Systemic family rehabilitation for children with behavioral problems

Jing LI; Xiufeng XU; Xudong ZHAO

ABSTRACT

BACKGROUND:

Family factor is the main reason for children's psychological and behavioral problems. Seen from the view of systemic family theory, in any circumstances, children's behavioral problems reflect various interpersonal systemic networks among society, school, family, relatives and friends and the relationship of complicated interactions among individuals.Family therapy is an important way to cure children's behavioral problems.

OBJECTIVE:

To observe whether systemic family rehabilitation is adequate for intervening in children's behavioral problems.

DESIGN:

Cluster sampling; Contrast observation

SETTING:

Department of Psychiatry, Kunming Medical College.

PARTICIPANTS:

A total of 276 students in grade four from Mingtong primary school of Kunming City were selected along with their parents from May 2004 to March 2005. A survey was conducted on students and their parents according to the principle of cluster sampling.

METHODS:

Self-rating family dynamics scale was used to investigate the characteristics of family dynamics of 276 students in grade four. Achenbach child behavior checklist for parents was adopted to investigate the situation of their children' s behaviors. 57 cases of children with behavioral problems were detected out, and took the families in which the whole family members voluntarily participated in the intervention as interventional group and the families in which any one of the family members did not want to participate in the intervention as abnormal control group. The students and their parents in interventional group were treated with 4-month systemic therapy. 4 months later, resent the above rating scales.MAIN OUTCOME

MEASURES:

Comparison of family dynamics and children's behaviors between interventional group and abnormal control group before and after intervention.

RESULTS:

After intervention, changes of family dynamics and children's behaviors in interventional group had taken place, which had statistical difference. The changes as follows family atmosphere changed from "depressive and hostile" to "harmonious, pleasant, equal and exoteric"; the degree of individuation of family members changed from low level to high; disease concept changed from "regarding the patients as helpless victims" to "regarding them as helpful doers", which realize "softening of disease concept". The total scores of Achenbach child behavior checklist for parents decreased [The scores of questionnaire for fathers before and after intervention were (42.20±22.58) and (28.95±21.90) respectively, and scores of questionnaire for mothers before and after intervention were (50.95±14.60) and (36.40-±15.36) respectively, P ＜ 0.05]. There was no significant difference between the changes of children's behaviors assessed by fathers and mothers in abnormal control group [The scores of questionnaire for fathers before and after intervention were (38.32±17.30) and (37.57±16.45) respectively, and scores of questionnaire for mothers before and after intervention were (45.54±16.02) and (40.14±17.95) respectively, P ＞ 0.05].

CONCLUSION:

Using the idea and technique of systemic family therapy ,it is feasible and effective to intervene in children's behavioral problems by family therapy.