Family support in late life: A review of the literature on aging,disability, and family caregiving

ABSTRACT

For older adults and people with disabilities in the United States, family caregiving is an important part of remaining at home and in the community. As care recipients and caregivers age, family dynamics change, and the health, social, and financial impacts of this (largely unremunerated) work have implications for individuals, families, and social policy. In this review, the authors map the literature across multiple fields related to disability and aging to understand caregiving in late life, what it means to be an older caregiver and/or to care for older people. The authors summarize the findings of 97 articles to address the care, services, and supports family caregivers provide for older adults; negative and positive impacts for caregivers serving in this role; supports that family members use or need; and societal impact of family caregiving. Much of the literature describes the work family caregivers provide and negative impacts of caregiving. Less attention is devoted to caregiving benefits, supports used by family caregivers, and societal impacts. The authors conclude with an agenda for future research that attends to the need for research that includes: more diverse samples, new types of caregivers, longitudinal data, qualitative data and analysis, and comparative research.     

What White Mental Health Professionals Need to Understand About Whiteness: A Delphi Study

This Delphi study surveyed an interdisciplinary panel of diversity expert trainers (N=20) about what white mental health professionals need to understand about whiteness. The panel endorsed 162 items that included what white mental health professionals need to understand about historical and contemporary whiteness within the mental health fields and larger social systems, self of the therapist work for white therapists, as well as challenges to understanding whiteness in clinical training and practice. More specifically, the panel provided guidance on the cognitive and emotional transformations necessary for white mental health professionals to address whiteness, as well as the challenges to those transformations. The researchers provide clinical training implications for marriage and family therapists (MFTs) and other clinicians based on the results.     

Compelling Family Processes

This article introduces the idea of family process research and asserts that the study of family processes is an indispensable component of any effort to conceptualize and measure family life. Within this article the family process approach is defined through the use of several domains that categorize core constructs. Further, several key assumptions are identified that form the foundation this family process approach. A related objective of this article advances the notion that family process–oriented research has grown increasingly sophisticated over the years, often in ways that have helped to shape and define the discipline of family science. This article instructs readers about using a family process approach, especially within the context of employing a large national data set such as the NLSY97.     

Explaining Family Change and Variation: Challenges for Family Demographers

Twenty years ago, the National Institute of Child Health and Human Development (NICHD) issued a request for proposals that resulted in the National Survey of Families and Households (NSFH), a unique survey valuable to a wide range of family scholars. This paper describes the efforts of an interdisciplinary group of family demographers to build on the progress enabled by the NSFH and many other theoretical and methodological innovations. Our work, also supported by NICHD, will develop plans for research and data collection to address the central question of what causes family change and variation. We outline the group's initial assessments of orienting frameworks, key aspects of family life to study, and theoretical and methodological challenges for research on family change. Finally, we invite family scholars to follow our progress and to help develop this shared public good.     

Being neither Pollyanna nor Henny Penny: Responding to McDonald and Jones

Abstract

This paper provides an account of the earliest contributions to family theory and practice by social workers, beginning in the late nineteenth century. The paper argues that the first widespread practice of ‘family work’ by the helping professions was carried out by social workers, primarily women, despite this being rarely acknowledged in the family therapy literature. An analysis of gender and its place in the development of professional status and the ownership of ideas is provided.

Summary

This paper has traced the place of the family in social work theory and practice since the beginnings of the profession, with a particular focus on theoretical developments in social work in the United States. A number of points have been argued. Firstly, there is significant historical evidence that social workers, most of them women, pioneered family work many decades before the term ‘family therapy’ was invented. This directly challenges the claim made by a number of family therapy historians that work with families was pioneered by psychiatrists in the 1950s and 1960s. It is argued here that this discrepancy is largely a result of differences in professional power and gender status.

Secondly, it is argued that the impact of psychoanalytic theory on social work was profound, not only in terms of how it might have distracted the profession from further developing its early family systems focus, but also in how its multidisciplinary practice tended to place social workers, again mostly women, in somewhat limited and prescribed positions.

In addition, it is argued that social work's emphasis on the family and family intervention has waxed and waned due to these concepts not appearing to fit neatly into divisions between fields of practice, such as casework, group work and Community development. While social work struggled with finding a place for the further development of family social work theory, the rapidly growing domain of family therapy quickly colonised this field of practice, giving little credit to the ground already laid by social workers.     

Family support: A review of the literature on families of adolescents with disabilities

ABSTRACT

For all youth, adolescence is a time of great change, marked by multiple transitions. For those with disabilities, these transitions can be especially challenging for the youth and their families. Although families of adolescents with disabilities often require support, it is unclear what types of assistance are most helpful. To understand the responsibilities of and, correspondingly, supports needed for parents and siblings, the authors conducted a comprehensive literature review. Specifically, the authors examined the literature to identify the supports that families provide to their adolescent relatives with disabilities, the impacts of caring for an adolescent relative with a disability, and the assistance that families receive. The authors conclude by discussing implications for future research about family support.     

