Behavioral Medicine: A Guide for Clinical Practice, 5e >Families

Mitchell D. Feldman, John F. Christensen, Jason M. Satterfield, Ryan Laponis+

Table 11-8.Family intervention.

Step Objective Statement

1. Understand the major conflicts in the family system.

“Tell me about [anything you see in the genogram that is often
2. Understand how the sick role functions in the family system.
Analyze, and “bring the pain into the room” difficult], e.g., … having your mother-in-law living with you or,
3. “Bring the pain into the room,” that is, help the patient (and
raising teenagers.”
family if present) experience the pain of their problems during
the interview.

1. Direct the patient’s (and family’s) attention to the underlying
family problems and away from the sick role establishing
Reframe somatization, excessive functional impairment, or dysfunctional
self-management behavior.
2. Endorse the patient’s objectives while separating them from the
use of the sick role to obtain them.
For 1. “In addition to your [symptom/problem] these family
problems are equally worthy of attention.”
For 2. “Even if you were in perfect health I could understand why
you would want your [family problem] resolved in a way that meets
your needs.”

“I am so impressed with how well you are doing despite all your
Empathically witness 1. Provide emotional support and empowerment to the patient. problems. You’re really determined to be a good wife … father …
2. Enhance the therapeutic alliance. daughter.”

“You have important questions to answer about how to change

1. Restate the problem from Step 1 as a question the patient your communication … relationship … you’re your mother …
Refer
needs to answer with help from an expert. husband. You need the help of a counselor to answering those
2. Address resistance to psychotherapeutic treatments. difficult questions.”

Date of download: 12/27/22 from AccessMedicine: accessmedicine.mhmedical.com, Copyright © McGraw Hill. All rights reserved.