Professional Documents
Culture Documents
Tools in Family Assessment
Tools in Family Assessment
JI Veridiano,Ofelia S.
Introduction
Every patient is a member of a family
A physician must always keep in mind that
the way a patient reacts to an illness will
depend a lot on his family
It will depend on the family physician as to
up to what level he will involve a patients
family to evaluate his problem.
Step 1
Recognize the Family Structure
Know the individual members of the family
A systematic way of obtaining and
recording this information is through the
use of a Family Genogram
Family Genogram
1. Family Tree
2. Functional Chart
It gives a more dynamic image of the
family especially the relationship of each
member to other members. This allows
one to judge the familys totality as a unit,
its strengths and weaknesses, and its
adaptability in future stressful situations
3. Family Illness/History
This indicates the presence of
heredofamilial diseases in which
potential problems in the family can
arise.
Step 2
Understand the normal family function
Functional Family
Defined as a family wherein a balance
between these functions is achieved.
Imbalances may result from over or under
emphasis of these functions.
Dysfunctional Family
Defined as a family with chronic inability to
respond to the needs or to cope with
changes and stresses in the environment
Step 3
Learn to assess Family Structure and
Function in Clinical Practice
Family assessment tools have been made
to aid the family physician in assessing the
family structure and function in clinical
practice.
Family Genogram
Family Circle
Family APGAR
FACES (Family Adaptability and Cohesion
Evaluation Scale)
FES (Family Environmental Scale)
Clinical Biography and Life Events
SCREEM
DRAFT (Draw A Family Test)
Family Mapping
Family Genogram
A graphic representation of a family tree
that displays detailed data about the
relationships among individuals in a family
Allows the user to analyze hereditary
patterns and psychological factors that
punctuate these relationships
Family Genogram
Quickly identify and understand various
patterns in the patient's family history
which may have had an influence on the
patient's current state of mind
Maps out relationships and traits that may
otherwise be missed on a pedigree chart
Family Genogram
An excellent tool to learn about the family structure but
has limited role in assessing the family functions. It
contains the following informations:
Names, gender, date of birth, date of death, and roles of
each family member
Divisions of an extended family into several households
Medical problems and chronic illnesses of each family
member
Significant dates in the family history
Nature of the family relationships
Veridiano Family
as of April 11, 2010
Project 4, Quezon City
1943
1947
Constantino, 64 2006
1967
1965
1982
2007
Thess 42
Nel 45
Ruptured aneurysm
Heart failure
Hypertension
Bronchial Asthma
May 39
Jojo 44
1973
Chok 36
1971
2005
Ja 4
Tere 38
Peng 27
Family Circle
Family circles are often used on
individuals and in some small groups.
Instructions are given to the patient to look
at the circle as if it is his family and then
draw small circles to represent the patient
and those people who are important to
him.
Difficulty of interpretation and
standardization poses as a disadvantage.
Family Circle
Dex
Mama Pesh
Mama
chuchi
Arra
Rihanne
Me
Ja
Kuya
Nel
Chok
Erin
Ate Tere
Family APGAR
This is a 5-question assessment tool used
for rapid assessment of family function
and dysfunction.
It measures an individuals level of
satisfaction about family relationships.
Family APGAR
Adaptation- the ability of a family to use and share
inherent resources which can be either intra- or extrafamilial
Partnership- the sharing of decision making which
measures the satisfaction of solving problems through
communicating
Growth- pertains to both physical and emotional aspects
and measures the satisfaction of the freedom to change
Affection- emotions that are shared with and between
family members which measures the satisfaction with the
intimacy and emotional interaction that exist in the family
Resolve- refers to how time, money, and space are
shared; this measures the satisfaction with the
commitment made by members of the family
Family APGAR
Part I
Almost
always
(2)
Some of
the time
(1)
Hardly
ever
(0)
Paminsa
nminsan
(1)
Halos
hindi
(0)
Part II
Name
Relationship
Age
Fairly
Poor
Sex
Part II
Name
Well
Relationship
Fairly
Age
Poor
Sex
Family APGAR
Scoring:
8-10 points = highly functional family
4-7 points = moderately dysfunctional
family
0-3 points = severely dysfunctional family
FACES
Family Adaptability and Cohesion
Evaluation Scale
This is an assessment tool based on the
Olsons circumflex model of family
function. The patient rates his family on a
30-item questionnaire on a 1-5 scale
which measures the adaptability and
cohesion of a family.
FES
Family Environment Scale
This is a tool developed by Moos which is
a 90-item questionnaire used as a
research tool to compare health care
results with family variables.
SCREEM
An important tool to assess a familys
capacity to participate in the provision of
health care or to cope with crisis. It makes
use of 6 factors which can be considered
as resource or as pathology.
SCREEM
Resource
Pathology
Social
Cultural
- Rigid dogma/rituals
SCREEM
Economic
- Economic stability is sufficient to provide
both reasonable satisfaction with financial
status and an ability to meet economic
demands of normative life events
-Economic deficiency
-Inappropriate economic plan
Educational
- Education of members is adequate to
allow members to solve or comprehend
most problems that arise within the format
of the lifestyle established by the family
-handicapped to comprehend
Medical
- Medical health care is available through
channels that are easily established and
have previously been experienced in a
satisfactory manner
DRAFT
Draw a Family Test
This is a simple, practical, and costeffective tool for assessing family
functions that can be administered
individually or in-group test.
Members of the family are given the
opportunity to express oneself and
consequently reveal innate difficulties
within the family system.
DRAFT
DRAFT has been found to be useful and
revealing because of the following reasons:
1.Evasive and guarded patients are more likely to
reveal their underlying traits because subjects
are more intellectually aware of what they may
reveal through verbal communication.
2.The unconscious label which represents
adultered basic needs can be expressed through
drawing.
3.Drawings are the first to show incipient
psychopathology and the last to lose the signs of
illness after patient recovery.
Health history
Family Mapping
This assessment tool was developed by a
psychiatrist-family therapist Salvador
Minuchin to facilitate the communication of
information about a family system to
colleagues through the use of symbols.
Family Mapping
A double line between two people
indicates a functional relationship
Thank You!