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Posted: November 24th, 2022

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Calgary Family Assessment Model
CFAM stands for Calgary Family Assessment Model

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CFAM stands for Calgary Family Assessment Model

Introduction

This model is an integrated, multidimensional framework that is intended to serve as a foundation for conceptualizing relationships between a family and their health-care provider (a nurse). The goal of the relationship is to provide an environment in which change and healing can occur (Wright & Leahey, 2013). The definition of family-centered care according to Wright and Leahey is when assessment, intervention, and relational practices are carried out in a responsible and respectful manner with the family. In Wright’s and Leahey’s opinion, nurses have a moral obligation to involve families in the provision of health care services (Wright & Leahey, 2013). As a result of the relationship between family member functioning and interventions provided by nurses, this model is intended to assist the nurse family unit in growing and flourishing. The model’s implementation is predicated on the assumption that the emphasis is placed on the strengths and resiliency of a family rather than on the family’s deficits and dysfunctions. The nurse then develops interventions that are tailored to the family’s unique set of strengths and resilience characteristics (Wright & Leahey, 2013). A nurse should therefore provide interventions without requiring the family to change the way they currently function.

Assessment of the Family’s Structural Dynamics

The structural assessment component of the Calgary family assessment model (CFAM) is a critical component because it allows for the examination of structural components within a family to be conducted. CFAM, according to Wright and Leahey, can be used to identify aspects of the internal structure, external structure, and context of a given structure (Wright & Leahey, 2013). Gender, sexual orientation, rank orders, and boundaries are some of the questions that nurses ask about family members and how they are connected to one another (Kaakinen, Coehlo, Gedaly-Duff, & Hanson, 2010). The use of a family genogram and ecomaps can assist a nurse in gaining a thorough understanding of the structure of a family. Both genograms and ecomaps provide a broad overview of a family by displaying the ages and genders of each member. Internal, external, and contextual aspects of a family’s structure are all considered during the structural assessment process.

In the context of family structural assessment, internal structure is important.

In family structural assessment, the internal structure is divided into six segments: family composition, rank order, gender, sexual orientation, boundaries, and subsystems (Wright & Leahey, 2013). A family unit consisting of Charles Bromley, the family’s patriarch, his wife Remona, and their two sons Xavier and Tyler makes up Bromley’s clan. Charles and Remona have a close friendship and spend a lot of time together when they are both not working or attending school. Charles is employed as a foreman in a construction company, and Remona is employed as a law enforcement officer. With her older sister, who is a psychologist, to whom Remona often turns for support, they have a close relationship. Remona’s desire to have another child, most likely a girl, has been causing friction in the family because Charles is adamantly opposed to the idea. In order to get support, Remona turns to her sister Kelly. Kelly is a close friend of the Bromley family, and she works with them as a psychologist. To put it in perspective of the family hierarchy, Charles and Remona have two children: 15-year-old Xavier and a five-year-old boy named Tyler. As a means of supporting their family, Charles and Remona both work full-time jobs.

In the context of family structural assessment, the external structure is important.

The external structure of a family, on the other hand, is comprised of extended family and larger systems in the context of a structural assessment of the family (Wright & Leahey, 2013). In his explanation, Charles explains that Remona is extremely close to her older sister, whom she confides in for support. Kelly, Ramona’s sister, is also married and has children of her own. She is very close to Bromley’s family and serves as both a family therapist and a relative to the Bromley children. Kelly’s son, who is also his age, and Tyler’s son, who is also his age, frequently visit each other to pass the time, especially during this pandemic.

In the context of family structural assessment, contextual structure is important.

Also included in a family structural assessment are ethnicity, religion, social class, and environment. Wright and Leahey explain that the contextual structure includes ethnicity, religion, social class, and the environment (2010). To provide for their family, Charles and Remona Bromley both work full-time jobs to supplement their incomes. The family appears to be from a middle-class background and to reside in New York. Charles puts in a lot of hours at work because it brings him joy and provides him with a sense of security. Both Charles and Remona are members of labor unions, which means they are eligible to retire from their jobs before they reach the age of 50. Charles’ reluctance to have another child stems from his belief that having another child will cause them to be forced to postpone their plans to retire to Florida.

Evaluation of the family’s developmental stage

The developmental assessment component of the Calgary family assessment model is the second segment. Structure assessment, in conjunction with a developmental assessment, provides information on the developmental lifecycle of a family in terms of stage, task, and attachment, according to Wright and Leahey (2013).

Stages of development in a family

Among the stages of family development are marriage, a family with infants, adolescents, middle-aged families, and families in their later years (Iknowledge, 2015). The six stages of development are followed by Bromley’s family, which is similar to Erickson’s theory of the psychosocial developmental stages (Crisp, Douglas, Robeiro, & Waters, 2016). According to the developmental lifecycle, there are six stages, and it is clear that Bromley’s family is in the fifth stage of their life cycle, which is the stage of launching children. After 15 years at home, Xavier may decide to leave in order to start his own family in the next couple of years.

Tasks involved in conducting a family developmental assessment

Accepting new family members and preparing the family’s financial independence in the wake of the addition of new members to the family are just a few of the tasks that would take place during this stage of the process. Because he wants to provide for his family, Charles has been putting in long hours. Remona, on the other hand, works as an officer full-time in order to be able to support her family’s living expenses. Both Charles and Remona are members of a labor union as they prepare to retire early and relocate to Florida from their current location.

