Social Science

For members of the sandwich generation who are working outside the home, flexible work schedules can help alleviate the stresses associated with both caregiving responsibilities and work responsibilities. The Family and Medical Leave Act, adopted in 1993, guarantees family caregivers some unpaid leave. In addition, some large corporations provide time off for caregiving.

Assessing and Intervening in Family Systems Families are characterized by multiple ongoing interactions. When social workers intervene with families, there is much to observe and understand. The dimensions of family interaction that will be dis- cussed here include communication, family norms, and problems commonly faced by families. In addi- tion, two prominent family-assessment instruments will be described: the ecomap and the genogram.

Verbal and Nonverbal Communication Communication involves transmitting information from one person to another, using a common system of symbols, signs, or behaviors. Verbal communica- tion involves the use of words and will be addressed first.

The first phase of verbal communication involves the translation of thoughts into words. The informa- tion sender must know the correct words and how to put them together. Only then will the information have the chance of being effectively received. The sender may be vague or inaccurate in forming the message, and interruptions and distractions may detract from the communication process.

The information receiver then must be receptive to the information. That is, he or she must be paying attention both to the sender and to the sender’s words. The receiver must understand what the spe- cific words mean. Inaccuracies or problems at any point in this process can stop the information from getting across to the receiver. At any point, distor- tions may interfere.

Verbal communication patterns inside the family include who talks a lot and who talks only rarely. They involve who talks to whom and who defers to whom. They also reflect the subtle and not so subtle qualities involved in family members’ relationships.

The sender also transmits nonverbal messages along with the verbal messages. These include facial

expressions, body posture, emotions displayed, and many other subtle aspects of communication. Some- where between verbal and nonverbal aspects of com- munication are voice inflection, intonation, and loudness. All this gives the receiver additional infor- mation about the intent and specific meaning of the message that’s being sent. Sometimes the receiver will attribute more value to the nonverbal aspects of the message than to the verbal.

For example, a 17-year-old son asks his father, “Dad, can I have the car next Saturday night?” Dad, who’s in the middle of writing up his tax re- turns (which are due in two days), replies “No.” Harry interprets this to mean that his father is an authoritarian tyrant who does not trust him with the family car. Harry stomps off in a huff. However, what Dad was really thinking was that he and Mom need the car this Saturday because they’re taking their best friends, the Jamesons, out for their 20th wedding anniversary. Dad was also thinking that perhaps the Jamesons wouldn’t mind driving. Or maybe he and Harry could work something out to share the car. At any rate, Dad really meant that he was much too involved with the tax forms to talk about it and would rather discuss it during dinner.

This is a good example of ineffective communica- tion. The information was vague and incomplete, and neither person clarified his thoughts or gave feedback to the other. There are endless variations to the types of ineffective communication that can take place in families. Social workers can often help to clarify, untangle, and reconstruct communication patterns.

One especially important aspect of assessing mes- sages is whether they are congruent or incongruent. Communication is incongruent when two or more messages contradict each other’s meaning. In other words, the messages are confusing. Contradictory messages within families disturb effective family functioning.

Nonverbal messages can sometimes contradict verbal messages. For example, a recently widowed woman says, “I’m sorry Frank passed away,” with a big grin on her face. The information expressed by the words indicates that she is sad. However, her accompanying physical expression shows that she is happy. Her words are considered socially appropri- ate for the situation. However, in this particular case, she seems relieved to get rid of “the old buz- zard” and happy to be the beneficiary of a large life insurance policy.

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The double message reflected by the widow’s ver- bal and nonverbal behavior provides a relatively simple, clear-cut illustration of potential problem communication within families. However, congru- ence is certainly not the only important aspect of nonverbal communication. All of the principles of nonverbal communication discussed in Chapter 11 can be applied to communication within families.

Family Norms Family norms are the rules that specify what is con- sidered proper behavior within the family group. Many times the most powerful rules are those that are not clearly and verbally stated. Rather, these are implicit rules or repeated family transactions that all family members understand but never discuss. It’s important for families to establish norms that allow both the entire family and each individual member to function effectively and productively.

Every family differs in its individual set of norms or rules. For example, the Myers family believes the husband’s role is to earn enough money to support his wife and three children. Mr. Myers works as a bus driver for the city he lives in, and makes about $50,000 a year. He works 40 hours a week, and then is free to lie on the couch or pursue his hobbies of hunting and fishing. His wife is expected to stay at home, raise the children, and perform all the house- hold tasks. She also home-schools the three school- age children. The Myers attend a fundamentalist church that urges the wife to play a supportive role to her husband. Mrs. Myers is unaware that she puts in more than 100 hours per week performing all her teaching and domestic tasks. The children are ex- pected to concentrate on their studies, and are not asked to help out around the house. As a result, Mrs. Myers is becoming physically and emotionally exhausted, looks haggard, and her blood pressure is elevated.

