This article critically analyzes the conceptual frameworks commonly used to study family caregivers who have a family member with a severe mental illness. Those frameworks that are commonly in use present significant limitations to the study of the family as a whole. In contrast, the Family Resiliency Model permits family level analysis. The authors present this model and argue for its use in studying families with members who have a severe mental illness.
Get full access to this article
View all access options for this article.
References
1.
Bebbington, P.
, & Kuipers, L. (1994). The predictive utility of expressed emotion in schizophrenia: An aggregate analysis. Psychological Medicine, 24, 707-718.
2.
Bentelspacher, E. C.
, Chitran, S., & Abdul Rahman, M. (1994). Coping and adaptation patterns among Chinese, Indian, and Malay families caring for a mentally ill relative. Journal of Contemporary Human Services, 75, 287-297.
3.
Bibou-Nakou, I.
, Dikaiou, M., & Bairactaris, C. (1997). Psychosocial dimensions of family burden among two groups of carers looking after psychiatric patients. Social Psychiatry and Psychiatric Epidemiology, 32(2), 104-108.
4.
Birchwood, M.
(1992). Family factors in psychiatry. Current Opinion in Psychiatry, 5, 295-299.
5.
Birchwood, M.
, & Cochrane, R. (1990). Families coping with schizophrenia: Coping styles, their origins and correlates. Psychological Medicine, 20, 857-865.
6.
Brooker, C.
, Falloon, I., Butterworth, C., Goldberg, D., Graham-Hole, V., & Hillier, V. (1994). The outcome of training community psychiatric nurses to deliver psychosocial intervention. British Journal of Psychiatry, 165, 222-230.
7.
Brown, W. G.
, Birley, L. J., & Wing, K. J. (1972). Influence of family life on the course of schizophrenic disorders: A replication. British Journal of Psychiatry, 121, 241-258.
8.
Bulger, M. W.
, Wandersman, A., & Goldman, C. R. (1993). Burdens and gratifications of caregiving: Appraisal of parental care of adults with schizophrenia. American Journal of Orthopsychiatry, 63(2), 255-265.
9.
Bull, J. M.
(1990). Factors influencing family caregiver burden and health. Western Journal of Nursing Research, 12, 758-776.
10.
Chafetz, L.
, & Barnes, L. (1989). Issues in psychiatric caregiving. Archives of Psychiatric Nursing, 3, 61-68.
11.
Chakrabarti, S.
, Kulhara, P., & Verma, S. (1993). The pattern of burden in families of neurotic patients. Social Psychiatry and Psychiatric Epidemiology, 28, 172-177.
12.
Chesla, C. A. (1988). Parents’ caring practices and coping with schizophrenic offspring: An interpretive study. Unpublished doctoral dissertation, University of California, San Francisco.
13.
Chesla, C. A.
(1989). Parents’ illness models of schizophrenia. Archives of Psychiatric Nursing, 3, 218-225.
14.
Cook, J. A.
, Lefley, H. P., Pickett, S. A., & Cohler, B. J. (1994). Age and family burden among parents of offspring with severe mental illness. American Journal of Orthopsychiatry, 64, 435-447.
15.
Doornbos, M. M.
(1996). The strengths of families coping with serious mental illness. Archives of Psychiatric Nursing, 10, 214-220.
16.
Doornbos, M. M.
(1997). The problems and coping methods of caregivers of young adults with mental illness. Journal of Psychosocial Nursing, 35(9), 22-26.
17.
Falloon, I. R.
, Boyd, J. L., McGill, C. W., Williamson, M., Razani, J., Moss, H. B., Gilderman, A. M., & Simpson, G. M. (1985). Family management in the prevention of morbidity of schizophrenia: Clinical outcome of a two-year longitudinal study. Archives of General Psychiatry, 42, 887-896.
18.
Fisher, G. A.
, Benson, P. R., & Tessler, R. C. (1990). Family response to mental illness: Developments since deinstitutionalization. Research in Community and Mental Health, 6, 203-206.
19.
Fox, L.
(1997). A consumer perspective on the family agenda. American Journal of Orthopsychiatry, 67, 249-253
20.
Gallagher, S. K.
