This paper will apply the Family Systems Stressor-Strengths Inventory (FS3I) to an Israeli family. The family in question comprises of a man, Aharon (49 years old), and his wife Aviva (47 years old). The family is upper middle class and lives on the outskirts of Tel Aviv. Aharon and Aviva have been married for 19 years. Aharon has a Ph.D. in forensic science and consults for a private security firm in Israel. As part of his duty, Aharon travels frequently to Europe, Asia and North America where the majority of his employer's clients are based. Aviva runs a management consultant firm in Tel Aviv. The Aharon family is Jewish and very religious. According to the developmental and family cycle theory, the Aharon family is in the middle-aged adults phase. Aharon and Aviva were interviewed in their family home. Each person completed the FS3I form, which provided composite and individual scores. The assessment of the Aharon family involved the application of the FS3I tools to identify the familys stressors and strengths to develop a relevant plan of action.
Aviva has a diagnosis of infertility, which has been a significant issue for the family since the couple got married. The couple appears to have given up on the hope of having their own biological child. As a result, they are considering adopting a child. At the beginning of 2017, the couple visited several adoptive agencies in search of information on how to get a child who they could adopt. While celebrating Gullion's 49th birthday in August, the couple agreed to adopt a boy child by March this year. It was not easier to identify the right child given that Aviva and Aharon had significant differences regarding the qualities they wanted. Aviva was not selective of religion and nationality, but Aharon felt that the two factors were very important. More specifically, Aharon was against adopting a child from an Arab, Asian or African country. Due to Avivas family origin from Poland, the couple agreed to adopt a three-year-old boy from the country. It took the couple several weeks to review the boy's medical history and other pertinent information. Having complied with all legal requirements for adoption, the couple is awaiting final approval by the Polish government. At the end of the month, Aharon and his wife will be flying to Warsaw to pick up the boy named Millom.
The Family Assessment
Stressors are events related to the family that has the potential to create stress within the family or between the family and the larger community. It was determined that the impending adoption of the Polish boy was the most important general stressor to the family. The family was worried about issues of dieting and nutrition and low self-esteem for lack of a biological child. Aharon was found to have low general stress than his husband. She stated that in addition to the noted stressors, she is concerned with stress due to the possibility of starting new housekeeping roles, a long-term physical problem affecting her shoulders, and her mothers deteriorating mental health. On his part, Aharon stated that concerns about her elder brother who has cancer cause him extra stress. Upon reviewing the family's stressors, the assessor rated the couple higher than they had rated themselves
These are specific stressors within the family that are affecting the health of the couple either as a whole or as individuals. It was identified that the main specific stressor that is causing Aharon the greatest stress is the Millom's adoption. Aharon is particularly concerned about how he will balance between his new role as a father and his highly demanding work. As already noted, Aharon travels frequently and can sometimes be away from his family for about a week. He fears that his frequent travels outside the country may cause him not to bond well with his adopted son. The additional specific stressor for Aharon is that his brothers medical upkeep requires a lot of money and since he (Aharon) is the only closest family member, he has to try his best to pay the medical bills. Moreover, attending to his ailing brothers medical needs is consuming a lot of time. Currently, the brother to Aharon is being taken care of in a private hospital in Jerusalem and although he has a health insurance, it is not enough to cater for all his medical needs.
The specific stressor identified for Aviva was how she is going to manage the childs needs given her highly demanding work as a management consultant. She is deeply concerned that she will not be able to manage the childs feeding schedule and that she will not be there to monitor the child each day. She confided that the family is used to eating in a restaurant, which makes meal preparation a great problem for her. In most cases, Aviva and Aharon never eat together due to their demanding work schedules. But once the child is adopted, Aviva will have to start cooking in their house, something that Aviva considers a big challenge, especially because the husband does not like cooking. Regrettably, Aviva considers herself a failure because she cannot manage family dinners in their house. But if they hire a maid, the family can overcome the challenge of cooking although it will not be possible to have family meals together each day.
Family Systems Strengths
These are the aspects and actions that contribute to the well-being of the Aharon family and help them to cope with stressors. It was identified that the Aharon family has many strengths, which they can leverage on to overcome the stressors. Both Aviva and her husband viewed each other as great people with strong family values. With her background in management consultancy, Aviva is a great problem solver, a skill she has taught he handstand over the years. As well, the couple has good communication skills and is hopeful that the adoption of Millom will strengthen the family unit. Both of them agreed that much of their current stress is related to an unknown fear about the relationship with Millom. But they are hopeful that once the boy arrives in the family, he will be nurtured well and that taking care of him will be an opportunity to strengthen vital relationships with the community.