The Woodbeck family has very different norms. Mr. and Mrs. Woodbeck value earning a lot of money so that the family can take exotic vacations and live a life of luxury. Mr. Woodbeck is an attor- ney, and Mrs. Woodbeck is a physician. They have a live-in housekeeper, Donna Maloney, who performs most of the domestic tasks. The Woodbecks send their two teenage children to a private high school and have urged them to aspire to attend prestigious colleges and eventually become high-paid profes- sionals. Mr. and Mrs. Woodbeck cherish the values that the school is helping to instill in their children,

as well as the socialization components of the school. Mr. and Mrs. Woodbeck have few hobbies, as both of them work an average of 70-plus hours per week. Their free time is spent primarily on fam- ily activities.

Social workers need to help families identify and understand that inappropriate, ineffective norms can be changed. For example, it simply is not in Mrs. Myers’s best interest to be putting in more than 100 hours a week on home-schooling and do- mestic tasks. If a social worker became involved (perhaps after a referral from Mrs. Myers’s physi- cian, who is concerned about her blood pressure), that social worker could help Mrs. Myers (and prob- ably eventually Mr. Myers) to examine the family norms that are adversely affecting her. Once such norms are identified, the social worker could help them clarify alternative solutions and help them as- sess which is the best solution for them.

Family System Assessment: The Ecomap An ecomap is a paper-and-pencil assessment tool that practitioners use to assess specific troubles and plan interventions for clients. The ecomap is a drawing of the client/family in its social environ- ment. An ecomap is usually drawn jointly by the social worker and the client. It helps both the worker and the client achieve a holistic or ecologi- cal view of the client’s family life and the nature of the family’s relationships with groups, associations, organizations, other families, and individuals. It has been used in a variety of situations, including mar- riage and family counseling, and adoption and foster-care home studies. The ecomap has also been used to supplement traditional social histories and case records. It is a shorthand method for recording basic social information. The technique helps users (clients and practitioners) gain insight into clients’ problems and better sort out how to make construc- tive changes. The technique provides a “snapshot view” of important interactions at a particular point in time. The primary developer of the technique is Ann Hartman (1978).

A typical ecomap consists of a family diagram surrounded by a set of circles and lines used to de- scribe the family within an environmental context. The ecomap user can create her or his own abbrevia- tions and symbols (see Figure 12.2).

To draw an ecomap, a circle (representing the cli- ent’s family) is placed in the center of a large, blank sheet of paper (see Figure 12.3). The composition of

Sociological Aspects of Young and Middle Adulthood 557

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

the family is indicated within the family circle. A number of other circles are drawn in the area sur- rounding the family circle. These represent the other systems (that is, the groups, other families, indivi- duals, and organizations) with which the family or- dinarily interacts.

Different kinds of lines are drawn to describe the nature of the relationships that the members of the client family have with the other systems. The direc- tional flow of energy (indicating giving and/or re- ceiving of resources and communication between the client family members and the significant sys- tems) is expressed by the use of arrows. A case example of the use of an ecomap follows.

Barb and Mike Haynes are referred to the Adult Services Unit of the Greene County Human Services Department by Dean Medical Clinic. The clinic has been treating Mike’s mother, Ruth Haynes, for Alz- heimer’s disease since she was diagnosed with the disorder four years ago. For the past three years she has been living with Barb and Mike. She now requires round-the-clock care, because during the evening hours she has trouble sleeping, wanders around the house, and starts screaming when she

40 Female, 40 years old

Male, 38 years old

Person, sex, and age unknown

Deceased female, died at age 62

A stressful, conflict-laden relationship

A tenuous, uncertain relationship

A positive relationship or resource (the thicker the line, the stronger or more positive the relationship or resource)

The direction of the giving and receiving exchange in a relationship or resource (in some relationships, the client may primarily receive or give)

38

62

FIGURE 12.2 Commonly Used Symbols in an Ecomap

Client family

Social environment

An ecomap is an assessment tool for depicting the relationships and interactions between a client family and its social environment. The largest circle in the center depicts the client family. The surrounding circles represent the significant groups, organizations, other families, and individuals that make up the family’s social environment.

FIGURE 12.3 Setting Up an Ecomap

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20 13

© Ce ng ag e Le ar ni ng

20 13

558 Understanding Human Behavior and the Social Environment

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becomes lost and confused. Dean Medical Clinic has referred Barb and Mike Haynes to the Adult Services Unit to explore alternative caregiving arrangements.

