2004)
demonstrated weak communication skills with either avoidance or difficulty
talking about their problems.
Negotiation on solutions involves accepting differences, with all family
members communicating with compassion and understanding. Well-
functioning families tend to avoid withdrawal, criticism, and blame.
Reconciliation is important after the problem is resolved to reconnect,
reestablish a family environment of comfort and security, and maintain
equilibrium (Kelly & Emery, 2003).

Financial Management
“Sound decision-making skills for money management and satisfaction
with economic status can contribute to family well-being” (McCubbin &
McCubbin, 1988, p. 248). Conversely, financial pressure in families con-
tributes to family tension and stress and has been shown to have a pervasive
effect on emotional well-being and interpersonal relationships (Mederer,
1999; Walsh, 2002). Family research suggests that economic pressures will
first affect the emotional lives and marital interactions of adults and then
diffuse into the caretaking environment of the children (Conger & Elder,
1994; Mederer, 1999).
Poor families potentially confront multiple stresses, such as unemploy-
ment, substandard housing, lack of health care, crime, violence, and substance
abuse (Staveteig & Wigton, 2005). The combination of psychological,

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44 Journal of Family Nursing

social, and economic burdens of poverty renders families more at risk for
multiple problems and crises due to forces beyond their control (Walsh,
1998). Despite these pressures, many low-income families not only meet
basic needs, but are able to avoid violence and crime involvement, keep
their children in school, engage their children in enriching activities, and
maintain family cohesion (Conger & Elder, 1994; Luthar, 1999; Woolley &
Grogan-Kaylor, 2006). The protective factors of 373 low-income households
with children found to overcome financial hardships included reciprocal
high levels of warmth, affection, and emotional support for one another and
a sense of promise for a brighter future (Orther et al., 2004). Social support,
financial assistance, and the availability of health care enhance resilience,
yet were found to be sorely lacking for poor American families.

Family Time
Spending time together during family meals, chores, and errands plays
an important role in creating continuity and stability in family life
(McCubbin & McCubbin, 1988). Meal time appears to be the main activity
families share together, totaling about 2 hours a week, followed by televi-
sion viewing (Crouter, Head, McHale, & Tucker, 2004). Time spent as a
family unit has been shown to decrease risky behavior significantly in
teenaged children (Milkie, Mattingly, Nomaguchi, Bianchi, & Robinson,
2004). Unfortunately, family time appears to be dwindling as a result of
increased parental demands and responsibilities. More than half of
American families feel they spend insufficient time with their children,
according to Milkie and colleagues. Full-time employed mothers were
reported to spend, on average, 50 hours a week with their preschool
children, with fathers spending 33 hours a week. In contrast, nonemployed
mothers spend 63 hours a week with children, with time declining as the
child enters adolescence and the young adult years.
A common parenting phenomenon is time strain, conceptualized as the
lack of spontaneity to respond to children’s needs, fatigue, and inability to dis-
connect feelings from work (Milkie et al., 2004; Scharlach, 2001; Voydanoff,
2004). Both employed mothers and fathers feel time strain, particularly when
children younger than 6 years old are in the household (Voydanoff, 2004).
Employer-sponsored efforts to reduce work-related family strain, such as child
care and family-supportive programs, have not been shown to increase quality
family time for working parents (Hammer, Neal, Newsom, Brockwood, &
Colton, 2005; Scharlach, 2001; Voydanoff, 2004).

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 Black, Lobo / Conceptual Review of Family Resilience 45

Time strain will likely be a growing family concern with the trend toward
dual earners and single-parent households. An effective way to reduce time
strain and increase family time is to include the family in constructive family
activities including housekeeping routines. Children may be assigned age-
appropriate meaningful tasks, such as caring for the family pet, where they
can learn skills, abilities, and empathy. Commute time spent together in the
car or bus can provide opportunities for sharing family time through conver-
sation, making future plans, or participating in fun learning activities.

