Professional Documents
Culture Documents
This chapter focuses on describing the model, its assumptions, and the spe-
cific concepts, including family dimensions, that are key to understanding
it. We begin with a brief discussion on our view of the normal family that
has been helpful in setting expectations or anchor points of family function-
ing. Clinical uses, research studies, and methods for teaching the model are
addressed in depth in other chapters in this book.
23
Functioning Continuum
It is important to remember that the McMaster model does not cover all
aspects of family functioning.13,14 Rather, the model focuses on the dimen-
sions of family functioning that are seen as having the most impact on the
emotional and physical health or problems of family members. We have
defined functioning within each dimension as ranging from most ineffec-
tive to most effective. We feel that most ineffective functioning in any
of these dimensions can contribute to clinical presentation whereas most
effective functioning in all dimensions supports optimal physical and emo-
tional health. Any family can be evaluated to determine the effectiveness of
its functioning with respect to each dimension. To provide a framework on
how we view families, we describe a familys functioning on each dimension.
Systems Orientation
The MMFF is based on a systems approach:
In this approach the family is seen as an open system consisting of
systems within systems (individual, marital, or dyad) and relating to
other systems (extended family, schools, industry, religions). The
unique aspect of the dynamic family group cannot be simply reduced
to the characteristics of the individuals or interactions between pairs
of members. Rather, there are explicit and implicit rules, plus action
by members, which govern and monitor each others behavior.8
The significance of these ideas for therapy is the fact that the therapist is
not concerned with the intrapsychic pathology in the individual, but rather
with the processes occurring within the family system which produce the
dysfunctional behavior. Therapy is directed at changing the system and,
thereby, the behavior of the individual. The concepts of communication
theory, behavior theory, learning theory, and transactional approach are
drawn on, although the infrastructure remains the systems model.
Value Orientation
Practicing clinicians must appreciate how cultural values play an important
role in influencing human behavior. In depicting a normal family, we often
use value judgments when describing behavior as, for example, the appro-
priateness of a family members reaction of sadness or anger. However, the
expression of many values varies by culture; therefore, the judgments of
health or normality are relative to the culture of the family. Although we try
not to impose our values in conducting therapy, we recognize that we do
make value judgments. Throughout this chapter we will point out areas of
family functioning in which cultural sensitivity may be particularly critical.
Basic Task Area. This is the most fundamental task area of the three. As
the name implies, this area involves instrumental issues such as pro-
viding food, money, transportation, and shelter.
Developmental Task Area. These tasks deal with family issues that arise
over the course of developmental stages at both the individual level
and family level. Individual level crises typically occur at infancy, child-
hood, adolescence, middle, and old age. Family level crises may occur
at the beginning of a marriage, at the first pregnancy, or at the empty
nest stage.
Hazardous Task Area. This task area involves handling crises that may
arise through illness, accident, loss of income, job change, etc.
Problem Solving
Problem solving refers to a familys ability to resolve problems to a level
that maintains effective family functioning. A family problem is an issue
that threatens the integrity and functional capacity of the family and which
the family has difficulty solving. Some families have ongoing unresolved
difficulties that, nonetheless, do not threaten their integrity and functioning;
these problems are not considered. In our early work, it had been surmised
that ineffective families would have more problems than would more effec-
tively functioning families. Research showed otherwise. Although families
dealt with a similar range of difficulties, effective functioning families solved
their problems whereas ineffectively functioning families were unable to do
so.7
Family problems are divided into two typesinstrumental and affective.
Instrumental problems refer to problems of everyday life such as managing
this stage and act in a predetermined manner. In this stage one also
looks to see if those involved in the action are actually informed of
the decision.
5. Acting on the decision. The action stage addresses the degree to which
the family carries out the alternative plan they have selected. Although
the family may have decided on a course of action, they may not act
on it, act in a limited way, or carry out the action completely.
6. Monitoring the action. The monitoring stage refers to whether the
family has a mechanism by which they check to see if the decisions
agreed upon are acted upon and carried out.
7. Evaluating the effectiveness of the action and the problem solving pro-
cess. The evaluation stage addresses if the family is able to review what
happened in the problem-solving process, if they are able to learn from
the situation, if they are able to recognize successful mechanisms of
action, and if they can discern inappropriate problem solving behavior.
Example:
The Simpsons cannot identify any major unresolved problems. A visit
by the grandmother led to some difficulties with the children. They
describe one son as cuddly, while the other son is more active and
independent. The independent grandson, who did not receive as much
attention from his grandmother, became jealous and acted up a bit
when she visited. When his grandmother scolded him, his behavior
Communication
We define communication as the verbal exchange of information within a
family. Non-verbal communication is, of course, tremendously important;
however, we had originally excluded it from the model because of the meth-
odological difficulties involved in measuring it. While we recognize that
some progress has been made in the conceptualization and measurement
of non-verbal communication, we feel that the focus should be on verbal
expression. This is in keeping with our philosophy of assuring both the
clinical and research utility of the model and our feeling that understand-
ing non-verbal communication patterns may entail more complexity (e.g.,
cultural, social, and linguistic issues) than can be addressed with the model.
Also, the MMFF focuses on the familys pattern of communication as op-
posed to an individual family members style of communication. We have
found that using this more global definition of communication is more
useful for both the therapist and family members.
