Family Resilience Therapies

Family Resilience Therapies

While family psychoeducation approaches have focused on roles that families can play in reducing frequency of illness relapse or buffering its severity, family resilience interventions extend this strategy to identify salutary family processes that not only buffer severity of illness, but prevent its onset for those at risk. Key processes can be identified that enable couples and families fac-ing disruptive crises or persistent stresses to strengthen relation-ships, regain functioning and further the growth of its individual members (Walsh, 1998; Wolin and Wolin, 1993).

Family resilience refers to coping and adaptational proc-esses in the family as a functional unit (Walsh, 1998; Wolin and Wolin, 1993). From this perspective, a stressor affects at-risk chil-dren only to the extent that they disrupt crucial family processes that otherwise would neutralize or buffer the stressor (Patterson, 1983). Family resilience rests upon several systemic principles:

·              The hardiness of individuals is best understood and fostered in the context of the family and larger social world, as a mutual in-teraction of individual, family and environmental processes.

·              Crisis events and persistent stresses affect the entire family, posing risks not only for individual dysfunction but for rela-tional conflict and family breakdown.

·              Family processes mediate the impact of stress on all members and their relationships, with protective processes fostering resilience by buffering stress and promoting recovery, and maladaptive responses heightening vulnerability and risks for individual and relationship distress.

·              All families have the potential for resilience, which can be maximized by encouraging their best efforts and strengthen-ing key processes.

With programs such as Beardslee’s (Beardslee et al., 1999), family resilience programs have moved past treatment of acute illness and relapse prevention, to primary prevention of the

disorder itself. Such programs identify risk factors and protective factors for onset of illness; relate these factors to family organiza-tion, communications, and knowledge of the disorder; and design family interventions that enhance family understanding, attenu-ate risk factors, and amplify protective factors (see Table 70.1).