, & Mechanic, D. (1996). Living with the mentally ill: Effects on the health and functioning of other household members. Social Science and Medicine, 42(12), 1691-1701.
21.
Gerace, L.
(1988). Schizophrenia and the family: Nursing implications. Archives of Psychiatric Nursing, 2, 141-145.
22.
Greenberg, J. S.
, Greenley, J. R., & Benedict, P. (1994). Contributions of person with serious mental illness to their families. Hospital and Community Psychiatry, 45, 475-480.
23.
Guarnaccia, P. J.
, & Parra, P. (1996). Ethnicity, social status, and families’ experiences of caring for a mentally ill family member. Community Mental Health Journal, 32, 243-260.
24.
Gubman, D. G.
, & Tessler, C. R. (1987). The impact of mental illness on families: Concepts and priorities. Journal of Family Issues, 8, 226-245.
25.
Hatfield, A. B.
(1981). Coping effectiveness in families of the mentally ill: An exploratory study. Journal of Psychiatric Treatment and Evaluation, 3, 11-19.
26.
Hatfield, A. B.
(1987). Coping and adaptation: A conceptual framework for understanding families. In H. P. Lefley (Ed.), Families of the mentally ill: Coping and adaptation (pp. 60-84). New York: Guilford.
27.
Hoening, J.
, & Hamilton, M. W. (1966). The schizophrenic patient in the community and his effect on the household. International Journal of Social Psychiatry, 12, 165-176.
28.
Hogarty, G. E.
, Anderson, C. M., Reiss, D. J., Kornblith, S., Greenwald, D., Javna, C., & Madonia, M. J. (1986). Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia: One-year effects of a controlled study on relapse and expressed emotion. Archives of General Psychiatry, 43, 633-642.
29.
Horwitz, A. V.
, & Reinhard, S. C. (1995). Ethnic differences in caregiving duties and burdens among parents and siblings of persons with severe mental illness. Journal of Health and Social Behavior, 36, 138-150.
30.
Howard, B. P.
(1994). Lifelong maternal caregiving for children with schizophrenia. Archive of Psychiatric Nursing, 7, 107-114.
31.
Jones, L. S.
, Roth, D., & Jones, K. P. (1995). Effect of demographic and behavioral variables on burden of caregivers of chronic mentally ill persons. Psychiatric Services, 46, 141-145.
32.
Jones, S. L.
(1996). The association between objective and subjective caregiverburden. Archives of Psychiatric Nursing, 10, 77-84.
33.
Kosciulek, J. F.
, McCubbin, M. A., & McCubbin, H. I. (1993). A theoretical framework for family adaptation to head injury. Journal of Rehabilitation, 35, 40-45.
34.
Leff, J.
, Kuipers, L., Berkowitz, R., Eberlein-Vries, R., & Sturgeon, D. (1982). A controlled trial of social intervention in the families of schizophrenic patients. British Journal of Psychiatry, 141, 121-134.
35.
Lefley, H. P.
(1996). Family caregiving in mental illness. Thousand Oaks, CA: Sage.
36.
Loukissa, A. D.
(1995). Family burden in chronic mental illness: A review of research studies. Journal of Advanced Nursing, 21, 248-255.
37.
Malone, A. J.
(1993). Beyond blame and shame: Families coping with long-term mental illness. New Directions for Mental Health Services, 58, 43-52.
38.
Martyns-Yellowe, I. S.
(1992). The burden of schizophrenia on the family. Journal of Psychiatry, 161, 779-782.
39.
Maurin, T. M.
, & Boyd, B. C. (1990). Burden of mental illness on the family: A critical review. Archives of Psychiatric Nursing, 6, 99-107.
40.
McCubbin, M. A.
, & McCubbin, H. (1993). Family coping with health crises: The Family Resiliency Model of family stress, adjustment and adaptation. In C. Danielson (Ed.), Families, health and illness (pp. 21-63). St. Louis, MO: Mosby.
41.
McCubbin, M.
, & McCubbin, H. (1996). Resiliency in families: A conceptual model of family adjustment and adaptation in response to stress and crisis. In H. McCubbin, A. Thompson, & M. McCubbin (Eds.) Family assessment: Resiliency, coping, and adaptation—Inventories for research and practice (pp. 1-64). Madison: University of Wisconsin System.
