Family Consultation for Couples Coping with Health Problems: A Social Cybernetic Approach

Michael J. Rohrbaugh and Varda Shoham

in The Oxford Handbook of Health Psychology

Published in print August 2011 | ISBN: 9780195342819
Published online September 2012 | | DOI:

Series: Oxford Library of Psychology

 Family Consultation for Couples Coping with Health Problems: A Social Cybernetic Approach

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We describe a social-cybernetic view of health behavior problems and a family consultation (FAMCON) intervention based on that view. Resurrecting foundational ideas from cybernetic family systems theory, this approach takes relationships rather than individuals as a primary unit of analysis, attaches more importance to problem maintenance than to etiology, downplays linear causality, and blurs the conceptual boundary between an individual patient and factors such as stress or support in his or her social environment. Intervention aims to interrupt two types of interpersonal problem maintenance—ironic processes and symptom–system fit (conceptualized, respectively, as positive and negative feedback cycles)—and to mobilize communal coping as a relational resource for change. Although this chapter draws primarily on a couple-focused intervention project with health-compromised smokers to illustrate both the clinical approach and supporting research, we have also applied both the FAMCON format and the social cybernetic view of problem maintenance to help couples and families cope with problems ranging from heart disease, cancer, and chronic pain to alcoholism, anxiety, and depression. If FAMCON proves effective with health problems that do not respond to other, more straightforward behavioral approaches, it could offer a useful alternative to psychoeducational and cognitive-behavioral interventions in the framework of stepped care.

Keywords: Family consultation; couples; coping; chronic illness; smoking; social-cybernetics

Article.  15875 words. 

Subjects: Psychology ; Health Psychology

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