Showing papers on "Family support published in 1997"

The Influence of Ethnicity and Culture on the Caregiver Stress and Coping Process: A Sociocultural Review and Analysis

Abstract: The authors review the literature on ethnic minority caregivers and suggest that ethnicity and culture play a significant role in the stress and coping process for Latino caregivers. Caregivers of older Latinos face special challenges in the caregiving for individuals at higher risk for specific chronic diseases, who are disabled at earlier ages, and who have more functional disabilities. Ethnicity and culture can also influence the appraisal of stress events, the perception and use of family support, and coping behaviors. Socioeconomic class and minority group status are discussed as additional sources of variation in the caregiver stress and coping model.

Family Support and Conflict: Prospective Relations to Adolescent Depression

Abstract: The relations between family support, family conflict, and adolescent depressive symptomatology were examined longitudinally in a sample of 231 female and 189 male adolescents and their mothers Structural equation models revealed that less supportive and more conflictual family environments were associated with greater depressive symptomatology both concurrently and prospectively over a 1-year period Conversely, adolescent depressive symptomatology did not predict deterioration in family relationships Depressive symptomatology and, to a greater extent, family characteristics showed high levels of stability over the 1-year period Counter to our expectations, the relations between family variables and depressive symptomatology were similar for boys and girls The results suggest that the quality of family interactions is relevant for understanding the development of depressive symptoms in adolescents

Parental Stress, Care Demands, and Use of Support Services for School-Age Children with Disabilities and Behavior Problems.

Abstract: Parental Stress, Care Demands, and Use of Support Services for School-Age Children With Disabilities and Behavior Problems* Frank J. Floyd and Erin M. Gallagher** Data were obtained from mothers and fathers of children (N = 231) with mental retardation (MR) or chronic illness (CI), and a nondisabled behavior-problems sample. Mothers identified fewer behavior problems in children with MR and more in children with CI than did teachers. The presence of significant behavior problems was more important than disability type in determining most forms of parental stress, and predicted mental health services use. MR group parents worried most about providing ongoing care into adulthood. Single mothers were not more stressed, but used more services than two-parent families. The results call for a wider array of community and family support services that target children with disabilities who have behavior problems. Key Words: child behavior problems, chronic illness, family adaptation, family stress, mental retardation. Previous research documents that the special child care demands faced by the parents of children with disabilities can cause significant stress for the parents and significant disruption in family relationships (e.g., Farber, 1960; Gath, 1973; Turnbull, Brotherson, & Summers, 1986). These demands persist throughout childhood and into the adult years, and require continuous adaptation by the parents to both ongoing stressors and frequent crises (Wikler, 1986). Previous longitudinal research indicates that, in turn, the psychosocial climate of the home affects the social development of children with disabilities (Nihira, Mink, & Meyers, 1985). Thus, models of family adaptation propose that when families are able to cope well with special childcare demands they may be able to enhance social and cognitive adjustment for the child, and may also avoid distress and disruption for other family members (Crnic, Friedrich, & Greenberg, 1983; Landesman, Jaccard, & Gunderson, 1989). One key to successful adaptation lies in the ability of families to access appropriate support services that both help families cope with the child's needs, and also reduce disability-related problems for the child and family (Singer, et al., 1993). Although some services are provided in school-settings, parents typically must make active efforts to seek additional and sometimes highly necessary services (Wilgosh, Waggoner, & Adams, 1988). Thus, service utilization is highly dependent on the parents' own motivation to obtain assistance. Of course, the types of services used by families will often depend on the nature of the child's disability (i.e., cognitive deficits as opposed to chronic illness), which influences the type of care demands placed on the family. However, motivation to seek and use services may also stem from other characteristics of the child and family that affect perceived needs and the family's ability to benefit from services (Dunst, Trivette, Hamby, & Pollack, 1990; Friedrich, Cohen, & Wilturner, 1988). For example, the ABC-X model of stress and coping suggests that families will make relatively greater use of support services when the child's problems exceed the family's own coping resources (Hill, 1958; McCubbin & Patterson, 1983; Orr, Cameron, & Day, 1991). Additionally, parents' use of services may be influenced by their optimism that the child and family can profit from the services (Margalit, Raviv, & Ankonina, 1992; Rimmerman & Portowicz, 1987; Sloper & Turner, 1992). Although considerable research documents that parents of children with disabilities experience stress associated with the disability that distinguishes them from the parents of children without disabilities, there is relatively little research that examines differences among disability groups. Comparison of selected groups can control for theoretically relevant conditions of child adjustment and family life, and can thus help to specify the processes by which characteristics of the child and characteristics of the family influence each other (Stoneman, 1989). …

Life stressors, neighborhood disadvantage, and resources: A focus on inner-city children's adjustment.