Art,Science and Curiosity: Research and Research Methodologies in Australian Family Therapy 1979–2000

This article presents an historical analysis of the development of research and research methodologies in an Australian context. The Australian and New Zealand Journal of Family Therapy was chosen as the site of the analysis. The first section of data consists of the articles that represent themselves as ‘research’ in the period from 1979 (the journal's inception) to 2000. These texts have been analysed using bibliometric analysis. The second section of data consists of commentary articles about research in family therapy. This data has been analysed using discourse analysis. Overall, I have been interested in how family therapists have defined ‘research’; how family therapists have chosen to inquire; representations of the researcher in Australian family therapy; associations between theoretical or clinical developments and the methodologies that have been chosen for inquiries. Findings from the study reveal very limited representations of research in the journal for the period under review, and an apparent struggle for family therapists to undertake a discussion about what research actually is. Questions are raised around how this has occurred, and some ideas are presented as to how research knowledges can be included in debates around theory diversity in family therapy.     

How to be a Marriage Therapist Without Knowing Practically Anything

Therapists in training as marriage and family therapists often do not learn techniques for bringing about change. They also do not learn ways to conceal from colleagues and from clients the fact that they do not know how to solve the presenting problems of couples in distress. Both general and specific techniques are reviewed for concealing ignorance as well as ways to make correct excuses for failure. The presentation is designed for therapists who find themselves not knowing what to do with a couple in a particular case and for therapists who do not know what to do with any case .     

Questioning the Suitability of Traditional Self-Report Family Functioning Measures for Single-Parent Families with Young Children

Family functioning is a common interest of social science and health researchers. Most often, well-established self-report instruments are used to measure family functioning. Although these instruments have been used with families of diverse compositions, our experiences using one of the commonly used instruments, the McMaster Family Assessment Device (FAD), suggest that it is not appropriate for single-parent families with young children. In addition to describing the difficulties we encountered with the FAD, we discuss our experiences in relation to current research findings about the processes and effectiveness of family functioning in single-parent families. As well, we examine other frequently used self-report family functioning instruments, the results of which lead us to question the suitability of any of the commonly used self-report family functioning instruments for single-parent families with young children. We conclude by arguing for the development of family functioning instruments that are appropriate for diverse family structures and compositions.     

LAYERED MEANINGS

Recent sociological inquiry into the family has focused on the decline of the male breadwinner family and the increasing diversity of family forms. Yet the term ‘family’ remains vague and assumes different meanings. This paper discusses the meanings of the term ‘family’ as it is used by interviewees in qualitative, in-depth interviews on family and kinship networks. The interviews were conducted as part of ethnographic fieldwork in a study of family and kinship in Swansea. Three contrasting areas of Swansea were selected, an affluent, popular area, one of the most deprived council estates and an inner-city area with a relatively high proportion of minority ethnic families. In the paper we draw out differences and similarities in the meanings given to the term ‘family’ by interviewees in the three areas. Differing meanings emerge, but what is striking is the layering of meanings. People refer to varying groups of relatives when they speak about their family but ‘family’ refers to a set of norms and practices about bringing up children, staying in contact or giving support. In the interview situation, the interviewees use these varying meanings in different contexts.     

Goodbye to the golden cage: Transformations in gender norms and family morality for working‐class women in occupations considered masculine in Mexico

This article seeks to contribute to the debate, within the feminist sociological theory and gender studies, about the possibility of ‘undoing gender’ in different social fields, mainly family relations. It is based on the premise that as women's objective dependency in the social structure decreases, the unstable character of what Bourdieu called ‘submissive dispositions’ becomes visible, and that women act reflectively, both to adapt to the challenges posed by their participation in different social fields and to gain personal liberties. The results of qualitative research, based on discussion groups and narrative interviews in which 109 women in working‐class sectors in Mexico City participated, are presented. Conflicts around breadwinning, housework distribution and personal liberties demonstrate a displacement of gender norms, parallel to efforts to maintain certain assurances regarding the traditional family model within the context of economic precariousness.     

The Family Outreach Model: Tools for Engaging and Working With Families in Distress

The purpose of this article is to present a family intervention model to family service providers that builds on previous research in areas of social support and family problem solving. The Family Outreach Model provides a set of strategies for engaging and working with families in five phases of family coping at different points in time in the family's life. The strategies reflect intentional choices by family service providers about both collaborative and directive styles of therapeutic alliance and highlights ways to determine which style best fits with what specific families want and need, depending on the manner of family coping that it is using. Implications for programs and public policy are presented.     

The Work and Family Researchers Network: an organizational and intellectual agenda

This essay outlines the organizational form and programmatic goals of the Work and Family Researchers Network (WFRN). This international membership organization aspires to bring together researchers and scholars from a range of academic disciplines as well as policy makers and practitioners. A brief sketch of the structure of the WFRN emphasizes its marriage of virtual and face-to-face communities. A sketch of the intellectual domain of work and family research maps this field with respect to basic social science and applied concerns. I suggest that the preoccupations of this field of inquiry are not marginal but rather occupy intellectually central space in several disciplines. Moreover, the policy questions of interest to work and family researchers are numerous and noteworthy, as they pertain to different stages of the life course and individuals facing a wide array of work and family interactions. Work and family research is interdisciplinary, based on the extensive cross-disciplinary citation patterns that are already well established in this area. WFRN can nonetheless play a role in facilitating communication and fostering collaborations. The essay ends with a brief note about opportunities and challenges that lie ahead.     