Like problem solving, communication is divided into instrumental and
affective areas that encompass the same problems and issues as discussed in
the Problem Solving dimension. Families can have marked difficulties with
the affective component of communication but function very well in the
instrumental area. Rarely, if ever, is the reverse true. Two other vectors char-
acterize other aspects of communication and are also expressed in this di-
mension: the clear vs. masked continuum and the direct vs . indirect
continuum. The clear vs. masked continuum focuses on whether the con-
tent of the message is clearly stated or camouflaged, muddied, or vague.
The direct vs. indirect continuum focuses on whether messages go to the
intended target or get deflected to someone else. For example, messages
intended for one family member may be transmitted via a third person. In
either case, both the sender and the receiver are involved in the familys
communication patterns.
The clear versus masked continuum and the direct versus indirect con-
tinuum are independent. We can therefore identify four distinct styles of
communication. The following stipulates the four styles and provides an
example of each.16
Joan is late for a meeting with Bill. When she arrives, the following state-
ments might be made:
1. Clear and direct. Both the message and the target are clear. Bill says to
Joan: Im upset that youre late, but lets get on with the meeting.
2. Clear and indirect. In this instance, the message is clear but the in-
tended target is not. Bill says to someone else who is present, Im
upset with Joan because shes late.
3. Masked and direct. Here the context is unclear but it is directed at the
intended person. Bill says to Joan, Are you ok? You dont look well?
4. Masked and indirect. The content of the message and for whom it is
intended are both unclear. Bill says to someone else who is present,
People who are late are a pain.
Roles
Roles are the repetitive patterns of behavior by which family members ful-
fill family functions. Families have to deal with some functions repeatedly
in order to maintain a healthy and effective system. We identify five necessary
family functions, each made up of a number of tasks and functions. Like
the first two dimensions, these functions comprise instrumental, affective,
and mixed components. In addition to necessary functions, other family
functions may arise in the course of family life.
We begin with the five necessary family functions:
Two additional and integral issues of role functioning include role alloca-
tion and role accountability. The concepts are defined as:
more family members are overburdened with family tasks, and account-
ability and role functions are unclear.
Affective Responsiveness
In this dimension, we examine the range of affective responses of family
members by looking at the experience of family responses to affective stimuli.
We are concerned with two aspects of affective responses, whether or not
family members are able to respond with the full spectrum of feelings expe-
rienced in emotional life and whether or not the emotion experienced is
consistent or appropriate with the stimulus or situational context.
We distinguish between two categories of affect:
Affective Involvement
Affective involvement is the extent to which the family shows interest in
and value for particular activities of individual family members. The focus
is on the degree of interest in each other and the manner in which the interest
is expressed. There is a range of styles of involvement, from a total lack of
involvement at one end to an extreme amount of involvement at the other
end.
We identify six types of involvement:
Behavior Control
The behavior control dimension defines the pattern a family adopts for
handling behavior in three specific areas: (1) physically dangerous situa-
tions, (2) situations involving meeting and expressing psychobiological needs
and drives, (3) situations involving socializing behavior both between family
members and with people outside the family system. In this dimension, the
focus is on the standards or rules that the family sets in these three areas
and the amount of latitude they tolerate. This dimension concerns both
parental discipline toward their children as well as standards and expecta-
tions of behavior that adults set toward each other.
Flexible behavior is the most effective form, and chaotic the least effective.
In order to maintain their style of behavior control, a family will develop a
number of functions to enforce what they consider acceptable behavior.
Family Composition
We believe that the organizational, structural, and transactional pattern
variables are more powerful in determining the behavior of family members
than are the intrapsychic variables. We do not dismiss the contribution of
intrapsychic factors to behavior, but merely comment on our belief in the
relative power of the variables. We also believe that the emotional health of
children is closely related to the emotional relationship between their parents.
When parental relationships are warm and supportive, children tend to be
happy and healthy.
We recognize that with the variety of family compositions found today,
two heterosexual parent families are not necessarily the norm. The relation-
ship between divorced or separated parents has a profound effect on children.
The more antagonistic the relationship between the adults, the more likely
the effect will be detrimental to the childrens development. Research is only
beginning to be published concerning the effects of divorce on childrens
functioning, and the findings have been inconsistent and controversial. We
are not aware of research on the functioning of families in same-sex house-
holds, but we would expect the basic principles of the MMFF to apply. That
is, if the relationship between the parental partners is warm and supportive,
the children will feel nurtured and accepted.
Cultural Variations
The MMFF was developed in Canada and in the United States. When it was
developed, we did not realize the amount of interest this model would
generate in the United States, Canada, and overseas. To date, the model has
been applied in a variety of cultural settings, usually via one of two formats.
First, one of the developers/senior therapists presents the model to other
clinicians or health care professionals in a series of workshops lasting up to
one week. Alternatively, professionals in the field of health care have come
from several countries to work with the Family Research Program at Brown
in order to learn the model. English-speaking countries in which the model
has been taught, or from which students have originated include: England,
Scotland, Ireland, Australia, Israel, South Africa, India, and the Netherlands.
Other countries where the model is being practiced are Mexico, Italy, Hun-
gary, France, Japan, Chile, Argentina, Peru, and Spain.