Family Context and Compliance Behavior in Chronically III Children
Barbara J. Anderson Harvard University Medical School
James C. Coyne University of Michigan Medical School
From a theoretical perspective, we know very little about family contributions to the development of compliant behavior patterns in children and adolescents with chronic physical illnesses. Theories of family functioning with respect to the development of children with chronic physical illnesses have not focused on responses over time to the tasks of compliance with medical treatment regimen that face both parents and child nor on the interactive context of parental helping with these tasks in the family.
Over the past two decades, three major theories of family functioning with respect to chronic childhood disease have been presented: Pless and Pinkerton's Integrated Model of Adjustment ( 1975), Minuchin, Baker, and Rosman's Psychosomatic Family Model ( 1978), and McCubbin and McCubbin's Family Adjustment and Adaptation Response Model ( 1988). These theories have not focused on compliance with the medical regimen as a central task facing children and families. After briefly discussing the lack of attention to this area in theories of families with chronically-ill children, we introduce the application of a theory that directly addresses the interactive context of family behavior around compliance tasks, the Miscarried Helping Model ( Coyne, Wortman, ∧ Lehman, 1988).
The major theories of family functioning that have been applied to chronic illness in childhood have not taken a family interaction or family process perspective on