Applying a stress and coping model to the families of the chronically mentally ill.

A stress and coping model was used to study the families of chronically mentally ill adults. Current understandings of these illnesses suggest that stress and coping may be more appropriate for understanding these families than other models. Factors measured include: the stressor (level of client functioning--Global Assessment Scale, Client Level Assessment Measure), the family's level of functioning (Family Assessment Device), coping responses (causal attributions, appraisals, and coping behaviors--McCubbin's F-Copes), and instrumental resources. Data were collected from mothers, fathers, siblings and the mentally ill son or daughter in 39 white working-class families in a family psychoeducational program in a Detroit suburban county. The agency therapist provided additional data on client functioning. Findings include a significant association between poor family functioning and causal attributions which held a person (oneself or others, whether in or out of the family) responsible for causing the illness, found among mothers, fathers, siblings, and the family as a whole, but not among clients. Attributions to biology, heredity, God or chance were not significantly associated with family functioning. Neither appraisals nor coping behaviors were associated with family functioning. Appraisals were associated with client functioning, particularly among mothers. Few consistent patterns of association were found between family functioning and client functioning. Cluster analysis indicated that relationship among many variables may not be linear and that some variables, such as client gender and level of functioning, may have interactive effects on family functioning. Family coping strategies appear to relate to family and client functioning, suggesting the need for more research to confirm and delineate these relationships. It is possible that in some families and contexts, treatment approaches which attribute etiology to persons may be detrimental to family functioning. Limitations to this study include a small and nonrepresentative sample, a wide range of patient diagnoses, and unmeasured program effects.PhDSocial Work and PsychologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/105545/1/9023626.pdfDescription of 9023626.pdf : Restricted to UM users only