Strengthening Family Resilience Third Edition

by Froma Walsh PhD MSW

Author Froma Walsh PhD MSW Isbn 1462529860 File size 5MB Year 2015 Pages 400 Language English File format PDF Category Family and Friendship In this widely used course text and practitioner resource Froma Walsh provides a state of the art framework for understanding resilience in families and how to foster it Illuminating the complex interplay of biopsychosocial influences in risk and resilience she identifies key transactional processes that enable struggling families to grow stronger and

Publisher :

Author : Froma Walsh PhD MSW

ISBN : 1462529860

Year : 2015

Language: English

File Size : 5MB

Category : Family and Friendship

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THE GUILFORD PRESS

Strengthening
Family Resilience

Also from Froma Walsh
Normal Family Processes, Fourth Edition:
Growing Diversity and Complexity
Edited by Froma Walsh
Spiritual Resources in Family Therapy, Second Edition
Edited by Froma Walsh

Strengthening
Family
Resilience
Thir d Edition

Froma Walsh

The Guilford Press
New York  London

© 2016 The Guilford Press
A Division of Guilford Publications, Inc.
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All rights reserved
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of practice that are accepted at the time of publication. However, in view of the
possibility of human error or changes in behavioral, mental health, or medical
sciences, neither the author, nor the editors and publisher, nor any other party
who has been involved in the preparation or publication of this work warrants
that the information contained herein is in every respect accurate or complete,
and they are not responsible for any errors or omissions or the results obtained
from the use of such information. Readers are encouraged to confirm the
information contained in this book with other sources.

Library of Congress Cataloging-in-Publication Data is available
from the publisher.
ISBN 978-1-4625-2283-5

About the Author

Froma Walsh, MSW, PhD, is the Mose and Sylvia Firestone Professor Emerita in the School of Social Service Administration and the Department of
Psychiatry at the Pritzker School of Medicine, University of Chicago. She
is also Co-Founder and Co-Director of the University-affiliated Chicago
Center for Family Health. Dr. Walsh is a past president of the American
Family Therapy Academy and past editor of the Journal of Marital and
Family Therapy. She has received many honors for her distinguished contributions and leadership in the mental health field, including awards from
the Society for Family Psychology of the American Psychological Association, the American Family Therapy Academy, the American Association for
Marriage and Family Therapy, the American Orthopsychiatric Association,
and the Society for Pastoral Care Research. Among her numerous publications are the edited books Normal Family Processes, Fourth Edition, and
Spiritual Resources in Family Therapy, Second Edition. Dr. Walsh is a
frequent speaker and international consultant on resilience-oriented professional training, practice, and research.

v

Preface

R

esilience—the ability to withstand and rebound from crisis and
prolonged adversity—has become a valuable concept at the forefront in
mental health and human services and in developmental and social science
research. While the preponderance of theory, research, and practice has
focused on resilience in individuals, there is now a groundswell of attention to the importance of resilience in families. My major work, over more
than two decades, has centered on increasing our understanding of family
resilience and developing useful practice applications with families facing a
wide range of serious life challenges.
Traumatic events, major losses, and highly stressful conditions impact
the entire family, rippling through the network of relationships. They challenge the family as a functional system; in turn, key family processes influence the adaptation of all members, their relationships, and the family unit.
How do some families overcome adversity—and even grow stronger in
doing so—when others falter and splinter? What processes enable family
members to rally in teamwork and mutual support through tough times?
To live well with an illness that can’t be cured or a problem that can’t be
solved? To rebuild lives after a shattering loss or life-altering transition?
To rise above severe trauma or barriers of poverty and discrimination? It’s
crucial to understand how families can effectively overcome scarring experiences and go forward to live and love well.
Leading scholars have come to see individual and family risk and
resilience in terms of dynamic multilevel processes over time, involving
an ongoing interaction of biopsychosocial influences across the family life
cycle. As families strengthen their resilience, they are better able to nurture
the positive development of their children, support loved ones in need, and
care for their elders.
vi