Abstract: Examined the contribution of particular stressors and resources to inner-city children's adjustment. Fourth, 5th, and 6th graders (N = 315; 66%from ethnic minority groups) reported on their recent exposure to stressful events and neighborhood disadvantage, their perceptiom of self-worth and social support, and their behavioral and academic adjustment. Hierarchical regressions indicated unique contributions of stressful events and neighborhood disadvantage to predicting antisocial behavior; higher levels of self-worth and family support were related to lower levels of antisocial behavior, but higher levels of peer support were related to higher levels of antisocial behavior. Furthermore, whereas family support buffered the relation between stressful events and antisocial behavior, peer support exacerbated the effect of stressors on behavioral maladjustment.

Disability and Family Burden in Obsessive—Compulsive Disorder:

Abstract: This paper reviews 2 aspects of obsessive-compulsive disorder (OCD): impairment in functioning and family burden associated with OCD. Impairment is evident from epidemiological and clinical studies in several areas, particularly in occupational and social maladjustment. Clinic outpatients show a range of impairment associated with OCD, while hospitalized patients exhibit consistently severe disabilities that rival those of patients with schizophrenia. Although behaviourally and medication-treated patients improve in adjustment levels, there is some evidence of persistent impairment, particularly in social and work functioning. Several studies support extensive family involvement and accommodation of OCD symptoms, as well as the considerable burden placed on families who reduce their social activities and increase their isolation and distress. Findings are equivocal regarding OCD and marital distress. Predictors of treatment outcome do not include marital dissatisfaction, but may include expressed anger and criticism. With regard to treatment, family support groups are popular but untested interventions, and family-assisted individual and group behaviour therapy have demonstrated good outcomes in limited trials.

Attitude Toward Self, Social Factors, and Achievement in Mathematics: A Meta-Analytic Review

Abstract: This meta-analysis integrated 143 primary studies on the relationship of attitude toward self and social factors with achievement in mathematics. Attitude was decomposed into self-concept about mathematics, perception of family support, and perception of mathematics as a male domain. Major findings included: (a) self-concept, family support, and mathematics as a male domain were all related to achievement; (b) the three relationships did not show significant gender differences; (c) the three relationships consistently decreased from the junior high grades to the senior high grades; (d) the relationship between self-concept and achievement varied as a function of ethnicity, whereas the relationship between family support and achievement was consistent across ethnic background; (e) the three relationships all varied across sample selection; (f) the relationship between self-concept and achievement varied with sample size, whereas the relationships of family support and mathematics as a male domain with achievement were sample-size invariant; (g) the relationship between self-concept and achievement increased over time, whereas the relationships of family support and mathematics as a male domain with achievement remained almost unchanged over time; and (h) there were no statistically significant interaction effects among gender, grade, and ethnicity for any of the three relationships.

Maternal recall of the neonatal intensive care unit.

Abstract: This study examined how mothers of prematurely born three-year-old children retrospectively recall their responses to their infant's hospitalization in the neonatal intensive care unit (NICU). Forty-four mothers of three-year-old prematurely born children were interviewed as part of a longitudinal study. Data from maternal interviews were analyzed using the analytic inductive method. Findings support the hypotheses that were based on the Parental Stress in the ICU model. Three years after the birth of their premature infants, mothers reported vivid memories of stress related to the appearance and behavior of their infants, the pain and procedures the infants endured, alterations in their role as parents, and stress related to the infant's illness severity and uncertainty about infant outcomes. Prenatal problems, such as high-risk pregnancy or birth, infant loss, and disturbances in family support, were also recalled as sources of stress. Findings have implications for family-centered nursing care in NICUs.

Mothers' resolution of their child's diagnosis and self-reported measures of parenting stress, marital relations, and social support.

