Family Resiliency

Resiliency is the capacity of a family to successfully withstand adversity. It is a feature of relationships that leads to personal growth and enhances family functioning (Walsh 2006b). Several aspects of family interaction are often associated with resiliency in the face of the challenges related to a child's physical illness (see Table 29-1).

Emotional and instrumental support from within the family as well as support from extended family members, friends, and colleagues is important. Parenting relationships characterized by emotional validation and collaboration allow for effective communication around critical assessment events and treatment plans. In contrast, parental distress and conflict generally have the opposite effect, interfering with the emotional support and validation that

Table 29-1. Selected coping characteristics of resilient families facing pediatric physical illness

Effective and positive communication between parents as well as between parents and children Helpful emotional and instrumental support from extended family members, friends, and colleagues Active problem-solving approaches and strategies Effective use of advice and information

Illness meaning sought and established through linking factual information about a physical illness with the family's own unique personal experience

Flexibility in the use of a range of coping strategies

Effective working relationship with the medical team parents of an ill child require. Single parents may be in particular need of outside emotional support given the heightened challenges of rearing and caring for a physically ill child. The ability to be flexible in the use of a range of coping and parenting approaches can only further enhance a family's capacity to respond to adversity. The reader is referred to Chapter 2, "Adaptation and Coping in Chronic Childhood Physical Illness," for further discussion.

As noted, there are different types of working relationships between families and their medical team (DeMaso and Meyer 1996). Those that are collaborative and characterized by trust can promote family resiliency, whereas those with ineffective communication and disagreement can interfere with a family's ability to respond and deal with their child's physical illness. The care of physically ill children must include attention to family resiliency and efforts to build on identified strengths while at the same time addressing vulnerabilities that interfere with and impede successful adaptation.

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