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. 3. 4. 5. 6.

Joining of families through marriage Families with Young Children Families with Adolescents Launching Children & Moving on Families in Later Life

Tasks
Stage 1. Leaving home Emotional Process Accepting emotional & financial responsibility Required Changes
Differentiation of self in relation to family of origin

Development of intimate peer relationships Work & financial independence

Tasks
2. Joining of families Commitment to Formation of marital system new 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 adolescents flexibility of boundaries
Shifting of parentchild relationship to permit independence Refocus on mid-life marital & career issues Beginning shift toward joint caring for older generation

Tasks
5. Launching of Accepting exits & Renegotiation of marital system children entries into -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. 2. 3. 4. 5. 6. 7. 8. 9. Emotional Communication Verbal Communication Nonverbal Circular Problem Solving Roles Influence & power Beliefs 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 familys 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