Abstract: Investigated the relation between maternal resolution/nonresolution of a child's diagnosis of chronic medical condition to self-reported measures of parenting stress, marital quality, and social support. Mothers were administered the Reaction to Diagnosis Interview, and classified as Resolved/Unresolved with respect to the child's diagnosis. Mothers also completed the Parenting Stress Index, Dyadic Adjustment Scale (DAS), Support Functions Scale, and Family Support Scale. Fathers completed the DAS. Maternal resolution vs. nonresolution of diagnosis was related to parenting stress, husband marital satisfaction, and level and helpfulness of social support. Resolution of diagnosis was not related to need for support. Specific subclassifications of Resolved and Unresolved also were differentially related to level and helpfulness of social support. Findings suggest that resolution/nonresolution of diagnosis has implications not only for individual functioning and child-parent interactions, as found in previous research, but also for other intimate familial relationships and social ecology.

Family support decreases influence of deviant peers on Hispanic adolescents' substance use

Abstract: Investigated the interplay of family support and peer modeling on adolescent alcohol, tobacco, and marijuana use and gang involvement within an ecosystemic model. The predominantly Hispanic sample of 236 eighth-grade students attended a public middle school in a high-density, impoverished Miami neighborhood, characterized by high rates of criminal activity, substance abuse, and other stressors, placing the adolescents at risk for negative developmental outcomes. The participants reported the level of perceived social support they received from family members and rates of drug use and gang, involvement for themselves and for peers. The results showed that family social support reduced the influence of deviant peers on some of the problem behaviors reported by these adolescents, specifically tobacco and marijuana use. Deviant peer modeling was strongly associated with levels of adolescent problem behavior for tobacco, alcohol and marijuana use and gang involvement.

Family support for the elderly in China: issues and challenges.

Abstract: With the introduction of economic reforms, families in China are challenged by a variety of family-related problems. Demographic and social changes are affecting both the capacity and willingness of the family to provide care for the elderly. The Chinese Government is aware of the importance of the family in the welfare of its citizens, and has promulgated a series of laws and regulations prescribing family obligations. Yet formal services supporting families are extremely underdeveloped, and it is urgent that the government formulate an effective policy to facilitate, support, and maximize family care.

Narrative Therapies with Children and Adolescents.

Abstract: Griffith, Foreword. Smith, Introduction: Traditional Therapies with Narrative Approaches. Epston, "I Am a Bear": Discovering Discoveries. Barrager-Dunne, "Catch the Little Fish": Therapy Utilizing Narrative, Drama and Dramatic Play with Young Children. Sax, Narrative Therapy and Family Support: Strengthening the Mother's Voice in Working with Families with Infants and Toddlers. Freedman, Combs, Lists. Anderson, Miserere Nobis: A Choir of Small and Big Voices in Despair. Lobovits, Freeman, Destination Grump Station - Getting off the Grump Bus. Adams-Westcott, Dobbins, Listening with Your "Heart Ears" and Other Ways Young People Can Escape the Effects of Sexual Abuse. Stacey, From Imposition to Collaboration: Generating Stories of Competence. Anderson, Levin, Collaborative Conversations with Children: Country Clothes and City Clothes. Law, Attention Deficit Disorder: Therapy with a Shoddily Built Construct. Weingarten, From "Cold Care" to "Warm Care": Challenging the Discourses of Mothers and Adolescents. Madigna with Commentary by Grieves, Re-considering Memory: Re-remembering Lost Identities Back Toward Re-membered Selves. Nylund, Ceske, Voices of Political Resistance: Young Women's Co-research on Anti-Depression. Hicks, Sex, Drugs and Postmodern Therapy: A Teen Finds Her Voice. Sanders, Re-authoring Problem Identities: Small Victories with Young Persons Captured by Substance Misuse. Berndt, Dickerson, Zimmerman, Tales Told Out of School.

Family Perspectives on Inclusive Lifestyle Issues for People with Problem Behavior

Abstract: Interviews were conducted with 17 families of children, youth, and adults with problem behavior (e.g., aggression toward others, property destruction, self-injurious behavior, and pica). From a larger study addressing many questions, the data reported in this article focus on inclusive lifestyle issues that are important to families. Results are organized into categories that emerged from the qualitative analysis, including family life, friendship issues, school issues, community inclusion, and supported living/supported employment. Themes suggest extremely scant and tenuous inclusive lifestyle supports for these people and their families. Key recommendations focus on expanded family support and priority topics for research and training.

Perceived Risks to Independent Living: The Views of Older, Community-Dwelling Adults

Abstract: The purpose of the present study was to gather the perceptions of older, community-dwelling adults about factors they considered essential for them to remain living within the community. In-depth interviews were conducted with 103 men and women over the age of 65 years who were living in their own home or apartment, within an urban center. Factors such as finances, health, family support, a sense of identity, and a feeling of independence were perceived by older adults to contribute to their ability to remain living in the community. Importantly, older adults viewed threats to this continued independent living as both (a) factors connected to losses and maintenance of capability, but also (b) as impediments to further growth of their personal well-being.