Shared Recreation
The multiple family benefits of shared recreation and leisure time have
been found to facilitate family health. Enjoyable family time can yield attach-
ments, intrinsic rewards, happiness, learning, humor, and the pleasure of
shared experiences (Bowlby, 1982; Hill, 1988; Russell, 1996). Mactavish and
Schleien (1998) examined parents’ perceived benefits of family recreation
and concluded that “shared recreation was especially helpful in developing
social skills, such as learning to problem solve, to compromise, and to nego-
tiate” (p. 221). A 5-year longitudinal study of 280 randomly selected couples
conducted by Hill (1988) suggested that families who play together tend to
stay together. There was a significant relationship between shared leisure
time and lower divorce and separation rates. Interestingly, the presence of
children in the household significantly reduced the amount of leisure time
that is viewed important in counterbalancing stress and strains. Zabriskie and
McCormick (2001) identified two types of family recreation: (a) core, or rou-
tine and common, activities, such as playing a board game after dinner; and
(b) balance, or novel, activities, such as bowling. Both types of recreation
were found to predict family adaptability and cohesion.
Lareau (2002) argued that middle-class families tend to make deliberate
efforts to spend time together. Working-class parents, however, felt it is up
to the children to devise their own recreational pursuits; yet these parents
strive to maintain safe play environments. Both approaches may be viewed
as family strengths that promotes either fun family time or child autonomy.
In recent years, screen media have taken precedence as a leisure activity
for many families. American families appear to be spending more time with
television, video games, and the computer (Bagley, Salmon, & Crawford,
2006). Although some educational and recreational benefits with moderate
screen media usage have been found, the difficulty arises when family
members sacrifice interaction time and physical exercise in favor of passive
viewing. Kubey and Csikszentmihalyi (2002) described an “addiction” to

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46 Journal of Family Nursing

excessive television viewing that can disrupt family cohesion. Moderate

screen media use can be fun and educational for the family, but not at the
sacrifice of true interactional activities.

Routines and Rituals

Based on reviews of 50 years of research on multicultural family routines
and rituals, Fiese and colleagues (2002) reported common strengths that
these embedded activities contribute to close family relationships, child
socialization, and mitigation of stressful situations. Routines are defined as
momentary time commitment tasks requiring little conscious thought.
Rituals, however, involve symbolic communication with enduring, affective,
and generational transmission. Research has indicated that families who
practice routines and rituals are associated with better child outcomes and
family stability than families lacking routines and rituals.
Routines are often dismissed in the event of a family crisis, such as mar-
ital separation or illness (Walsh, 1998). The loss of a comforting practice,
such as a habitual bedtime routine or family dinner times, can be unsettling
to children. Well-functioning families attempt to maintain family routines in
the midst of turbulence to provide the family with a feeling of predictability,
cohesion, and comfort (Walsh, 1998). Young and older generations alike find
rituals and celebrations to be a way to maintain family-of-origin values and
to build and maintain successful families through the generations (Fiese
et al., 2002).

Support Network
A family’s community and social support system can offer a rich, pro-
tective sense of belonging and cohesion. There is a growing appreciation
for the broader view of resiliency as a complex interaction with community
networks (Feely & Gottlieb, 2000; Luthar et al., 2000; McCubbin &
McCubbin, 1993). Resilient families not only attain social support from
their communities, but also give back to the community (Patterson, 2002).
Extended kin and social networks can interact reciprocally with families to
provide information, services, respite, avenues to contribute to the welfare
of others, and companionship (Luthar et al., 2000; Rutter, 1987; Seccombe,
2002). Children who perceive their community and neighborhood as safe
and satisfying have been found to benefit through improved academic
grades and fewer problem behaviors than those who see their neighborhood
as threatening (Woolley & Grogan-Kaylor, 2006). Particularly for families

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 Black, Lobo / Conceptual Review of Family Resilience 47

