Prevention and early intervention in strengthening families and relationships: Challenges and implications
Family and couple relationship wellbeing
Within each individual's life, there are a range of interpersonal relationships that vary in importance and purpose. These relationships are strong determinants of health and wellbeing, evidenced by their importance in discussions of concepts such as resilience (Luthar, 2006). Interpersonal relationships are also a key aspect of an ecological perspective of development, which provides a framework for considering how the individual is affected by "systems" that impact on him or her, ranging from settings in which the individual directly participates - such as family and school - to the impact of broader social institutions (Smith, Cowie, & Blades, 1998). It also considers ways in which social institutions can impact on people - such as parents or siblings - with whom an individual interacts, thus affecting the quality and nature of relationships between the parties. The complexity of human relationships is thus illustrated.
While there is recognition of the impact of broad societal structures on interpersonal relationships, this paper will mainly limit itself to in-depth discussion of intimate and family relationships and how one affects the other. This will enable the discussion to focus most effectively on what influences a person to seek help to strengthen relationships. The level and quality of our closest interpersonal relationships, as well as individual wellbeing, will impact on family wellbeing as a whole. Therefore, it is important to consider which elements are fundamental to family wellbeing before moving on to how these goals are reached most effectively.
Couple relationship wellbeing
A strong partner relationship is, put simply, one that is stable because both partners are satisfied and want it to continue (Halford, 1999). Research has identified a number of characteristics of a healthy marriage, through quantitative studies of groups of happy and unhappy couples and qualitative studies of couples in long-lasting marriages. Based on studies of married couples, the core elements of a healthy marriage have been described as follows:1
- commitment: a long-term view of the relationship; perseverance in the face of difficulties; balancing couple and individual needs; a sense of "we-ness" and connection through friendship, shared values and history;
- communication: positive and respectful; contains elements of humour and compromise;
- conflict resolution: couples understand that some conflict is inevitable; they "fight fair" and learn to "pick their battles"; however, violence is unacceptable;
- interaction and time together: quality and quantity are both critical, as is the balance of "couple time" and time spent on individual pursuits, enjoyment of each other's company and of the time together; and
- intimacy and emotional support: physical and, in particular, psychological intimacy are core aspects of healthy relationships and are developed and strengthened over time, particularly through overcoming difficulties.
Further, according to Gottman (1999), deep friendship is a critical dimension of happy marriages. This friendship incorporates mutual respect and enjoyment of each other's company, and deep knowledge of each other's likes and dislikes, hopes and dreams. Happily married couples also express their affection for each other on a daily basis, and in a range of ways. In terms of intimate relationships outside of marriage, it would be reasonable to expect that a similar set of elements also existed.
While the term "family wellbeing" is now part of the public, media and political lexicon, its meaning is difficult to determine (Families Australia, 2007a). Part of this difficulty derives from the complexity of contemporary families, as reflected in Families Australia's definition of family:
Families are diverse in their composition and forms. There are many definitions of family. Families Australia believes that families are what people define them to be. It is helpful for people to reflect about whether "family" refers, for example, to a group of people living under one roof, to people who are related, to people with shared emotional bonds, or to other things. (Families Australia, undated)
Different age groups also view families in different ways. In one study, adolescents viewed affective factors as more important criteria of being a family than legal status or the presence of two parents (Anyan & Pryor, 2002). In a similar study of children (Rigg & Pryor, 2006), the majority had an image of family that did not mirror a traditional nuclear family form; affective factors were again important. These findings may indicate a generational change in understanding the concept of family. Policy and programs need to be responsive, therefore, not only to the ways in which families are changing on a broader, demographic scale, but also to changes in how families are perceived and understood by their members.
Australia does not have a comprehensive national picture of how families are doing overall (Families Australia, 2007b), a point that has also been raised in an American report on measuring indicators of family wellbeing (Colorado Foundation for Families and Children, 2003). This report notes that the US has many statistics on families, but less information on the strength of family relationships, level of parental involvement, how families spend their time, the role of government in family support and the quality of education. Their wide-ranging review of family research identified a number of key indicators of family wellbeing for which there was consensus across private and public sectors, including: family time together, discipline and monitoring of children, positive communication, safe communities, and access to quality child and health care. Differences in emphasis and priorities occurred, however, between families, government and agencies. For example, families prioritised transportation and substance use prevention, but these were less emphasised by public agencies. This indicates the critical importance of including families in this work to make sure that priorities made by government and/or agencies are in line with what families see as important.
The importance of strong and healthy interpersonal relationships is reflected in the many frameworks or lists of indicators of family wellbeing proposed by different countries and agencies over recent years. For example, the Families Australia's National Family Wellbeing Symposium, held in June 2007 in Canberra (Families Australia, 2007a), aimed to explore the meaning of family wellbeing. A key conclusion from the symposium was the significant need to develop a family wellbeing framework to inform national family research and policy, with carefully selected indicators that were inclusive of all families and family types.