Research on Social Support In Adolescents With IDDM: A Critical Review

Abstract: This article provides a review of the findings of 32 scientific studies that examined the relationship between social support and adherence/metabolic control in adolescents with insulin-dependent diabetes mellitus. Social support included qualitative family support characteristics, communication patterns, sibling and peer relationships, and regimen- specific support behaviors. The literature was examined in the context of adolescent development. Although the results of these studies were somewhat inconsistent, some general patterns emerged that are described and discussed in detail. Methodological limitations and suggestions for future research are provided.

A comparison of the level of hope in patients with newly diagnosed and recurrent cancer.

Abstract: PURPOSE/OBJECTIVES To compare levels of hope in patients with newly diagnosed and recurrent cancer. DESIGN Descriptive study. SETTING Three oncology practices in two urban areas of the southern United States. SAMPLE Convenience sample of 20 newly diagnosed patients with cancer and 16 patients with recurrent cancer (mean age = 56 years). The majority of the patients were Caucasian, female, and married; had a high school degree; and had a religious affiliation. METHODS Subjects completed the Herth Hope Scale and answered the open-ended question "What gives you the most hope at the present time?" Analysis included descriptive statistics (i.e., frequency, means, standard deviations, percents), t-tests, Chi-square, and analysis of variance. MAIN RESEARCH VARIABLES Level of hope each subject had in relation to the stage of the cancer at the time of diagnosis. FINDINGS Contrary to expectations, patients with newly diagnosed and recurrent cancer did not differ in regard to their level of hope. However, significant differences were found related to the type of hope utilized. Married patients and male patients experienced higher levels of hope. Recurrent themes in response to the open-ended question were family support, nonfamily support, faith, outlook, and health professionals/care. CONCLUSIONS Patients with newly diagnosed cancer use their treatment and nurses, physicians, and other healthcare professionals as sources of hope and support. Patients with recurrent cancer reported drawing hope from faith. IMPLICATIONS AND NURSING PRACTICE: Heightened awareness of the patient-healthcare professional relationship will enable healthcare professionals to provide care that is more sensitive to one congruent with patients' needs. Healthcare professionals need to assess the meaning of faith for each individual patient and offer services to foster this source of hope.

Closeting and the Quality of Lesbian Relationships

Abstract: Analysis of data collected from 124 lesbians currently involved in a couple relationship indicated that closeting is related to the couple's relationship quality. Openness vs. secrecy with family and friends is most highly associated with the quality of their relationship. Further analyses suggested that particular family behaviors-inviting a member's lesbian partner to family events and accepting demonstrations of affection between the couple-can influence their relationship. These findings underscore the importance of support from family members and indicate the need for future studies to include multiple measures of closeting.

Child Protection and Family Support: Tensions, Contradictions and Possibilities

Abstract: 1. Child Protection and Family Support: Current Debates and Future Prospects Nigel Parton 2. The Re-Focusing of Children's Services: The Contribution of Research Mike Little 3. Implementing the Family Support Clauses of the 1989 Children Act: Legislative, Professional and Organisational Obstacles Jane Tunstill 4. Policing Minority Child Rearing Practices in Australia David Thorpe 5. Relating Outcomes to Objectives in Child Protection Policy Jane Gibbons 6. Introducing Non-Punitive Approaches into Child Protection: Legal Issues Judith Masson 7. Can Filtering Processes be Rationalised Corinne Wattam 8. Children abused within the care system - do current representation procedures offer the child protection and the family support? Christine Lyon 9. Protection and Child Welfare: Striking the Balance Elaine Farmer 10. Need, Risk and Significant Harm June Thoburn, Marion Brandon and Anne Lewis 11. Delivering Family Support: Issues and Themes in Service Development Nick Frost 12. Partnership with Service Users in Child Protection and Family Support Bill Jordan 13. Putting Child and Family Support and Protection into Practice Barbara Hearn

Assessment-based intervention for severe behavior problems in a natural family context.