living in impoverished or isolated conditions, the availability and use of

quality support systems can dramatically increase positive outcomes, such
as perseverance, hope, education, and companionship (Aronowitz &
Morrison-Beedy, 2004; Conger & Elder, 1994; McCreary & Dancy, 2004;
Orthner et al., 2004). If parents are not able to provide emotional support
for children, other kin or mentors may step in to offer the children support,
positive role models, and protection (Aronowitz & Morrison-Beedy, 2004;
Bowlby, 1982; Rutter, 1987).
Healthy families have the strength to admit when they need help and are
more likely to turn to extended family, friends, neighbors, community
services, or counseling (Walsh, 1998). Unfortunately, there appear to be two
trends diminishing a family’s interaction with the community. One is the
tendency to withdraw from society; the other is a lack of available services.
The trends toward relocation and smaller family size in modern society
have frayed kin and community connections, requiring the establishment of
new forms of social support (Hanson, 2001a). Americans are more socially
isolated than they were just 20 years ago, according to McPherson, Smith-
Lovin, and Brashears (2006), who recently replicated a 1985 social survey.
During the past two decades, adults reported a 50% reduction in intimate
social ties, both within and outside the family, and 25% of the adult
Americans surveyed reported that they do not have a confidant. The
researchers contemplated that increased professional responsibilities, tele-
vision viewing, and technology dependence may be some of the recent
sociodemographic trends to blame for growing social isolation.
Additionally, a recent tendency for families to become privatized, with
reduced concern and responsibility for their neighbors, has been described.
Toth, Brown, and Xu (2002) expressed this dichotomy as a public-private
division; families feel a time pull for either private or public life, often with
a perceived inability to focus on both. When a balance was made between
public and private realms, community satisfaction was found to be posi-
tively correlated with family life satisfaction.
It may be, however, that families are not becoming privatized, but rather
the cause of social isolation lies in the paucity of community services.
Walsh (1998) cautions:

We must beware of the myth of family self-reliance that has grown out of
society’s individualistic strain. The major problems of families today largely
reflect difficulties in adaptation to the social and economic upheavals of
recent decades and the unresponsiveness of larger community and societal
institutions. (p. 101)

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48 Journal of Family Nursing

All families benefit from community resources, but those with a host of
other social problems can particularly benefit from external support
(Staveteig & Wigton, 2005). The poor have all the personal and family prob-
lems everyone else has, along with complications of poverty, isolation, and
a loss of community. Family isolation with a lack of social support can erode
resilience, particularly under stressful conditions (Luthar, 1999). Seccombe
(2002) argues that American society lacks policies inherent in other coun-
tries to improve the odds of poverty’s problems: “The U.S. has wallowed in
a laissez-faire approach in which families are largely left to fend for them-
selves” (p. 389). She recommends national health insurance, livable wages,
and enforcement of child support as methods to improve resiliency among
the poor.

Discussion

The conceptualization of family resilience makes clear that these are not
superhuman families invincible to stress and adversity. Rather, the studies
identify common underlying protective and recovery factors used that
support strong and healthy families. The past decade has enjoyed an expand-
ing research base on family resilience, but much needs to be done to under-
stand, measure, and promote family resilience.
Many questions about family resilience remain unanswered. For one,
how does the family resilience perspective take into account within-family
variations in response to adversities and the use of resilience factors? For
instance, the research regarding spirituality often fails to address the diffi-
culties that may ensue if one member of the family either does not share
other members’ spiritual views or perceives spirituality as unimportant.
Hypothetically, could this disjunction portend family stress, or might other
factors be called in to maintain equilibrium? Another question is if the same
adversity may result in different outcomes for individuals within as well as
between families. A recovery factor that promotes positive adaptation to an
adversity for one family member may be less beneficial or even have neg-
ative consequences for another. For example, not all family members may
accept seeking social support during problems such as a financial predica-
ment or child behavioral issues. Furthermore, because family resilience is
dynamic, what are the changes that occur in families over time?
To date, there is no universal agreement on the measurement of family
resilience. Many challenges exist in attempts to measure this complex con-
cept. First, the outcome of family resilience is best described on a family

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 Black, Lobo / Conceptual Review of Family Resilience 49

level, and individual family member scores do not truly represent a reflec-
tion of holistic family functioning. Whereas data from individual family
members are useful, they fail to conceptualize family resilience as a family
level variable. Second, specific protective or recovery factors have often
been narrowly examined rather than the reciprocal interactions between the
factors. However, the concept of family resilience is so multifactorial that a
scale encompassing its components and unified family perception of impor-
tance would indeed be daunting. Third, cross-sectional measurements do not
offer a causal or long-term conceptualization of resilience. Family resilience
is a dynamic trait that cannot be captured as a single point in time.
Currently, researchers tend to use either qualitative approaches or quan-
titative scales to measure family strengths and risk factors. McCubbin,
Thompson, and McCubbin (1996) have compiled instruments for family
assessment that may adapt to family resilience research. These scales assess
family variables that include coping, problem-solving communication,
attachment and changeability, regenerativity and adaptation, and organiza-
tional climate. Qualitative studies have asked families to describe their per-
ceived strengths and resilience factors. The study of family resilience is a
recent endeavor and at too young a stage for robust empirical evidence.
Understanding family resilience’s causal and long-term outcomes better
could be achieved through rigorous, longitudinal studies, with various family
structures, ages, and ethnic samples. An increased focus on social support,
found to be instrumental in undermining family resilience, is another research
need. Finally, many studies examining low-income families employ samples
from assistive agencies. Families lacking community services would add
insight into the family strengths and needs for future research.

