Calgary Family Assessment Model CFAM

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Calgary Family Assessment Model (CFAM)

• A Multidimensional Framework

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Theoretical Foundations

• 1. Postmodernism multiplicity of views
• 2. Systems Theory family system as mobile
• 3. Cybernetics feedback loops
• 4.Communication Theory content relationship
• 5. Change Theory cognitive, affect, behaviour
• 6. Biology of Cognition different views of
  reality

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CFAM Categories of Family Life

• I. Structural dimension
• II. Developmental dimension
• III. Functional dimension

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I. Structural Assessment

• 1.Internal who is in the family and how
  they are connected.
• 2.External- connection of family members
  to those outside.
• 3.Context relevant background

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Internal Structure

• Family Composition as defined by the
  family.
• Gender- set of roles, beliefs, or expectations
  of male female behavior.
• Sexual orientation heterosexual, gay, lesbian,
  bisexual, transgender.
• Rank order position of children in family.
• Subsystems smaller clusters within family.
• Boundaries to protect the differentiation of
  subsystems may be clear, diffuse, rigid.

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External Structure

• Extended Family includes
• those in family of origin (parents sibs)
• family of procreation (spouse children)
• present generation step relatives
• 2. Larger Systems
• groups or organizations that exert influence
  (e.g. work, school, social agencies, friends)

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Context

• Ethnicity more than country of origin
• Race e.g. Caucasian, Asian, First Nation
• Social Class educational, income level,
  occupation
• Religion spirituality may influence values,
  healthcare practices, etc.
• Environment home, neighborhood, community

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II. Developmental Dimension

• Family life cycle the typical path most families
  go through.
• Stages
• Tasks
• Attachments

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Stages of the Family Life Cycle

• Leaving home Launching single young adults
• Joining of families through marriage
• Families with Young Children
• Families with Adolescents
• Launching Children Moving on
• Families in Later Life

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Tasks
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Tasks
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Tasks
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Tasks
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Tasks
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III. Functional Assessment

• 1. Instrumental routine A.D.L.

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Expressive Functioning

• Emotional Communication
• Verbal Communication
• Nonverbal
• Circular
• Problem Solving
• Roles
• Influence power
• Beliefs
• Alliances Coalitions

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Emotional Communication

• Range types of emotions or feelings expressed
• Generally a wide range from happiness, to sadness
  to anger
• Families with emotional difficulties often have a
  narrow range of expression

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Verbal Communication

• Direct vs. Indirect
• Direct message sent to intended target
• Clear vs. masked
• Say what you mean and mean what you say to the
  intended recipient leads to clear direct
  communication
• Masked communication give distorted messages

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Nonverbal Communication

• Highly influenced by culture
• Body posture (e.g. slumped, fidgeting)
• Eye contact (e.g. intense, minimal)
• Touch, gestures, facial expressions
• Proximity distance between family members
• Para-verbal communication crying, tone

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Circular Communication

• Reciprocal communication between people
• C.P.D.s concretely show simplify repetitive
  sequences of interactions
• Three components
• Affect (emotional state)
• Behavior
• Cognition (thoughts, ideas or beliefs)

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Problem Solving

• Strongly influenced by familys beliefs about its
  abilities and past successes
• Who identifies the problem?
• What are the families solution patterns?
• What resources are relied upon for help inside
  the family or external?

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Roles

• Established patterns of behavior for family
  members
• How do family members cope with their roles?
• Formal vs. informal roles
• Is there role conflict or role strain?
• Does family believe that roles need to be
  altered?

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Influence and Power

• Power may present as overt acts of domination
• Note power differences among family members
• Instrumental influence use of objects or
  privileges as rein forcers (e.g. money, TV.
  viewing, use of computer, etc.)
• Psychological influence use of words or feelings
  (e.g. praise criticism threats guilt)
• Corporal control use of body contact (e.g.
  hugging spanking, etc)

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Beliefs

• Attitudes, values and assumptions
• Beliefs influence behavior.
• Explore beliefs about etiology of the health
  problem, treatment, prognosis, religion
  spirituality

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Alliances Coalitions

• Directionality, balance intensity of
  relationships between family members
• Note any triangles shifting alliances