Abstract: Functional assessments and assessment-based interventions were conducted with a boy with disabilities and severe problem behavior in the context of two family routines: using the bathroom in the family home and dining in a fast-food restaurant. A multiple baseline design demonstrated the effectiveness of the intervention package as implemented by the boy's mother in the two routines. The results provide a systematic replication and extension of behavior-analytic interventions in natural family contexts.

Work/Non-work Conflict and Health in Shiftwork: Relationships with Family Status and Social Support.

Abstract: This study examined work/non-work conflict and subjective health among female shift workers. Questionnaire data from 172 nurses were used to examine the effects of family status [single (S), living with partner (P), and living with partner and children (P + C)] and social support (from supervisors, co-workers, and family) on work/non-work conflict and health. Results indicated that work/non-work conflict was positively related to family status and negatively related to supervisor support. Psychological symptoms were related positively to work/non-work conflict and negatively to family support. Physical symptoms were related positively to work/ non-work conflict and negatively to co-worker and family support. Time-budget data from 24 nurses indicated that the P + C group spent more time on domestic work than the S and P groups and less time on leisure than the S group. Data collected from eight couples indicated that the nurses recorded more domestic work and less leisure than their male partners. The results indicate that work/non-work conflict is particularly salient for female shift workers living with a partner and dependent children, and highlight the importance of social support for this group of shift workers.

Does family support buffer the impact of specific chronic diseases on mobility in community-dwelling elderly?

Abstract: The present study explores whether different structural (presence of partner and children) and functional (amounts of instrumental and emotional support provided by partner and children) family characteristics buffer the influence of chronic diseases on physical functioning Logistic regression analyses were performed in a population-based sample of 2830 community-dwelling elderly people with chronic diseases as independent variable, and mobility difficulties as dependent variable, for separate strata of family characteristics The presence of buffer effects was ascertained by comparing the associations between disease variables and mobility difficulties across the strata of family characteristics, using the odds ratios and 95% confidence intervals Living together with a partner appears to buffer the association between the presence of one chronic disease and mobility difficulties, but no such effect is present among subjects with more than one disease Regarding specific chronic diseases, partner presence has a beneficial influence only on the association between stroke and mobility difficulties, regardless of whether the partner provides little or much support For patients with chronic non-specific lung disease (asthma, chronic bronchitis or pulmonary emphysema), a small amount of instrumental support (help with daily chores in and around the house) received from the partner is associated with a higher risk for mobility difficulties, compared to patients who receive a large amount of instrumental support and to patients who are not living with a partner Neither the presence of children, nor the amounts of support received from them, influences associations between specific chronic diseases and mobility difficulties The present study provides limited evidence supporting a buffer effect of family characteristics on the association between chronic diseases and mobility Only in elderly people with a relatively low burden of disease does family support mitigate the adverse effects of disease on physical functioning

General deviance and psychological distress: impact of family support/bonding over 12 years from adolescence to adulthood

Abstract: Comorbidity occurs within and across various domains of human pathology and may be diverse manifestations of a single, general dysfunction in early family support and bonding. Family socialisation, pseudomaturity, and self-derogation theories were tested using cross-sectional and 12-year prospective data from a community sample assessed in late adolescence (age 18) and again in adulthood (age 30). All of the hypotheses and expected findings received some support in the data analyses. these have confirmed that: (1) general deviance and psychological distress were significantly correlated for both men and women and therefore are overlapping and comorbid disorders; (2) both general distress and psychological distress were significantly predicted by family support/bonding in cross-sectional analyses for men and women; (3) family support/bonding fully accounted for the cross-sectional association between general deviance and psychological distress for men and substantially reduced the association between these constructs for the women; (4) over time family support/bonding reduced psychological distress for the women and general deviance for the men; (5) both theories of pseudomaturity and self-derogation explained many of the prospective effects from late adolescence into adulthood; (6) sexual involvement, although an indicator of general deviance, related negatively with indicators of psychological distress; (7) different patterns were evident for the developmental periods of adolescence compared with adulthood; and (8) many of the processes differed by sex. Copyright © 1997 Whurr Publishers Ltd.

A Survey Analysis of Women's Long-Term, Postdivorce Adjustment

Abstract: This study examined the long-term adjustment to divorce for women. The women (N = 272) were surveyed during the summer and fall of 1994, and the winter of 1995; they had to have been divorced for a minimum of five years and not remarried. The sample was obtained from a variety of social, religious, fraternal, and employment networks in 20 states. Adjustment was measured by standardized scales including depression, self-esteem, and sustained impact of trauma. Findings were derived through bivariate and mul-tivariate analysis. Twenty-six percent of the women were found to have a clinically significant problem with depression. Contributing to this depression were the following: abuse (physical, verbal/emotional, infidelity) during the marriage, poor legal representation at divorce, persistent strong negative feelings about the former spouse, lack of friend and family support at time of divorce, low level of social activity during and after marriage, lower income, and the lack of a romantic partner a...

