Family, Disability, and Lifespan
Development, RC 631
Dr. Julia Smith
Summer, 2009
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RC 631 Family, Disability, and
Lifespan Development
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Syllabus Review
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What is a typical family?

Divide into pairs and sketch a picture
of a typical U.S. family
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What is the Definition of Family
2-parent biological family (mononuclear family)
 Single parent family
 Blended family
 Extended family
 Partners without children

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U.S. Census Definitions

Family Group: A family group is any two
or more people (not necessarily including
a householder) residing together, and
related by birth, marriage, or adoption.
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
Family Household: A family household is
a household maintained by a householder
who is in a family (as defined above), and
includes any unrelated people (unrelated
subfamily members and/or secondary
individuals) who may be residing there.
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What makes up a family?

Cultural influences
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WASP families (mono-nuclear)
African-American families (include kin and
community)
Italian families (include grandparents and
godparents)
Chinese and other Asian families (include
ancestors and future descendants)
Native American families (include tribal group
and community)
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Erikson’s Psychosocial Stages of
Development
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1. Infancy or Oral-Sensory
Ages – Birth to 18 months
 Basic Conflict – Trust vs. Mistrust
 Important Events - Feeding
 Important for child to develop
trusting relationship with caregiver

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Infants and Disability
Severe disabilities identified
prenatally or at birth
 Abortion?
 Hospitals will screen for 30 metabolic
and genetic diseases
 Grief cycle
 How should information be shared
with parents?

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2. Early Childhood or MuscularAnal
Ages – 18 months to 3 years
 Basic Conflict – Autonomy vs.
Shame/Doubt
 Important Events – Toilet Training
 Development of control over physical
skills

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Early Childhood and Disability
Disabilities are identified as child
matures
 Participation in early intervention
programs
 IDEA (Individuals with Disabilities
Education Act) Part C (from birth to
age 3)
 Emphasis on family involvement

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3. Preschool or Locomotor
Ages – 3 to 6 years
 Basic Conflict – Initiative vs. Guilt
 Important Events –
Exploration/Independence
 Assertion of control/power over
environment

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4. School Age or Latency
Ages – 6 to 12 years
 Basic Conflict – Industry vs.
Inferiority
 Important Event – School
 Learning new social and academic
skills

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School Age and Disability
Child’s special needs are apparent
 Parents begin to develop a vision for
child’s future
 Professionals can strongly influence
how parents develop this vision
 Discuss mainstream vs. separate
classes

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RC 631 Family, Disability, and
Lifespan Development
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5. Adolescence or Latency
Ages - 12 to 18
 Basic Conflict – Identity vs. Role
Confusion
 Important Event – Social
Relationships
 Develop sense of self and personal
identity

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Adolescence and Disability
Strongly influenced by cultural
context values
 Increased family stress
 Increased isolation
 Sexuality education
 Expanding self-determination skills

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6. Young Adulthood
Ages – 19 – 40
 Basic Conflict – Intimacy vs. Isolation
 Important Events – Relationships
 Forming of intimate relationships

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Young Adulthood and Disability
Off-time transitions
 Issues of independence and
dependence
 Separation issues
 Relationship issues
 Identifying appropriate transitions

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Postsecondary educational programs and
support
Accessing supported employment options
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7. Middle Adulthood
Ages – 40 to 65
 Basic Conflict – Generativity vs.
Stagnation
 Important Events – Work and
Parenthood
 Creation of something that will
continue
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Mid-Life and Disability
Employment issues
 Social support
 Family support

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8. Maturity
Ages – 65 to death
 Basic Conflict – Ego Integrity vs.
Despair
 Important Events – Reflection on Life
 Look back on life and experience
feelings of success or failure

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Old Age and Disability
Disability is more common in the
elderly
 Disability is more frequent in lower
socioeconomic groups
 Lifestyle predicts disability (70%)
compared with genetics (30%)
 Cognitive and sensory decline
 Increase in ADL care (activities of
daily living)

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Eating, bathing, dressing, using the toilet
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RC 631 Family, Disability, and
Lifespan Development
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FAMILY LIFE CYCLE
Independence
 Coupling or Marriage
 Parenting: Babies through
Adolescents
 Launching Adult Children
 Retirement or Senior Years

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Independence Stage
Separation and individuation
 Identity
 Develop intimate relationships
 Establish career
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Coupling Stage
Develop new family system
 Interdependence
 Create life-style values
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Finances
Recreational activities/hobbies
Friendships
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Parenting: Babies through
Adolescents
Deciding to have a baby
 Develop parenting role
 Maintain individuality as well as
family commitments
 Allow for individuality with
adolescents
 Mid-life issues
 Caring for older family members

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Parenting: Empty Nest
Re-define relationship with children
 Re-define relationship with spouse
 Establish new relationships with adult
children’s families
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Senior Stage
Freedom
 Physical and mental challenges
 New roles with family and society
 Dealing with loss/death
 Reviewing life

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Family Life Cycle Summary
Families need to be seen from a
multigenerational perspective.
 Changes in one generation complicate
adjustments in another.
 Families often develop problems at
transitions in the life cycle.
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Environmental
Developmental
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Discussion Questions
Describe the challenges at the 8
different developmental stages. Give
an example of each.
 What are off-time or off-cycle
transitions? Give examples of off-time
transitions at the different stages.
 How has your role in your family
changed as you have gone through
different developmental stages?

