Couple and Family Interventions in Health Problems

Abstract

Intervention research for couples and families managing chronic health problems is in an early developmental stage. We reviewed randomized clinical trials of family interventions for common neurological diseases, cardiovascular diseases, cancer, and diabetes, which is similar to the content of previous reviews discussed later. One overriding theme of these studies is that patients with chronic illnesses and their families face a variety of challenges to which researchers have responded with an array of treatment modalities. Very few of the interventions reviewed, with the exception of treatment for adolescents with diabetes, tested family psychotherapy models. Most interventions were time-limited therapeutic interventions that trained families to improve their communication and problem-solving skills, individual and family coping skills, and medical management. Researchers more clearly described mechanisms of change in intervention studies with cancer and diabetes than with other diseases, and not surprisingly, they found greater empirical support for their interventions. Family interventions show promise to help patients and family members manage chronic illnesses. To develop an empirical base for family approaches to managing chronic illnesses, interventions must be based on theories that delineate mechanisms of change in family processes and skills in medical management necessary to maintain patients' and family members' health.

Dyadic associations between cancer-related stress and fruit and vegetable consumption among colorectal cancer patients and their family caregivers

“…These findings underscore calls for providing proper education to cancer patients and their family members together, treating patients and caregivers together as a unit to effectively intervene on their unhealthy behaviors. Although the importance of including family in a patient’s chronic illness management has begun to grow in awareness, healthy lifestyle interventions that include caregivers and capitalize on family support are rare (Shields, Finley, Chawla, & Meadors, 2012). Only three dyadic interventions have been reported addressing dietary change among patients with chronic illness and their caregivers (Fridlund, Högstedt, Lidell, & Larsson, 1991; Riemsma, Tall, & Rasker, 2003; Wing, Marcus, Epstein, & Jaward, 1991).…”

“…Only three dyadic interventions have been reported addressing dietary change among patients with chronic illness and their caregivers (Fridlund, Högstedt, Lidell, & Larsson, 1991; Riemsma, Tall, & Rasker, 2003; Wing, Marcus, Epstein, & Jaward, 1991). Although these interventions have shown mixed results, behavioral interventions that include family members have been shown to improve both patients’ and caregivers’ outcomes greater than patient-only interventions (Hartmann, Bazner, Wild, Eisler, & Herzog, 2010; Martire, Lustig, Schulz, Miller, & Helgeson, 2004; Martire, Schulz, Helgeson, Small, & Saghafi, 2010; Shields et al, 2012). As such, inclusion of family members in healthy lifestyle behavior interventions must become the norm, rather than the exception.…”

Does problem-solving training for family caregivers benefit their care recipients with severe disabilities? A latent growth model of the Project CLUES randomized clinical trial.

“…Although demonstrating beneficial effects of family interventions on care recipients is important, it is essential that interventions “… be based on theories that delineate mechanisms of change in family processes and skills … necessary to maintain patients’ and family members’ health” (Shields, Chawla, Finley, & Meadors, 2012, p. 265). Several mechanisms might account for the indirect benefits of caregiver PST for care recipients in our study.…”

A Report: Couples with Medical Conditions, Attachment Theoretical Perspectives and Evidence for Emotionally-Focused Couples Therapy

“…Previous social support interventions have largely focused on psycho-educational approaches geared to specific chronic illnesses couples are facing (Shields et al 2012). We suggest that EFT provides an intervention and resource that can incorporate psycho-education but goes beyond information giving and skill development to assist couples to strengthen their emotional bond and learn how to ask for and give sensitive care in times of high stress and strain.…”