Asian Older People: Housing, Health and Access to Services

Abstract: We report the findings of a survey of 104 Asian older people in Bradford. For a high proportion, their condition was characterised by poverty, limited entitlements, inadequate housing, low levels of knowledge of health and social services, and problems of access to welfare benefits, health and social care. The situation of women was of particular concern. The study also highlights the problems of divided families, caused by restrictive immigration rules, resulting in many elderly people having no family support in this country.

Parent to parent support and health care.

Abstract: Parent to Parent programs offer a unique model for personalizing family support services according to family preferences. Over 500 of these programs across the United States provide emotional and informational support through careful matching of veteran parents with referred parents who have a child with a disability. A national survey of Parent to Parent program coordinators and participating parents examined referral sources, program supports, program demographics/descriptions, and examples of best practices. Parent to Parent programs can complement health care services by empowering parents through information and support and should be an essential component of a comprehensive family support system.

Overcoming Barriers Faced by African-American Families with a Family Member with Mental Illness.

Abstract: A qualitative research design combined with a quantitative analytic technique, concept mapping, was used to examine and address barriers to African-American families' involvement in the treatment of their family members with mental illness. Focus groups were formed with lay and professional informants. The focus groups recommended a variety of strategies for improving caregiver supports and increasing the involvement of caregivers in the treatment process. The implications of these findings for mental health professionals are discussed. Overcoming Barriers Faced by African-American Families with a Family Member with Mental Illness* David E. Biegel**, Jeffrey A. Johnsen, and Robert Shafran Family members of persons with severe mental disability can play critical roles in enhancing the treatment and care of their ill family members. However, the ability of families to fulfill their caregiving role is negatively affected by a number of barriers, including significant levels of perceived burden experienced by many caregivers and a lack of perceived support from mental health professionals and from caregivers' own informal social networks (Biegel, Milligan, Putnam, & Song, 1994). A major gap in the literature is a lack of full understanding of the role of race and ethnicity in family caregiving for persons with mental illness. There is a large body of research evidence documenting the fact that different groups of individuals meet needs and solve problems in differing ways and that there are often obstacles-systemic and personal-that differentially affect the ability, opportunity, and willingness of specific population groups to participate in organized help-seeking and receiving activities (Giordano, 1973; Naparstek, Biegel, & Spiro, 1982; Neighbors & Jackson, 1996; Padgett, 1995). Nevertheless, the role of race and ethnicity has received relatively little attention in the mental health family caregiving literature (Davis, 1982; Davis & Proctor, 1989). Thus, a fuller understanding of obstacles and barriers faced by minority populations in family caregiving for persons with mental illness is needed. Understanding the barriers facing African-American family caregivers is of particular concern to mental health professionals for several reasons. First, African-American consumers with severe mental disability would appear to have even greater needs for family support than do Caucasian consumers, given the fact that they have higher rates of use of in-patient mental health services. In addition, African-American consumers have lower utilization and higher drop-out rates for out-patient mental health services than do Caucasian consumers (Snowden & Cheung, 1990). Second, the samples of only a few research studies have included a sufficient number of African-American family caregivers to allow a specific examination of their problems and needs (Biegel, Milligan, Putnam, & Song, 1994; Pickett, Vraniak, Cook, & Cohler, 1993; Struening, Stueve, Vine, Kreisman, Link, & Herman, 1995). Conceptual Framework and Research Questions This study specifically focused on ways to enhance the involvement of African-American families in the treatment and care of their family member with mental illness. A systems theoretical orientation underlies the design of this study. General systems theory (Bertalanffy, 1969) broadly defines a system as a complex of interacting elements which function together to manage the environment. Individual system elements or components are embedded within a web of interlocking relationships such that change in any one element ultimately affects the entire system. In order to truly understand the functioning of any one system element, it must be examined from within the context of the system of which it is a part. The key informants targeted in this study-family caregivers, mental health consumers, agency case managers, and staff of the county mental health board authority-each represent major components of the local mental health system which have the greatest direct impact on the day-to-day conduct of family caregiving to persons with severe mental disability. …