42.
McFarlane, R. W.
, Link, B., Dushay, R., Marchal, J., & Crilly, J. (1995). Psychoeducational multiple family groups: Four year relapse outcome in schizophrenia. Family Process, 34, 127-144.
43.
Oldridge, M. L.
, & Hughes, I. C. (1992). Psychological well-being in families with a member suffering from schizophrenia. British Journal of Psychiatry, 161, 249-251.
44.
Parker, G.
, & Hadzi-Pavlovic, D. (1990). Expressed emotion as a predictor of schizophrenic relapse: An analysis of aggregated data. Psychological Medicine, 20, 961-965.
45.
Pickett, S. A.
, Vraniak, D. A., Cook, J. A., & Cohler, B. J. (1993). Strength in adversity: Blacks bear burden better than Whites. Professional Psychology: Research and Practice, 24, 460-467.
46.
Reinhard, C. S.
(1994). Living with mental illness: Effects of professional support and personal control on caregiver burden. Research in Nursing & Health, 17, 79-88.
47.
Robinson, A. E.
(1996). Causal attributions about mental illness: Relationship to family functioning. American Journal of Orthopsychiatry, 66, 282-295.
48.
Rose, E. L.
(1996). Families of psychiatric patients: A critical review and future research directions. Archives of Psychiatric Nursing, 10, 67-76.
49.
Ryan, A. K.
(1993). Mothers of adult children with schizophrenia: An ethnographic study. Schizophrenia Research, 11, 21-31.
50.
Salleh, R. M.
(1994). The burden of care of schizophrenia in Malay families. Acta Psychiatrica Scandinavica, 89, 180-185.
51.
Scazufca, M.
, & Kuipers, E. (1996). Links between expressed emotion and burden of care in relatives of patients with schizophrenia. British Journal of Psychiatry, 168, 580-587.
52.
Solomon, P.
, & Draine, J. (1995). Subjective burden among family members of mentally ill adults: Relation to stress, coping, adaptation. American Journal of Orthopsychiatry, 65, 419-427.
53.
Stirling, J.
, Tantum, D., Thomas, P., Newby, D., Montague, L., Ring, N., & Rowe, S. (1993). Expressed emotion and early onset schizophrenia: The ontogeny of EE during an 18 month follow-up. Psychological Medicine, 23, 771-778.
54.
Stueve, A.
, Vine, P., & Struening, E. L. (1997). Perceived burden among caregivers of adults with serious mental illness: Comparison of Black, Hispanic, and White families. American Journal of Orthopsychiatry, 67(2), 199-209.
55.
Szmukler, I. G.
, Burgess, P., Herrman, H., Benson, A., Colusa. S., & Bloch, S. (1996). Caring for relatives with serious mental illness: The development of the experience of caregiving inventory. Social Psychiatry Psychiatric Epidemiology, 31, 137-148.
56.
Tarrier, N.
(1991). Family factors in psychiatry. Current Opinion in Psychiatry, 4, 320-323.
57.
Tessler, R. C.
, Killian, L., M., & Gubman, G. D. (1987). Stage in family response to mental illness: An ideal type. Psychosocial Rehabilitation Journal, 10, 3-16.
58.
Veltro, F.
, Magliano, L., Lobrace, S., Morosini, P., & Maj, M. (1994). Burden on key relatives of patients with schizophrenia vs neurotic disorders: A pilot study. Social Psychiatry Psychiatric Epidemiology, 29, 66-70.
59.
Walsh, F.
(1996). The concept of family resilience: Crisis and challenge. Family Process, 35, 261-281.
60.
Winefield, H. R.
, & Harvey, E. J. (1993). Determinants of psychological distress in relatives of people with chronic schizophrenia. Schizophrenia Bulletin, 19, 619-625.
61.
Xiong, W.
, Phillips, M. R., Hu, X., Wang, R., Dai, Q., Kleinman, J., & Kleinman, A. (1994). Family-based intervention for schizophrenic patients in China: A randomised controlled trial. British Journal of Psychiatry, 165(2).
62.
Yamashita, M.
(1996). A study of how families care for mentally ill relatives in Japan. International Nursing Review, 43, 121-125.