Preface vii

This volume presents my research-informed family resilience framework for intervention and prevention to strengthen key family processes in
overcoming adversity. This fully updated, revised, and expanded third edition incorporates the latest research and practice advances for clinical and
community-based services. It presents core principles of a multilevel developmental systemic framework, addressing the ongoing interplay of individual, family, community, sociocultural, and spiritual influences in risk
and resilience. Program applications, practice guidelines, and case illustrations are provided to address a wide range of adverse situations: recovering
from crisis, trauma, and loss; navigating disruptive transitions, such as job
loss, divorce, and migration; overcoming persistent multi-stress challenges
with chronic conditions of illness, disability, ongoing trauma, or poverty;
and overcoming obstacles to success for at-risk youth. Expanded coverage
is given to resilience-oriented approaches with war-related trauma and collective trauma in major disasters and terrorist attacks. Two new chapters
address resilience-oriented family assessment and disruptive transitions
and resilience across the family life cycle.
A family resilience framework is especially relevant in clinical and
community-based practice because most clients seek help in highly stressful
times. It shifts focus from how families have failed to how families, when
challenged, can succeed. My research and practice experience have deepened my conviction that even highly vulnerable or troubled families have
the potential to strengthen their resilience. In contrast to deficit-focused
practice models, the resilience-oriented approach I present in this book
draws out and expands each family’s strengths and resources for mastering
challenges. Beyond coping or problem solving, resilience involves positive
adaptation and can yield transformation and growth. In building relational
resilience, families strengthen their bonds and become more resourceful in
meeting future challenges. Thus, every intervention has preventive benefits.
I’ve long been interested in the concept of resilience. I grew up in a
family challenged by serious hardships, tragic losses, and social stigma. As
a young adult, my experience of traditional psychotherapy, after my mother
died, dredged up all the negative aspects of my childhood and elaborated on
my parents’ faults. The longer I was in therapy, the worse my parents got. I
was viewed as hardy despite their failings, as if I grew myself up. I only later
came to see that those adverse experiences made me stronger than I might
have been growing up in a family blessed with every advantage. It took a
long time to appreciate my parents’ struggles and their remarkable courage,
perseverance, and resourcefulness.
My early clinical training, in the late 1960s, taught me how to diagnose and treat disorders but not how to recognize and promote positive

viii Preface

functioning. I was drawn to the field of family therapy just as it was flowering, especially engaged by a workshop with Virginia Satir, who saw the
healthy strivings in troubled families. It was refreshing to cast off deterministic theories of early-childhood, maternal causality for individual
problems—with such pejorative labels as schizophrenogenic and refrigerator mothers. The systemic paradigm expanded the focus of assessment and
intervention to address the multiple influences in functioning and wellbeing through transactional processes over time involving the broad relational network and social context. I was fortunate to benefit from clinical
training on an innovative psychiatric inpatient unit at Yale Medical Center
based on the philosophy of milieu therapy—a patient–staff community
with combined interventions of psychotropic medication and individual,
group, family, and multifamily group approaches. My first supervisor,
Carol Anderson (who later developed family psychoeducation), involved
families respectfully, appreciating their challenges with mental illness.
Coming to Chicago, I was fortunate to work as Family Studies Coordinator in a schizophrenia research program funded by the National Institute
of Mental Health and directed by the visionary psychiatrist Roy Grinker,
Sr. Grinker, who had pioneered the study of combat stress in World War II
(Grinker & Spiegel, 1945), was a close colleague of von Bertalanffy (1968),
the founder of general system theory. Both programs put into practice a
biopsychosocial interactionist perspective.
Yet the mental health field continued to focus on family deficits, reflecting the widespread belief that most families were more or less dysfunctional. When I sought to include a “normal” (i.e., nonclinical) comparison
group in the schizophrenia research, some colleagues chided me, saying
that I wouldn’t find any normal families—and they definitely wouldn’t
recommend their own! Undaunted, I did include a nonclinical group of
families in the community and was impressed by their vitality and diversity. Yet even those families faced tough challenges and worried about their
adequacy—one mother asked if she and her family could receive a “certificate of normality”!
That experience led me to pursue doctoral studies in human development at The University of Chicago to expand my understanding of family
and social processes in healthy functioning and positive growth. My perspective was enriched by early studies of resilience by my mentor, Bertram
Cohler; by studies of creative processes by Mihaly Csikszentmihalyi; and
by emerging developments in phenomenology and social constructionism.
My clinical teaching, training, and practice became increasingly strengths
oriented, and I’ve striven since then to bridge advances in the social sciences