Relationships in the context of a family developmental assessment

Charles explains that he and his wife, Remona, have a very good relationship and that they spend a lot of time together. The fact that he plans to retire before the age of 50 will also allow them to spend more time together because he works long hours, sometimes up to 60 hours per week. Charles is not prepared to have another child, despite his wife Remona’s desire to have another child with him. He also mentions that the prospect of having another child will cause them to postpone their retirement plans. Xavier finds it difficult to stay at home and follow the regulations to avoid being exposed to the pandemic, so he uses Facetime to communicate with his friends. Tyler, on the other hand, pays a visit to Kelly’s son, with whom he shares an age difference. When it comes to their extended family, Bromley’s family is extremely close, and it is difficult for them to be away from them during the COVID-19 crisis.

Assessment of the Family’s Functional Capacity

Another stage is a functional assessment, which seeks to provide insight into the way in which one member of the family interacts with another member of the same household. Occupational assessment, according to Wright and Leahey (2013), is an important component of understanding family interaction. A functional evaluation takes into account both expressive and instrumental aspects.

Aspects that are instrumental in family functional assessments

Instrumental functions are those that are performed on a daily basis in the family. Charles Bromley and his wife Remona are both full-time employees in Bromley’s family business. Remona was unable to participate in the interview because of a work commitment on the day of the interview. Given that Xavier is unable to leave the house, he chooses to engage in video game play in order to maintain contact with his friends. Despite the fact that both Charles and Remona have daily work obligations, Charles makes time to spend with his wife. They also take part in community family gatherings and pay visits to their extended families to keep them connected.

In family functional assessments, expressive aspects are taken into consideration.

Nine aspects of expressive functioning are evaluated as part of a family functional assessment. During the interview, it is important to cover topics such as emotional, verbal, nonverbal, roles, problem-solving, circular communication, power and influence, beliefs, as well as alliances and coalitions, amongst other things (Wright & Leahey, 2013). Remona, a member of Bromley’s family, expresses her desire to have another child, a desire that is denied by her husband, Charles, because of his religious beliefs. As a result, Remona and her husband, Charles, experienced some difficulties in their relationship as a result. Charles, on the other hand, explains that he has a strong emotional attachment to his work because it brings him joy. Remona’s method of problem-solving is talking to her sister Kelly, who is always there to lend a helping hand. Bromley’s family seeks help from Kelly, a psychologist, who serves as the family’s therapist in order to help them resolve their problems.

List of Issues

Bromley’s family is beset by issues that have yet to be resolved. In addition to her father’s heart condition, Remona’s son Xavier suffers from asthma as well. Richard, Remona’s brother, is also suffering from a heart condition. Remona’s mother is suffering from diabetes. Gilbert, Charles’s father, is suffering from cancer. The family is also experiencing difficulties in their marriage over whether or not they should have another child, as Remona wishes to have a daughter.

Prioritization and issues pertaining to the family

Remona’s desire to have another child, most likely a girl, is one of the family issues that Bromley’s family is dealing with. Charles disagrees with Remona on having another child as it would delay their relocation to Florida. Xavier is finding it hard to adapt to stay at home orders and prefers to play video games or Facetime with his friends. Xavier shares a strong bond with his friends and wishes the lockdown was over already so he can have time to connect with them. Bromley’s family priority is for both Charles and Remona to retire early and relocate to Florida before they reach 50 years.

Role of the Clinical Nurse Leader

The role of a clinical nurse leader in the Calgary family intervention model is to offer interventions to a family. Using the Calgary family intervention model, the nurse is not supposed to demand change in the way a family functions; rather, a nurse should design interventions that align with how a family functions (Svavardottir, 2008). The clinical nurse leader, after an assessment, should collaboratively decide on an appropriate intervention as well as the duration and the intensity. The design of the intervention should be focused on how Bromley’s family unit functioned. Nursing leaders also should provide support to families system nurses who need further training to implement the Calgary family assessment model.

In conclusion, nurses involved in the Calgary family assessment model should be aware of the ethical cultural and social justice implications needed to implement the CFAM model for families effectively. Interventions designed for a family should be based on these understandings to increase the effectiveness of the interventions offered to the family. Nurses should use the Calgary family assessment model to create a relationship between them and the families for effective treatment and recovery.

References

Crisp, J., Douglas, C., Robeiro, G., & Waters, D. (2016). Potter & Perry’s Fundamentals of Nursing – Australian Version. Elsevier.

Iknowledge. (2015, March 21). Family assessment. Retrieved May 27, 2020, from Iknowledge: https://clinicalgate.com/family-assessment/

Kaakinen, J. R., Coehlo, D. P., Gedaly-Duff, V., & Hanson, S. H. (2010). Family Health care Nursing: Theory, Practice, and Research. Philadelphia: F.A Davis Company.

Svavardottir, E. K. (2008). Excellence in Nursing: A Model for Implementing Family Systems Nursing in Nursing Practice at an Institutional Level in Iceland. Journal of Family Nursing, 456-468.

Wright, L. M., & Leahey, M. (2013). Nurses and Families: A Guide to Family Assessment and Intervention (6 ed.). F.A. Davis, 2013.

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