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Family Structure

Family patterns of interaction are
predictable.

Family subsystems are determined by
generation, gender, common
interests, and function.
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Family Subsystems
Marital Subsystem
 Parental Subsystem
 Sibling Subsystem
 Extended Family Subsystem
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Family Genogram/Mapping
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RC 631 Family, Disability, and
Lifespan Development
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FAMILY COUNSELING
THEORIES
Psychoanalytic Family Therapy
 Bowen Family Systems Therapy
 Experiential Family Therapy
 Cognitive-Behavioral Family Therapy
 Narrative Family Therapy
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Psychoanalytic Family Therapy
Focus on uncovering and interpreting
unconscious impulses and defenses
 Focus on basic wants and fears
 Sexuality and aggression drives
behaviors
 Couples focused
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Psychoanalytic Family Therapy

Self-Psychology
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Every human longs to be appreciated
Object-Relations
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We relate to others based on expectations
formed by early experiences
“Internal objects” form the core of the
personality
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Psychoanalytic Therapy Techniques

Listening

Attend to clients’ fears and longings
Empathy
 Interpretations

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Clarify hidden aspects of experience
Analytic Neutrality

Don’t worry about solving the problem
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Psychoanalytic Therapy
Techniques

Focus on:
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Internal experience
The history of that experience
How the partner triggers that experience
How the context of the session and the
counselor’s input contribute to experience
between partners
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Important Names in Psychoanalytic
Family Therapy
Jill and David Scharff – ObjectRelations
 John Bowlby – Attachment Theory
 Ivan Boszormenyi-Nagy – Contextual
Therapy
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Bowen Family Systems Therapy

Focus on multigenerational family
systems
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Focus on subsystems
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Major problem is emotional fusion
Major goal is differentiation
Focus on the triangle
Focus not on solving family issues but
on learning individual roles in the
family and how system operates
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 “A
therapist can only
progress as far with a family
as he/she has progressed
with their own family
relationships.” Bowen
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Systems Therapy Techniques
Genograms
 The Therapy Triangle
 Process Questions
 Relationship Experiments
 Coaching
 “I” Position
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Important Names in Systems Family
Therapy
Murray Bowen – Systems Theory
 Milton Erickson – Strategic Theory
 Jay Haley – Communication Model
 Salvador Minuchin – Structural Theory
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Experiential Family Therapy

Developed in reaction to
psychoanalysis
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Freedom and immediacy vs. determinism
Focus on fulfillment vs. “accepting”
neurosis
Focus on emotional wellbeing/experience of individuals vs.
problem solving
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Experiential Therapy Techniques
Family sculpting/choreography
 Clarify communication
 Role-play
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Envision difficult situation
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Experience your feelings
Imagine child’s feelings or other’s feelings
Imagine being observer
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Important Names in Experiential
Family Therapy
Carl Whitaker – Experiential Theory
 Virginia Satir – Experiential Theory

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Cognitive-Behavioral Family
Therapy
“Behavior is maintained by its
consequences.”
 Family behavior will change when
reinforcements change
 Focus on identifying behavioral goals,
learning new techniques, and using
social reinforcers
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Cognitive-Behavioral Family
Therapy Techniques

Operant conditioning
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Reinforcers used may be tangible or social
(not just money or candy)
Shaping (small steps toward goal)
Token economy (system which rewards)
Contingency (contracts/agreements)
Time-out
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Important Names in CognitiveBehavioral Family Therapy
Gerald Patterson - Parent Training
 Robert Liberman - Role rehearsal and
modeling
 Richard Stuart - Contigency
contracting (focus on increasing
positive behavior using reinforcement
recriprocity)
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Narrative Family Therapy
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Narrative Therapy Assumptions
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People have good intentions
People are profoundly influenced by
discourse around them
People are not their problems
People can develop alternative,
empowering stories
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Narrative Family Therapy

