Developmental Aspects of Health Compliance Behavior

By Norman A. Krasnegor; Leonard Epstein et al. | Go to book overview

mended changes. B.J.'s mother and father are relieved and are able to see now that their concern and pressure removed their daughter's focus from the issue of her own health to the issue of her autonomy.

The Miscarried Helping Theory addresses the reality that parents with chronically ill children are faced with two sometimes conflicting sets of tasks: first, taking responsibility for implementing a regimen at home and warding off the immediate threat of medical crises; and second, establishing a context in which the child takes developmentally appropriate strides in assuming self-responsibility. In meeting the first set of tasks, particularly when driven by a sense of urgency and impending disaster or not adequately informed about their limits of influence over the disease, the child may be seen as an object or obstacle. The parent may resort to coercive or hostile-critical responses that achieve immediate compliance but make it more difficult to achieve compliance in the long run or to develop the child's self-responsibility. Baron ( 1988) has discussed how destructive hostile criticism can be in families:

Criticism leaves recipients feeling badly not only about themselves, but about the providers of criticism. It can derail efforts at problem-solving and reconciliation. Once introduced into an ongoing disagreement, hostile criticism and the resulting rebuttals and counter-accusations can replace what has been the topic at hand. Such criticism serves to initiate or intensify conflict and strengthen patterns of avoidance or defiance. More generally, destructive criticism increases family members' reliance on ineffective ways of dealing with their conflicts and negative feelings. (p. 199)

The Miscarried Helping theory clarifies how parental hostility and criticism can evolve out of initially well-intentioned behavior to help the child and directly addresses issues of how and when to intervene in compliance struggles in families.


REFERENCES

Baron R. A. ( 1988). "Negative effects of destructive criticism: Impact on conflict, self-efficacy, and task performance". Journal of Applied Psychology, 73,199-207.

Coyne J. C., ∧ Anderson B. J. ( 1988). "The Psychosomatic Family reconsidered: Diabetes in context". Journal of Marital and Family Therapy, 14( 2), 113-123.

Coyne J. C., ∧ Anderson B. J. ( 1989). "The Psychosomatic Family reconsidered II: Recalling a defective model and looking ahead". Journal of Marital and Family Therapy, 15( 2), 139-148.

Coyne J. C., Wortman C. B., ∧ Lehman D. R. ( 1988). "The other side of support: Emotional overinvolvement and miscarried helping". In B. Gottlieb (Ed.), Social support: Formats, processes, and effects (pp. 305-33). New York: Sage.

Fiske V., Coyne J. C., ∧ Smith D. A. F. (in press). "Couples coping with myocardial infarction: An empirical reconsideration of the role of overprotectiveness". Journal of Family Psychology.

Gervasio A. H. ( 1986). "Family relationships and compliance". In K. E. Gerber ∧ A. M. Nehemkis (Eds.), Compliance: The dilemma of the chronically ill (pp. 98-127). New York: Springer.

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