A family wellbeing framework could more effectively provide the criteria by which families are assessed, thus allowing consideration of what aspects of family life could be strengthened through service provision. A working draft of a conceptual and practice framework for family wellbeing was outlined in a 2006 document by Families Australia (Babington, 2006), which suggested as a starting point that four main elements of family wellbeing are:
- physical safety and physical and mental health;
- supportive intra-family relationships, including possession of effective conflict resolution skills, opportunities to learn values, traditions, languages, ideas important to the family, and receipt of support and encouragement for achievement/attainment from within the family;
- social connections outside the family, including in the local community; and
- economic security and independence.2
A draft Family Wellbeing Framework is being developed by the Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) as a departmental tool to provide a better understanding of the influences on family wellbeing, the changing nature of Australian families, and the impacts of interventions. The framework is as yet unpublished but was discussed at the aforementioned symposium.
Internationally, the East Asia Ministerial Forum on Families, which first occurred in Hanoi in 2004, saw participating countries agree to develop national indicators of family wellbeing and to strengthen mechanisms for monitoring family wellbeing.3
Family input into a wellbeing framework
There have also been a number of efforts to determine what families themselves see as important in terms of family wellbeing. Karakas and Dean Lee (2004) conducted qualitative interviews with 87 families and proposed three paradigms of family wellbeing as a result:
- Family wellbeing as effective parenting: Parenting is a job to be done and that children are raised well is important. Quality child care and education and healthy happy family members are salient dimensions.
- Family wellbeing as love and being together: Relationships between family members, quality time, communication, support and happiness are important.
- Family wellbeing as peace and harmony: Interdependence where individuals all play their part. Satisfaction derived from family work, comfort with workload, having personal time and quality time with family members are all important.
The difficulties with the concept of family wellbeing were noted, including the complexity and multifaceted nature of the concept. The authors felt, however, that the different paradigms could help both individuals and services identify personally important dimensions to work on.
A broader, multi-method approach was taken by the Family Strengths Research Project,4 in the development of the Australian Family Strengths Template (AFST). The template was designed to offer a framework from which community resources and other research projects could be developed. The framework was based on the results of inventories, interviews and surveys filled out by families who self-identified as "strong" (Silberberg, 2001). The template was not designed to be used as an either/or dichotomy of strong/functional or troubled/dysfunctional families, but to encourage families to identify their own strengths. Eight qualities comprised the AFST:
- Communication: family interacts with each other frequently, and predominantly in an open, honest manner.
- Togetherness: the invisible "glue" that bonds a family and gives them a sense of belonging, including sharing similar values, beliefs and morals.
- Sharing activities: for example, sport, camping, playing games and reading stories.
- Affection: family members show love, concern and interest for each other on a regular basis; often ritualised - for example, greetings and farewells, bedtime story reading.
- Support: assisting, encouraging, reassuring and looking out for each other; family members feel equally comfortable to ask for and offer support.
- Acceptance: showing respect, appreciation and understanding for individuality and uniqueness.
- Commitment: showing dedication and loyalty towards the family as a whole; wellbeing of family a priority.
- Resilience: ability to withstand and rebound from adversity.
Communication breakdown, parenting, and difficult relationship dynamics were identified as the biggest challenges to these family strengths.
Alternate family types had strengths that differed in importance and emphasis compared to those in the nuclear family framework. For example, sole-parent families showed two clear strength themes that were most important - support from extended family and friends, and a positive co-parenting arrangement. In a Colorado Foundation review (2003), indicators of family wellbeing, such as time together, positive communication and family dinners, were more consistently endorsed across the reviewed literature and reports than the need for marriage or a two-parent home. This illustrates the need to avoid stereotyping when examining family strengths, and the need to acknowledge that all families are likely to have their own unique set of strengths. As Wolcott (1999) states, descriptions of "strong" families will still fail to explain why some families create a stable and nurturing environment and cope with stressors, while others fail to thrive.
From a resilience perspective, the literature clearly indicates that attachment to at least one parent figure and supportive/responsive parenting are among critical factors in resilience (Luthar, 2006). This would indicate a need to encourage families to celebrate strong connections and actively engage in accessing information about parenting throughout their children's lives. Warm and supportive relationships, combined with appropriate discipline, are key to positive socialisation in childhood, with strong intimate relationships such as marriage providing the strength to meet challenges in adulthood (Luthar, 2006). As such, resilience feeds into positive relationships, just as positive relationships are a factor in resilience.
In summary, this section outlines some of the frameworks available to consider what elements will strengthen family and relationship health and wellbeing, and highlights the importance of gathering information from family members themselves. It is also an indication of the difficulties in conceptualising a single, comprehensive family wellbeing framework that acknowledges and respects the diversities and strengths of all families and their many interdependent relationships. Theoretically, if a particular family wellbeing framework was widely agreed upon and adopted, the elements of this framework could be highlighted in service provision to families in an attempt to help them avoid problems. The pursuit of such a framework appears to be important in facilitating effective preventative and early intervention work in strengthening families and relationships.
The difficulty with advocating for increasing strengths in relationships without an existing problem as a goal for service provision, however, is that it effectively requires people to seek help when a situation is not necessarily problematic. While galvanising people to cope with the stresses and storms of life seems a logical pursuit, the difficulty is finding effective ways to reach people who are not in significant distress. The question is that if barriers to help-seeking exist for people in distress, are there similar, or even greater, barriers to accessing information and resources for those who perceive no identifiable problems? The following section looks at the factors that influence help-seeking behaviour.