Narrative Family Counselors
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Show strong interest in family’s story
Search for times when family was strong
or resourceful
Use questions to respectfully understand
story
Never label individuals – see each as
unique
Support alternative life stories
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Narrative Family Therapy
Techniques
Deconstruct unproductive stories
 Reconstruct new and more productive
stories
 Look for strengths and talents
 Family problem is separate from
individuals
 Re-author new story
 Reinforce new story
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Important Names in Narrative
Family Therapy
Michael White – Founder of Narrative
Movement
 David Epston – from Auckland, New
Zealand
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RC 631 Family, Disability, and
Lifespan Development
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Discussion Questions
When would you recommend
individual counseling vs. family
counseling?
 What are the trade offs of focusing on
the system vs. focusing on the
individual?
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COMMON PROBLEMS OF
BEGINNING FAMILY COUNSELORS

I. FAILURE TO ACT
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Failure to establish structure
Failure to show care and concern
Failure to engage family members in the
therapeutic process
Failure to let the family work on its
problems
Failure to attend to nonverbal family
dynamics
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II. OVER-ACTION
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Over-emphasis on details
Over-emphasis on making everyone
happy
Over-emphasis on verbal expressions
Over-emphasis on coming to too early or
too easy resolutions
Over-emphasis on dealing with one
member of the family
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What rehab counselor should keep in
mind:
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Family demographic data (SES,
ethincity/cultural background, etc.)
Family communication patterns
Division of labor in the family
Extent of family member’s outside
socialization and access to social and
cultural experiences
Family health or illness
Characteristics of disability or illness
Impact of disability on the family
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Also, examine the following:
Family strengths and weaknesses
 Family reaction to the disability
 Information the family has
concerning the disability and
expectations held by the family
member with a disability
 Services needed to enhance
rehabilitation
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Points to remember…
Many families do not openly discuss
disability issues with each other
 Initial meeting with VR counselor may
feel threatening
 Explore impact of disability on each
family member
 Remain neutral toward all family
members
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Carefully examine your own
attitudes/biases toward disability to
reduce any prejudices in client
contacts
 Implicit and explicit messages by the
counselor can convey disapproval or
acceptance of particular family
members
 The client should be asked which
family members would benefit from a
family meeting to discuss
rehabilitation
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Family Boundaries
Boundaries are invisible barriers that
regulate the amount of contact with
others.
 Rigid boundaries
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Disengagement
Enmeshment
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What is the impact of a family
member with a disability on the
marital subsystem?
 What is the impact of a family
member with a disability on the
parental subsystem?
 What is the impact of a family
member with a disability on the
sibling system?
 What is the impact of a family
member with a disability on the
extended family subsystem?

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QUALITIES OF HEALTHY
FAMILIES (Turnbull & Turnbull, 2006)
Legitimate source of authority,
established and supported over time
 Stable rule system established and
consistently acted upon
 Stable and consistent nurturing
behavior
 Effective and stable childrearing and
marriage-maintenance practices
 Set of goals toward which the family
and each individual works
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Sufficient flexibility and
adaptability to accommodate
normal developmental challenges
as well as unexpected crises
 Commitment to the family as well
as its individuals
 Appreciation of each other (i.e., a
social connection)
 Willingness to spend time together
 Effective communication patterns
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High degree of spiritual/religious
orientation
 Ability to deal with crisis in a positive
manner (i.e., adaptability)
 Encouragement of individuals
 Clear roles
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HEALTHY COPING STRATEGIES
OF FAMILIES (Carter & McGoldrick, 2007)
Ability to identify the stressor
 Ability to view the situation as a
family problem, rather than a
problem of one member
 Solution-oriented approach rather
than blame
 Tolerance for other family
members
 Clear expression of commitment to
and affection for other family
members
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Open and clear communication among
members and outside the family
 Lack of physical violence
 Lack of substance abuse
 Recognizing that stress may be
positive and lead to change
 Realizing that stress is usually
temporary
 Focusing on working together to find
solutions
 Realizing that stress is a normal part
of life
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Changing the rules to deal with stress
and celebrating victories over events
that led to stress
 Evidence of high family cohesion
 Evidence of considerable role
flexibility
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OBSERVING FAMILY
INTERACTIONS
1. What is the outward
appearance of the family?
 2. What is the cognitive functioning
in the family?
 3. What repetitive, non-productive
sequences do you notice?
 4. What is the basic feeling state in
the family and who carries it?
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5. What individual roles reinforce
family resistances and what are
the most prevalent family
defenses?
 6. What subsystem are operative
in this family?
 7. Who carries the power in the
family?
 8. How are the family members
differentiated from each other and
what are the subgroup
boundaries?
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9. What part of the family life cycle is
the family experiencing and are the
problem-solving methods stage
appropriate?
 10. What are the counselor’s own
reactions to the family?
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RC 631 Family, Disability, and
Lifespan Development
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