Promotion of Family Resilience

in Nursing Practice

A family resilience approach is based on the conviction that all families

have inherent strengths and the potential for growth:

If researchers study only family problems, they are likely to find them.
Similarly, if educators, community organizers, therapist, and researchers are
interested in family strengths, they look for them. When these strengths are
identified, they can become the foundation for continued growth and positive
change in a family and a society. (DeFrain, 1999, p. 6)

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50 Journal of Family Nursing

A strength-based orientation provides the family nurse with an opportu-

nity to facilitate family adjustment and adaptation by not only examining
deficits but also by focusing on strengths and capabilities. Previous coping
mechanisms and current responses can set the foundation for planning
interventions to facilitate healthy families.
The family resilience model is increasingly recognized in family assess-
ment and therapy, although the deficit and individualist views still seem to
be the predominant approaches (Allison et al., 2003). Family services that
accentuate the positive qualities of families, such as teaching relationship
patterns, interpersonal skills, and competencies, have been shown to build
and maximize family resilience (Letourneau et al., 2001; Middlemiss,
2005; Rutter, 1999). Other resilience-promoting interventions, such as
competent parenting education, problem solving, and mentorships, have
also been developed with successful outcomes (Hipke et al., 2002; Rutter,
1999). These effective prevention programs underscore long-term strength
development and set the stage for positive lifelong adaptations. Because of
the potentially detrimental effect of pile-up environmental stressors that are
out of control for many families in poverty, society-wide measures to
reduce disparity are called for. Recommendations to help poor families
include health insurance availability, stricter enforcement of child support
payment, crime watches, and safe housing (Orthner et al., 2004; Seccombe,
2002; Staveteig & Wigton, 2005; Woolley & Grogan-Kaylor, 2006).
A promising strength-based orientation to family nursing services is pro-
posed by Feely and Gottlieb (2000). These authors advocate positive affirma-
tive approaches in interactions with families through a process of identifying
and developing strengths, then using those strengths in planning care. Simple,
yet often effective, ways to elicit family strengths are suggested through direct
questions. “What are the strengths and competencies of the individual family
members and of the family unit?” is an example of an open-ended question.
Family strengths are then collaboratively used by the family and nurse in strat-
egy planning. Both previous and newly learned coping factors can set the
foundation for planning interventions to facilitate healthy families.
It is well acknowledged that nursing assessment and care of the family
is not limited to the interior of the family but extends to interface with the
community and social support systems. An awareness of community
resources is instrumental in the search for hidden family resources and link-
ages that may prove to be protective and recovery factors. If assistive fam-
ily resources are not identified in the community, the family nurse is called
to serve as an advocate to create resiliency-building networks and reduce
the risks especially inherent in vulnerable families.

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 Black, Lobo / Conceptual Review of Family Resilience 51

Conclusion

The conceptualization of family resiliency offers a cogent lens through

which to view the reasons some families succeed through adversities
whereas others do not cope well. Resilient families have been shown to
interact in a dynamic manner, integrating the protective and recovery factors
of optimism, spirituality, accord, flexibility, communication, financial man-
agement, time and recreation, routines and rituals, and social support. These
factors have been shown to not only compensate for risk factors but to pro-
mote synergistically family harmony, balance, and security. With diminish-
ing social support in America, families are apt to increasingly turn to one
another for maintenance and security. Understanding how to enable families
to become and stay healthy and to struggle well is a workable challenge for
family nursing.

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Keri Black, MN, CFNP, is a nursing doctoral candidate at the University of New Mexico and
a certified family nurse practitioner in primary family health care in Albuquerque, New Mexico.
Her research interests are companion animal attachment and human health correlates,
promoting positive family health, and adolescent loneliness.

Marie Lobo, PhD, RN, FAAN, is a professor and graduate program director at the University
of New Mexico College of Nursing. Her research interests are family adaptations to health and
illness, families with children with pulmonary conditions, and impact of health policy on
children and families.

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