Family dysfunction and the cancer patient: early recognition and intervention.

Cancer affects the entire family, not just the patient. Dysfunctional family systems can be assessed by looking for recurrent patterns of maladaptive processes that exclude other coping mechanisms. Intervening to ameliorate the situation in such families involves development of a plan to restore equilibrium wherever possible; when appropriate, a mental-health referral may be needed for families with severe dysfunction. A physician must know how to assess and appropriately intervene in dysfunctional family systems, both when support services are and are not available for assistance. To explain recognition and anticipation of the early signs of family dysfunction to the practicing oncologist, Olsen's Circumplex Model of family functioning is presented as a theoretical frame for assessment and intervention.