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Calgary Family Assessment Model _CFAM_

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Calgary Family Assessment Model _CFAM_ Powered By Docstoc
					Calgary Family Assessment
      Model (CFAM)
  A Multidimensional Framework
       Theoretical Foundations
1.Postmodernism –multiplicity of views
2.Systems Theory – family system as mobile
3.Cybernetics –feedback loops
4.Communication Theory – content & relationship
5.Change Theory – cognitive, affect, behaviour
6.Biology of Cognition – different views of
  reality
CFAM Categories of Family Life
I. Structural dimension
II. Developmental dimension
III. Functional dimension
     I. Structural Assessment
1.Internal –  who is in the family and
              how they are connected.
2.External- connection of family
            members to those outside.
3.Context – relevant background
            Internal Structure
1. Family Composition – as defined by the
          family.
2. Gender- set of roles, beliefs, or expectations of
          male & female behavior.
3. Sexual orientation –heterosexual, gay, lesbian,
          bisexual, transgender.
4. Rank order – position of children in family.
5. Subsystems – smaller clusters within family.
6. Boundaries – to protect the differentiation of
          subsystems; may be clear, diffuse, rigid.
           External Structure
1. Extended Family includes:
•   those in family of origin (parents & sibs)
•    family of procreation (spouse & children)
•    present generation & step relatives
2. Larger Systems:
•   groups or organizations that exert influence
     (e.g. work, school, social agencies, friends)
                 Context
1. Ethnicity – more than country of origin
2. Race – e.g. Caucasian, Asian, First Nation
3. Social Class – educational, income
   level, occupation
4. Religion & spirituality – may influence
   values, healthcare practices, etc.
5. Environment – home, neighborhood,
   community
  II. Developmental Dimension
• Family life cycle the typical path
   most families go through.
1. Stages
2. Tasks
3. Attachments
Stages of the Family Life Cycle
1. Leaving home: Launching single young
                    adults
2.   Joining of families through marriage
3.   Families with Young Children
4.   Families with Adolescents
5.   Launching Children & Moving on
6.   Families in Later Life
                Tasks
Stage        Emotional        Required
             Process          Changes
1. Leaving   Accepting        Differentiation of
home         emotional &      self in relation to
                              family of origin
             financial
             responsibility
                              Development of
                              intimate peer
                              relationships

                              Work & financial
                              independence
                   Tasks
2. Joining of   Commitment    Formation of
families        to new system marital system
                                Realignment of
                                relationships with
                                extended families
                                & friends


                                Decisions re:
                                parenthood
                   Tasks
3.Families with Accepting new Making space for
young children members into children
                system
                                Joining in
                                childrearing,
                                financial &
                                household tasks
                                Realignment of
                                relationships with
                                extended family -
                                grand parenting
                      Tasks
4. Families with Increasing       Shifting of parent-
adolescents      flexibility of   child relationship
                                  to permit
                 boundaries
                                  independence
                                  Refocus on mid-
                                  life marital &
                                  career issues
                                  Beginning shift
                                  toward joint caring
                                  for older
                                  generation
                    Tasks
5. Launching of Accepting exits Renegotiation of
children        & entries into  marital system -
                                dyad
                family
                                  Development of
                                  adult-adult
                                  relationships with
                                  grown children
                                  Inclusion of in-
                                  laws & partners
                                  Dealing with
                                  disabilities & death
                                  of grandparents
   III. Functional Assessment
1. Instrumental – routine A.D.L.
       Expressive Functioning
1.   Emotional Communication
2.   Verbal Communication
3.   Nonverbal
4.   Circular
5.   Problem Solving
6.   Roles
7.   Influence & power
8.   Beliefs
9.   Alliances & Coalitions
   Emotional Communication
• Range & types of emotions or
  feelings expressed
• Generally a wide range from
  happiness, to sadness to anger
• Families with emotional difficulties
  often have a narrow range of
  expression
      Verbal Communication
• Direct vs. Indirect:
 Direct message sent to intended target
• Clear vs. masked
• “Say what you mean and mean what
  you say” to the intended recipient
  leads to clear & direct communication
 Masked communication give distorted messages
    Nonverbal Communication
• Highly influenced by culture
• Body posture (e.g. slumped, fidgeting)
• Eye contact (e.g. intense, minimal)
• Touch, gestures, facial expressions
• Proximity & distance between family
  members
• Para-verbal communication – crying, tone
     Circular Communication

• Reciprocal communication between
  people
• C.P.D.’s concretely show & simplify
  repetitive sequences of interactions
• Three components:
• Affect (emotional state)
• Behavior
• Cognition (thoughts, ideas or beliefs)
          Problem Solving
• Strongly influenced by family’s beliefs
  about its abilities and past successes
• Who identifies the problem?
• What are the families solution
  patterns?
• What resources are relied upon for
  help – inside the family or external?
                  Roles
• Established patterns of behavior for family
  members
• How do family members cope with their
  roles?
• Formal vs. informal roles
• Is there role conflict or role strain?
• Does family believe that roles need to be
  altered?
         Influence and Power
• Power may present as overt acts of domination
• Note power differences among family members
• Instrumental influence: use of objects or
  privileges as rein forcers (e.g. money, TV.
  viewing, use of computer, etc.)
• Psychological influence: use of words or feelings
  (e.g. praise; criticism; threats; guilt)
• Corporal control: use of body contact (e.g.
  hugging; spanking, etc)
                  Beliefs
• Attitudes, values and assumptions
• Beliefs influence behavior.
• Explore beliefs about: etiology of the
  health problem, treatment, prognosis,
  religion & spirituality
      Alliances & Coalitions
• Directionality, balance & intensity of
  relationships between family
  members
• Note any triangles & shifting alliances

				
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