Epilogue
Using a strengths approach to understand resilience and build health capacity in families
Debra Jackson
Professor, Faculty of Nursing, Midwifery and Health, University of Technology, Sydney (UTS), Broadway NSW
Philip Darbyshire
Philip Darbyshire Consulting Pty Ltd, Adelaide SA; University of Western Sydney, Sydney NSW; School of Health Science, University of Swansea, Swansea; Bournemouth University, Poole, United Kingdom
PP: 211 - 212
Article Text
Happy families are all alike; every unhappy family is unhappy in its own way.
Leo Tolstoy (1828 - 1910), Anna Karenina, Chapter 1, first line
In opening this special issue of Contemporary Nurse (Advances in Contemporary Child and Family Health Care ISBN 0-9750436-3-3) we discussed the family, and acknowledged that from a health perspective and despite all of its faults, the family has been and continues to be the most important of all social institutions. Morals and values are shaped within the family, and the family is the site for the development of health and personal care practices, that provide the foundation for lifelong health and longevity.
While some families have certain inherent and long-standing difficulties that make them particularly vulnerable, all families at some time or other experience stress or instability and can become potentially vulnerable. Some families manage to overcome adversity, while others fracture and do not survive intact. This raises questions for health and other professionals who are involved in family support. Why is it that some families can survive and even thrive in the face of stress, while other families do not?
This question has absorbed theorists and practitioners, and has lead to examination of the characteristics of various types of family, particularly those families who are considered to be resilient. Looking at families from a position of seeking to understand their strengths (rather than find problems), changes the focus of the professional gaze and has led to a strength orientation to working with families (Allison et al. 2003). Taking a strengths' approach means to focus on the family strengths, rather than focusing on negatives or weakness - it means to see them as functional, rather than dysfunctional. 'Professionals who work from a strengths perspective ... focus on what is working in the family rather than what is not' (Silberberg 2001: 55).
There are several models of family strengths, and they generally are comprised of attributes that are seen as positive, and contributory to a sound family life. A multi-method approach was used to develop The Australian Family Strengths Template, which is based on eight qualities (Silberberg, 2001). These are communication, togetherness, sharing activities, affection, support, acceptance, commitment and resilience (Silberberg 2001). Resilience is a concept that is gaining increasing attention in the literature (Allison 2003). It describes the capacity a family has to survive and recover from crisis and hardship (Silberberg 2001). Allison et al. (2003) cites two concepts ~ coherence and hardiness ~ as being features of family resilience.
Family strengths models present descriptions of traits and outcomes, but they do not elucidate how or why some families are more resilient than others. Silberberg (2001) cautions against viewing any particular family strengths model as a 'blueprint' for a resilient family. She suggests that rather than merely being a list of qualities, resilience involves the use of strategies and processes to overcome challenges (Silberberg 2001). Some of these strategies and processes are identified as 'pulling together rather than apart; reframing the crisis in a more positive, manageable light; and seeking help' (Silberberg 2001: 56). Silberberg (2001) suggests that family strengths models are a useful framework for teaching and program development.
A strengths' approach offers many potential benefits to nurses and others working with families. A strengths approach acknowledges and privileges the functional aspects of a family, rather than stigmatizing a family as dysfunctional or acopic. Focusing on strengths means that family members do not need to succumb 'to an account of themselves as incompetent and dysfunctional' (Allison et al. 2003:278). Rather than labeling a family as dysfunctional or by some other negative terms, it is more useful and more helpful to identify the strengths a family has, and use those strengths as a means for further positive growth and development.
The very nature of nursing is that we tend to come into contact with people when they (or a member of their family) are in some sort of health crises, and it is easy to see people and families as being either one thing or another, in a kind of functional/dysfunctional dichotomy rather than seeing their true dynamic natures (Silberberg, 2001). Like the individuals that comprise them, families are not a static entity, they grow and change, and at times are strong, while at other times may become beleaguered with stress and difficulty (Silberberg 2001). Nurses have a crucial role to play in supporting families through all manner of crises and stressful situations. It is essential therefore that nurses engage in the discourses about family focused approaches and consider the potential benefits of using a strengths approach to understand resilience and build health capacity in families.
Philip Darbyshire and Debra Jackson
WCH Chair of Nursing, Women's & Children's Hospital, University of South Australia, and Flinders University, Adelaide, South Australia and Associate Professor, School of Nursing, Family and Community Health, College of Social and Health Sciences, University of Western Sydney, Australia
References
Allison S, Stacey K, Dadds V, Roeger L, Wood A & Martin G (2003) What the family brings: gathering evidence for strengths based work. The Association for Family Therapy and Systemic Practice 25, 263-284.
Silberberg S (2001) Searching for family resilience. Australian Institute of Family Studies 58, 52-57.
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