Barb and Mike Haynes meet with Maria Garcia, Adult Services Worker. They indicate that they feel a moral obligation to continue caring for Ruth in their home, because Ruth spent most of her adult years caring for Mike and his brother and sister when they were children. Barb and Mike also indi- cate that they have a 2-year-old child, Erin, at home. This is a second marriage for both Barb and Mike, and they are paying for Mike’s son, Brian, to attend the state university. With such expenses, both believe they need to continue to work. Mike’s oldest sister, Mary Kruger, is a single parent who has two children in high school. Mary Kruger has a visual disability but has been able to be the primary caregiver for Ruth and Erin during the daylight hours when Mike andBarb are at work. Recently,Mary informedMike and Barb that caring for Ruth is becoming too diffi- cult and that some kind of alternative care is needed. Ms. Garcia suggests that adult day care for Ruthmay be a useful resource.

Mike adds that it is emotionally devastating to see his mother slowly deteriorate. He indicates he is in a double bind; he feels an obligation to care for his mother, but doing so is causing major disruptions in his family life. The stress has resulted in marital dis- cord with Barb, and he adds that both he and Barb have become increasingly short in temper and patience with Erin.

At this point, Ms. Garcia suggests it may be help- ful to graphically diagram their present dilemma. Together, the Hayneses and Ms. Garcia draw the ecomap shown in Figure 12.4. While drawing the map, Mike inquires whether Ruth’s medical condi- tion might soon stabilize. Ms. Garcia indicates that Ruth may occasionally appear to stabilize, but the long-term prognosis is gradual deterioration in men- tal functioning and in physical capabilities. The eco- map helps Mike and Barb see that even though they are working full-time during the day and spending the remainder of their waking hours caring for Erin and Ruth, they are becoming too emotionally and physically exhausted to continue doing so. During the past three years, they have ceased social- izing with friends. Now they seldom have any time to spend even with Brian. Feeling helpless and hopeless, they inquire if some other care arrangement is avail- able besides a nursing home. They indicate that Ruth

has said on numerous occasions, “I’d rather die now than be placed in a nursing home.” Ms. Garcia tells them of some high-quality adult group homes in the area and gives them the addresses.

After visiting a few of the care facilities, Barb and Mike ask Ruth to stay for a few days at one they particularly like. At first Ruth is opposed to going for a “visit.” But after being there a few days, she adjusts fairly well and soon concludes (erroneously, but no one objects) that it is a home she bought and that the people on the staff are her “domestic employees.” Ruth’s adjustment eases the guilt that Barb and Mike feel in placing Ruth in a care facility, and this results in substantial improvements in their marital relationship and in their interactions with Erin, Brian, and their friends.

A major value of an ecomap is that it facilitates both the worker’s and the client’s view of the client’s family from a systems and an ecological perspective. Sometimes, as happened in the case of the Hayneses, the drawing of the ecomap helps clients and practi- tioners gain greater insight into the social dynamics of a problematic situation.

Family System Assessment: The Genogram A genogram is a graphic way of investigating the origins of a client’s problem by diagramming the family over at least three generations. The client and the worker usually construct the family geno- gram jointly. The genogram is essentially a family tree. Murray Bowen is the primary developer of this technique (Kerr & Bowen, 1988). The genogram is a useful tool for the worker and family members to examine problematic emotional and behavioral patterns in an intergenerational context. Emotional and behavioral patterns in families tend to repeat themselves; what happens in one generation will of- ten occur in the next. Genograms help family mem- bers to identify and understand family relationship patterns.

Figure 12.5 shows some of the commonly used symbols. Together, the symbols provide a visual re- presentation of at least three generations of a family, including names, ages, genders, marital status, sibling positions, and so on. When relevant, additional items of information may be included, such as emotional difficulties, behavioral problems, religious affilia- tion, ethnic origins, geographic locations, occupations, socioeconomic status, and significant life events.

Sociological Aspects of Young and Middle Adulthood 559

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Daryl
Highlight

The following case example illustrates the use of a genogram.

Chris Witt makes an appointment with Kyle Nolan, a social worker in private practice. Chris is distraught. He indicates that his wife, Karen, and two children are currently at Sister House, a shelter for battered women. Chris states he and his wife had a “scuffle” two days ago, and she bruised her face. Yesterday, when he was at work, she left home with

the children and went to Sister House. He adds that she has contacted an attorney and is now seeking a divorce.