Preface ix

and the mental health field. I look back on those valuable learning experiences as my professional “flight into health.”
Two myths about normal families have clouded our understanding.
First, the erroneous assumption that healthy families are problem free can
overpathologize ordinary families struggling with stressful life challenges
or traumatic experiences. Second, the assumption that a single, universal
model of the healthy family is essential, fitting an idealized image of families of the past, has led to the faulty presumption that varying family structures are inherently dysfunctional and damage children. With the growing
diversity of families in societies worldwide, no single model fits all—or even
most—families today. In this volume, family is defined broadly, to encompass varied family forms, committed couple relationships, and extended
formal and informal kinship networks. Studies of strong families worldwide (DeFrain & Asay, 2007) show that families can thrive and children
can be raised well in a variety of kin arrangements. What matters most
are effective transactional processes for stable, nurturing, and protective
bonds.
Over the past three decades, family systems research has provided
empirical grounding to identify many key processes that support effective
family functioning (Walsh, 2012d). Drawing together these findings with
a growing body of research on resilience, the family resilience framework
presented here provides a flexible map to guide practice with a broad diversity of families facing varied situations of adversity. This approach attends
to the interplay of individual, family, socioeconomic, cultural, and spiritual
influences and affirms many varied pathways in resilience.
The family resilience practice approach described in this volume builds
on recent advances in strengths-based, collaborative systemic models, contextualizing distress in highly stressful experiences. The framework and
practice applications in this new edition have been developed, refined, and
reformulated over many years of clinical teaching, supervision, and direct
practice grounded in a developmental systems orientation. Key processes
are identified and practical guidelines are offered to foster family empowerment in mastering a wide range of life challenges. Case illustrations draw
on many varied examples of family resilience from my professional practice, research, and training of practitioners, as well as from my personal
life. Names and details have been carefully altered to protect families’ privacy. Throughout this volume, I discuss ways in which couples, families,
and helping professionals can identify, affirm, and strengthen ways of forging positive change and growth from adversity.
In Part I of the volume, Chapter 1 presents the foundation for a family
resilience approach to practice. It clarifies the concept of resilience, surveys

