INTERRUPTED FAMILY PROCESSES
Change in family relationship or functioning
• Assigned tasks
• Availability for affective responses and/or emotional support
• Communication patterns
• Effectiveness in completing assigned tasks
• Expressions of conﬂict within family and/or community resources
• Expressions of isolation from community resources
• Participation in problem solving and/or decision making
• Stress-reduction behaviors
• Developmental crises
• Modiﬁcation in family ﬁnances
• Developmental transition
• Modiﬁcation in family social
• Family role shift
• Interaction with community
• Situational transition
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
Family members will
• Not experience physical, verbal, emotional, or sexual abuse.
• Communicate clearly, honestly, consistently, and directly.
• Establish clearly deﬁned roles and equitable responsibilities.
• Express understanding of rules and expectations.
• Report the methods of problem solving and resolving conﬂicts
• Report a decrease in the number and intensity of family crises.
• Seek ongoing treatment.
SUGGESTED NOC OUTCOMES
Family Coping; Family Functioning; Family Normalization; Social
Interaction Skills; Substance Addiction Consequences
INTERVENTION AND RATIONALES
Determine: Assess family’s developmental stage, roles, rules, socioeco-
nomic status, health history, history of substance abuse; history of sex-
ual abuse of spouse or children, problem-solving and decision-making
skills, and patterns of communication. Assessment information will
provide development of appropriate interventions.
Perform: Meet with family members to establish levels of authority
and responsibility in the family. Understanding the family dynamics
provides information about the kinds of support the family needs to
work with the patient’s issues.
Create an environment in which family members can express
themselves openly and honestly to build trust and self-esteem.
Establish rules for communication during meetings with the family
to assist family members to take responsibility for their own behavior.
Inform: Teach family members basic communication skills to enable
them to discuss issues in a positive way. Have them role-play with
one another numerous times to demonstrate what has been learned.
Involve the family in exercises to reduce stress and deal with
Attend: Hold adults accountable for their alcohol or substance abuse
and have them sign a “Use contract” to decrease denial, increase
trust, and promote positive change.
Involve patient in planning and decision making. Having the abil-
ity to participate will encourage greater compliance with the plan.
Assist family to set limits on abusive behaviors and have them
sign “Abuse contracts” to foster feelings of safety and trust.
Manage: Refer to case manager/social worker to ensure that a home
assessment is done.
Refer to support groups that deal with substance abuse, domestic
violence, or sexual abuse depending on the needs of the patient
and/or family to enhance interpersonal skills and strengthen the fam-
Provide all appropriate phone numbers so that the family
members can initiate whatever follow-up is needed.
SUGGESTED NIC INTERVENTIONS
Coping Enhancement; Family Integrity Promotion; Family Process
Maintenance; Family Support; Normalization Promotion; Substance
Use Prevention; Substance Use Treatment
Yonaka, L., et al. (2007, January–February). Barriers to screening for domestic
violence in the emergency department. Journal of Continuing Education for
Nursing, 38(1), 37–45.