Shapiro Ester R
Psychology Department, University of Massachusetts, Boston, MA 02125-3393, USA.
J Clin Psychol. 2002 Nov;58(11):1375-84. doi: 10.1002/jclp.10085.
This paper describes a social-developmental approach to interventions in chronic illness using naturally occurring processes of change during family life-cycle transitions to promote more positive developmental outcomes. Clinical interventions can help build resilience by creating a therapeutic collaboration designed to help patients improve their use of existing and new resources in multiple systems. They can then better meet demands of the illness as it impacts on shared development. A case example of a 13-year-old daughter with complex, chronic health problems and developmental disabilities illustrates clinical interventions designed to promote family resilience during the entry into adolescence and a transition in schooling. This approach involves focusing on the family's own definition of the current problem and relevant history, constructing a multidimensional, coherent story of the illness and its impact that recognizes stressors yet highlights strengths, and normalizing their strategies for stability under circumstances of developmental stress. These interventions with mother, daughter, and family helped improve health efficacy, communication toward mutual understanding and shared problem solving, and better use of existing and new resources to enhance current and future developmental adaptation.
本文描述了一种针对慢性病干预的社会发展方法，该方法利用家庭生命周期转变过程中自然发生的变化过程，以促进更积极的发展成果。临床干预可以通过建立一种治疗合作关系来帮助增强复原力，这种合作旨在帮助患者更好地利用多个系统中的现有资源和新资源。这样，当疾病影响共同发展时，他们就能更好地应对疾病带来的需求。一个患有复杂慢性病和发育障碍的13岁女儿的案例，说明了在进入青春期和学校过渡期间旨在促进家庭复原力的临床干预措施。这种方法包括关注家庭对当前问题的自身定义和相关病史，构建一个多维、连贯的疾病及其影响的故事，既要认识到压力源，又要突出优势，并使他们在发育压力情况下保持稳定的策略正常化。对母亲、女儿和家庭的这些干预措施有助于提高健康效能、促进相互理解和共同解决问题的沟通，以及更好地利用现有资源和新资源，以增强当前和未来的发育适应能力。
