1. THE FAMILY LIFE CYCLE Aileen B. Pascual, MD, DPAFP July 17, 2010

2. The Family Life Cycle Conceptual tool for understanding family development Transitions from one stage to another are rarely clear cut Stages tend to merge Several different models 3 general phases: coupling, expansion, contraction 6 stages

3. The Family Life Cycle The Family System undergoes important psychosocial changes Changes are predictable and observable

5. Family Life Cycle

6. The Unattached Young Adult Major tasks to master: Selection of a way of life Selection of a partner in life Emotional Process of Transition: Accepting parent-offspring differentiation

7. The Unattached Young Adult Second-Order Changes: Differentiation of self in relation to family of origin Development of intimate peer relationships Establishment of self in respect to work and financial independence

8. The Unattached Young Adult Problems encountered Medical Emotional Social

9. Family Life Cycle

10. Newly Married Couple Joining of families through marriage Emotional Process of Transition: Commitment to the new system

11. Newly Married Couple Second-Order Changes: Formation of the marital system Realignment of relationships with extended families and friends to include spouse

12. Newly Married Couple Problems encountered: Medical Emotional Social

13. Family Life Cycle

14. Family with Young Children Begins with the birth of the couple’s first child Emotional Process of Transition: Accepting new members into the system

15. Family with Young Children Second-Order Changes: Accepting marital system to make space for children Taking on parenting roles Realignment of relationship with extended family to include parenting and grandparenting roles.

16. Family with Young Children Problems encountered: Children Parents Grandparents

17. Family Life Cycle

18. Family with Adolescents Can be turbulent for both the adolescent and the family Emotional Process of Transition: Increasing flexibility of boundaries to include children’s independence

19. Family With Adolescents Second-Order Changes: Shifting of parent-child relationships to permit adolescent to move in and out of the system Refocus on midlife marital and career issues Beginning shift toward caring for the older generation

20. Family With Adolescents Problems encountered: Adolescents Parents Grandparents

21. Family Life Cycle

22. Launching Family Begins with the first child becoming a young adult and leaving home Ends with the empty nest as the last child leaves his or her family of origin Emotional Process of Transition: Accepting multitudes of entry and exits into the family system.

23. Launching Family Second-Order Changes: Renegotiation of marital system as a dyad Development of adult to adult relationships between parents and their grown children Re-alignment of relationships to include in-laws and grandchildren Dealing with disabilities and deaths of parents, or grandparents

24. Launching Family Problems encountered: Children Parents Grandparents

25. Family Life Cycle

26. The Family In Later Years During this final stage of the family life cycle, the elderly persons must accept the shifting of generational roles Children will create families of their own, be responsible for their own life decisions and play less active roles in the family circle in which they grew up

27. The Family in Later Years Emotional Process of Transition: Accepting of shifting of generational goals

28. The Family in Later Years Second Order Changes: Maintaining own or couple functioning and interests in face of physiologic decline: exploration of new familial and social options Support for more central role of middle generation

29. The Family in Later Years Second Order Changes: Making room in the system for the wisdom of the elderly , supporting the older generation without over-functioning for them Dealing with loss of spouse, siblings and other peers and preparation for death

30. Family in Later Years Problems encountered: Children Parents Grandparents

31. Family Life Cycle

32. The Life Cycle Approach

33. Family Life Cycle Approach Where in the life cycle are the three generations of this family? Are the life cycle stages in phase or out of phase? What developmental challenges predominate for the family? How are the relevant developmental challenges related to the presenting complaint?

34. Family Life Cycle Approach Where in the life cycle are the three generations of the family? What is happening to the parents? What is happening to the grandparents? What is happening to the children?

35. Family Life Cycle Approach Are the life cycle stages in phase or out of phase? Higher risk for physical and emotional symptoms

36. Family Life Cycle Approach What developmental challenges predominate for the family ?

37. Family Life Cycle Approach How are the relevant developmental challenges related to the presenting complaint?