Mr. Nolan inquires as to the specifics of the “scuffle.” Chris says he came home after having a few beers. His dinner was cold, and he “got on” Karen for not cleaning up the house. He adds that Karen then started mouthing off, and he slapped her to shut her up. Mr. Nolan inquires whether such

Deceased husband’s pension plan

(sufficient for Ruth’s financial needs)

Ruth’s friends (no longer

contact Ruth)

Richard—Ruth’s other son

(no longer has contact with

Ruth)

Metro Transit (Mike has been a bus driver for

13 years)

Porta Bella Restaurant

(Barb has been a waitress for

9 years)

Dean Medical Clinic

(treats Ruth for Alzheimer’s disease)

State university

(Brian is majoring in computer science

and living in a residence

hall)

Mary— Mike’s sister

(primary caregiver during the day for Erin and Ruth) Friends

(Barb and Mike have mutual friends, but now are usually

too busy to socialize with

them)

Erin 2

Barb 38

Jim 44

Mike 42

Ruth 62

Brian 19

Divorced Divorced Married 4 years

M ar

y is

e xh

au st

ed

in p

ro vi

di ng

c ar

e

Liz 37

Pat 44

Barb’s parents

(retired and moved to Florida; Barb seldom sees

them)

St. James Church (Barb attends but

Mike does not)

FIGURE 12.4 Sample Ecomap: Barb and Mike Haynes

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560 Understanding Human Behavior and the Social Environment

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

incidents had occurred in the past. Chris indicates, “A few times,” and adds that getting physical with Karen is the only way for him to “keep her in line.” He says he works all day long in his small business

as a concrete contractor, while his wife sits at home watching soap operas. He feels she is not doing her fair share and the house usually looks like a disaster.

Mr. Nolan asks Chris if he feels that getting phys- ical with his wife is justifiable. He responds, “Sure,” and adds that his dad frequently told him, “Spare the rod, and spoil both the wife and the kids.” Mr. Nolan asks Chris if his dad was abusive to him when he was a child. Chris indicates that he was and adds that to this day he detests his dad for abusing him and his mother.

Mr. Nolan then suggests that together they draw a family tree, focusing on three areas: episodes of heavy drinking, episodes of physical abuse, and traditional versus modern gender stereotypes. Mr. Nolan ex- plains that a traditional gender stereotype includes the husband as the primary decision maker, the wife as submissive to him, and the wife as primarily re- sponsible for domestic tasks. The modern gender ste- reotype involves an egalitarian relationship between husband and wife. After an initial reluctance (Chris expresses confusion as to how such a tree would help get his wife back), Chris agrees. The resulting geno- gram is presented in Figure 12.6.

The genogram helps Chris to see that he and his wife are products of family systems that have strik- ingly different values and customs. In his family, the males tend to drink heavily, have a traditional view of marriage, and tend to use physical force in inter- actions with their spouses and children. Upon ques- tioning, Chris mentions that he has at times struck his own children. Mr. Nolan asks Chris how he feels about repeating the same patterns of abuse with his wife and children that he despised his father for using. Tears come to his eyes, and he says one word, “Guilty.”

Mr. Nolan and Chris discuss what Chris might do to change his family interactions and how he might best approach his wife to request that she and the children return. Chris agrees to attend AA (Alco- holics Anonymous) meetings and a therapy group for batterers. After a month of attending these meet- ings, Chris contacts his wife and asks her to return. Karen agrees to return if Chris stops drinking (most of the abuse occurred when he was intoxicated) and if he agrees to continue to attend group therapy and AA meetings. Chris readily agrees. Karen’s parents express their disapproval of her returning.

For the first few months, Chris Witt is on his best behavior, and there is considerable harmony in the

21 21-year-old male

Deceased male (died at age 67)

Deceased female (died at age 32)

33-year-old identified female client

27-year-old identified male client

23-year-old female

Couple separated (/) in 1981, divorced (//) in 1983

Unmarried couple living together since 1982, with a 4-year-old son

Married couple with an adopted daughter

Married couple (married in 1982)

Married couple with two children: an 8-year-old daughter and a 3-year-old son

Married couple, wife pregnant

m 82

8 3

33

67

23

82

4

s 81; d 83

32

27

FIGURE 12.5 Commonly Used Genogram Symbols

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Sociological Aspects of Young and Middle Adulthood 561

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Witt family. Then one day Chris has to fire one of his employees. Feeling bad, he stops afterward at a tavern and drinks until he is intoxicated. When he finally arrives home, he starts to verbally and physi- cally abuse Karen and the children. This is the final straw for Karen. She takes the children to her par- ents’ house, where they stay for several days until they are able to find and move into an apartment. She also files for divorce and follows through in obtaining one.

In many ways, this is not a success case (in reality, many cases are not). The genogram, however, was useful in helping Chris realize that he had acquired,

and was acting out, certain dysfunctional family pat- terns. Unfortunately, he was not yet fully ready to make lasting changes. Perhaps sometime in the fu- ture he will be more committed to making changes. At the present time, he has returned to drinking heavily.

The ecomap and the genogram have a number of similarities. With both techniques, users gain insight into family dynamics. Some of the symbols used in the two approaches are identical. There are also dif- ferences. The ecomap focuses attention on a family’s interactions with groups, resources, organizations, associations, other families, and other individuals.

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