The family has adopted the consensual decision-making approach, which is a great strength. However, the nurse noted that the distribution of power in relation to decision making is situational in that either spouse who has more experience with a given issue attempts to influence the other. For example, Aviva is a management consultant with extensive experience in human resource management. She, therefore, has more power in the management of the familys domestic workers. On the other hand, Aharon is a security expert and hence has a greater say in matters pertaining to the familys security.
Another important element of the familys strength relates to the values espoused by the couple. The critical family values are openness, good neighborhood, education, family health, caring for others and religiosity. Since Aviva and Aharon got married, the couple has demonstrated a caring relationship founded on true love and genuine concern for each other. For 19 years, the family has remained cohesive and is only excited about the adoption of Millom, who they think will bring more excitement to reinvigorate the family joy. The adoption will also be a very big boost to the familys self-esteem, which has remained low due to Avivas inability to conceive.
Identification of Health Issues
The main health issue for this family is the depression associated with not having a child, as well as the anxiety of starting a new life as adoptive parents. Given the pervasiveness of infertility-related stress, mental health problems are inevitable in Aharons family. These may, in turn, lead to serious chronic conditions such as diabetes, high blood pressure, asthma and panic attacks (Lacerda, Cirelli, Barros & Lopes, 2017). Other major health conditions that may result from depression include stroke, cardiovascular diseases hepatitis C and chronic pain (Zaker & Boostanipoor, 2016). Depression may make it difficult for the Aharon family to deal with their health, which can lead to more complications.
Proposed Interventions/Family Care Plan
There are a number of interventions that can help the family to cope with the depression. These include counseling, psychotherapy, and medications. Short-term counseling may help the couple to enhance their coping strategies and make the right decisions in life, especially now that they are adopting a child (Sullivan, 2015). Interpersonal therapy and cognitive behavioral therapy can give relief to the familys depression (Hvidman, Petersen, Larsen, Macklon, Pinborg & Andersen, 2015). Psychotherapy can be more effective when delivered to the couple jointly as opposed to individually. The intervention of medications may include anti-anxiety medicines and anti-depressants (Rogers & Pies, 2017). These medications can be very effective for the treatment of moderate to severe depression. For long-term gains, it is recommended that the family seeks support from community resource. The best resource, in this case, is the Jewish Children's Adoption Network, which offers training support for adoptive parents in Israel.
A careful review of Aharon familys strengths and stressors and their current circumstances shows that the family has the necessary strength to start a new cycle of life as parents. The family is well prepared to take care of their adoptive child and has the resources required to provide for the childs material, emotional and social needs. Given Gullion's status as a wealthy man, he has enough resources to support his ailing brother. Since the family lives in a secure, affluent neighborhood that is racially and ethnically diverse, the adopted boy will have an opportunity to interact with other children from diverse backgrounds. This will enhance his social and interpersonal skills. To their advantage, the family is capable of coping with various stressors owing to the couples strong solving skills. Going forward, the family is willing to seek information and garner support from other people on how best to take care of their adoptive son.
Hvidman, H., Petersen, K., Larsen, E., Macklon, K., Pinborg, A. & Andersen, A. (2015). Individual fertility assessment and pro-fertility counseling; should this be offered to women and men of reproductive age? Human Reproduction, 30(1), 915.
Lacerda, M. S., Cirelli, M.A., Barros, A. & Lopes, J. L. (2017). Anxiety, stress, and depression in family members of patients with heart failure. Rev Esc Enferm USP, 51, 1-7.
Rogers, D. & Pies, R. (2017). General Medical Drugs Associated with Depression. Psychiatry, 5 (12), 2841.
Sullivan, K. (2015). An Application of Family Stress Theory to Clinical Work with Military Families and Other Vulnerable Populations. Clin Soc Work J, 43, 8997.
Zaker, B. & Boostanipoor, A. (2016). Multiculturalism in counseling and therapy: Marriage and family issues. International Journal of Psychology and Counseling, 8(5), 53-57.
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