Kinship Reconsidered: Research on a Neglected Topic

This article reviews the recent history of kinship research, noting the relative neglect of the topic in recent decades. The lack of scholarly and empirical work on kinship has been hampered by both the absence of survey and qualitative research on contemporary kinship practices. The author focuses on what is known and not known about how individual put into practice kinship in the standard, nuclear form of the family. There is surprising in attention to the ceremonial family and, little is know about how families draw boundaries and construct kinship on ritual occasions in the literature. The author concludes by suggesting research strategies for examining both how kinship is constructed and practiced in the United States and in other advanced economies.     

Wider Perspectives in Family Mediation: An Ecosystemic Approach

All mediation processes are constrained by their theoretical frameworks. A wider ecosystemic framework extends perspectives and can open new windows on family systems, interdisciplinary connections, and links between past, present, and future that shape decisions. While showing some similarities to family therapy, ecosystemic family mediation is a discrete process with clearly defined principles and boundaries. In practice, it needs to be tailored to the needs of the particular family, with special attention to the importance of listening and talking with children who are experiencing parental separation and major changes in their lives. Family mediators help family members to manage change. Mediators need to look for change within themselves too, remaining open to new ideas and the development of their thinking and practice.     

Teaching and Learning Theory For Family Therapy Practice: On The Art and Craft of Balancing

As with all practice knowledges, family therapy theory sits in a complicated relationship to practice. This paper offers a set of reflections exploring challenges of teaching and learning theory for, and about, practice in family therapy. The importance of teaching particular frameworks of practice sits in tension and balance with the importance of the common factors of therapeutic change, and the inseparability of the use of self and the use of particular practice knowledge. Passion and commitment to particular ways of working is held in balance with the need for flexibility and the freedom to think independently. Discipline and focus is balanced with creativity and the room for integration. A number of balancing practices are identified in the art and craft of teaching, and the contextual issue of power and vulnerability in the teaching and learning relationship is acknowledged. Finally, the three ‘Rs’ in teaching and learning family therapy practice theory are drawn out – reflection, the recursiveness of theory and practice, and the reflexivity of self in relation to context and knowledge.     

How to study multilingualism of the past: Investigating traditional contact situations in Daghestan

Reconstructing contact situations for an unwritten language is a challenging task, as the sociolinguistic past of such speech communities is very rarely documented. The paper describes research in which a method of retrospective family interviews is applied, where respondents’ recollections about recent multilingual past and, in particular, about the language repertoires of their elder relatives, are converted into quantitative data. It is a case study of three neighboring villages in the mountains of Daghestan, each of which has its own first language. It is shown that the multilingual pattern in the cluster is now shifting from the knowledge of neighbor languages towards Russian – an external lingua franca which is not native to any of the communicants.     

When is a family a family? Evidence from survey data and implications for family policy

This article examines the correspondence between common assumptions about the American family and actual patterns. The assessment is based on national data on individuals, households, and families. Findings indicate that the coresident nuclear model should be considereda model rather thanthe model of family. Past as well as current marital ties need to be considered in defining “family,” and divorce rather than death should be the expected cause of losing the main breadwinner in the family, except among elderly women. Parent-child ties to either young or adult children often span separate households. Coresidents can include individuals other than nuclear family members, and change rather than stability is the modal pattern in living arrangements. Rather than shaping concepts of the family from a single mold, policy makers and researchers are better advised to recognize the diversity and fluidity in family and household structures. Her major research interests include economics of the family, intergenerational transmission, intergenerational transfers, labor economics, and poverty and welfare. She received her Ph.D. in Economics from the University of Michigan in 1977.     

Editor's Comments

Abstract

This paper examines some of the challenges that family researchers face in assessing the effects of divorce, particularly on children. The author highlights five of the most significant of these challenges. They include examining (1) the effects of divorce before it is completed, (2) controlling for socioeconomic status, (3) the effects of divorce on the general population, who are not immediately involved in the change in family structure, (4) the problems in assessing the effects of divorce, and (5) considering what psychological and academic measures to use when assessing the influence of family structure. Based on contemporary research, this paper addresses some of the relevant issues under each of these challenges and then offers some solutions.     

Family decision making in child welfare: challenges in developing a knowledge base for practice

Over the past two decades, engaging families in decision‐making has grown in popularity across child welfare systems internationally. The family group conference in particular has generated interest as a practice model that facilitates broader family engagement in care and protection. As the practice has flourished, research has been undertaken to strengthen the knowledge base and to support the introduction of family engagement strategies across jurisdictions. This paper examines the recent research relating to family engagement strategies in child welfare and explores the ways in which family involvement in decision‐making can be incorporated into emerging protective practices. Copyright © 2010 John Wiley & Sons, Ltd.