x Preface

what we have learned from studies of individual resilience, and presents a
multilevel systemic view of resilience that integrates ecological and developmental perspectives. Chapter 2 situates family resilience in social context,
highlighting trends in the growing diversity and complexity of families and
their stressful challenges in our rapidly changing world. This perspective
is essential for family assessment and intervention to be attuned to today’s
families and their varied pathways in resilience.
Part II integrates research findings and practice perspectives to identify
key transactional processes that can facilitate effective family functioning
and resilience. Because practitioners can be overwhelmed by the complexities of family processes under stressful conditions, I have found it useful to
organize these processes into three domains of family functioning: belief
systems, organizational processes, and communication processes. Chapters 3–5 describe and illustrate key processes for family resilience in each
dimension of functioning. This is not a typology or model of static universal traits. Rather, these are dynamic processes that are recursive and
synergistic. They may be expressed in varying ways and to varying degrees
depending on cultural differences; on family preferences, resources, and
constraints; and on the adverse situations and emerging challenges families
face over time.
Part III describes and illustrates assessment and practice principles
and programmatic applications of this family resilience framework. This
practice approach builds on developments in strengths-based systemic practice. Parallel to a practice focus on common factors (i.e., core processes) in
effective family therapy identified by Sprenkle, Davis, and Lebow (2009),
practitioners can target these key process components identified in family
process research to strengthen family resilience as presenting problems are
addressed. Chapter 6 offers useful maps as tools to guide resilience-oriented
family assessment and intervention. Chapter 7 provides core principles,
practical guidelines, and case examples to facilitate resilience in work with
distressed couples and families. Chapter 8 presents program applications
and illustrations of family resilience-oriented clinical and community-based
training and service projects developed through the Chicago Center for
Family Health locally, nationally, and internationally. Practitioners’ own
resilience and courageous engagement with clients are discussed.
The chapters in Part IV describe and illustrate the application of a
family resilience approach in various adverse situations, from crisis events
to disruptive transitions to prolonged adversity. Chapter 9 provides a developmental perspective on challenges and resilience over the changing family
life cycle. Chapter 10 addresses the profound challenges families face with
death and dying and key variables in risk and resilience with loss. Chapter

Preface xi

11 focuses on resilience-building approaches for family and community
recovery in the wake of major traumatic events, ranging from community
violence to large-scale disasters, terrorism, war-related atrocities, and refugee experience. Chapter 12 tracks the family journey with chronic physical
and mental illnesses, offering guidelines to reduce stress and enable families
to thrive in the face of illness-related demands and uncertainties. Chapter
13 addresses the persistent challenges faced by multi-stressed, low-income,
highly vulnerable families, countering faulty presumptions that they are
too dysfunctional and unmotivated to work with. Useful principles, guidelines, and case examples are offered that reveal their deep yearning for a
better life and demonstrate ways to engage collaboratively to support their
positive strivings. Chapter 14 draws on my own personal experience as
well as the efforts of others who have inspired me. It explores possibilities for reconnection, reconciliation, and forgiveness in families, in groups
that have suffered oppression, and in parts of our world torn by strife. It
challenges common assumptions that those wounded by past trauma or
troubled relationships survive best by severing ties to their families and
their past, fortifying themselves as rugged individuals.
The family resilience practice approach presented here is grounded in
the firm conviction that we human beings survive and thrive best through
deep connections with those around us, those who have come before us,
and those who will follow us, including all who have been, and could be,
significant in our lives. Even experiences of severe trauma and very troubled
relationships hold potential for healing and transformation across the life
course and the generations. In facing adversity, resilience is nurtured and
sustained through strong family, social, community, cultural, and spiritual
connections. I see these as “relational lifelines” for resilience.
This book can serve as a valuable resource for all professionals who
are interested in fostering human adaptive capacities and supportive social
systems, regardless of practice orientation, discipline, or level of experience.
A family resilience framework can be applied in the fields of mental health,
health care, human services, child welfare, family life education, community organization, the justice system, family law, and pastoral counseling;
by practicing professionals, educators, and students; and by marriage and
family therapists, social workers, psychologists, psychiatrists, counselors,
nurses, and physicians. It has found application in workplace resilience initiatives, family businesses, and faith-based organizations.
The framework presented here has also found wide international
application, with culturally attuned adaptation, in mental health and psychosocial training and services, family research, and social policy, from
Latin America, Canada, Europe, Australia, and New Zealand to Africa,

xii Preface

the Middle East, and Asia. Previous editions have been translated into
Spanish, Portuguese, Italian, Chinese, and Korean.
Although the book is written primarily for helping professionals, it
is also of value for a general readership—especially for family members
who have faced tragedy or hardship and who are interested in understanding how to build relational resources to strengthen their own individual,
couple, family, or community resilience. It is encouraging to see the burgeoning interest worldwide in positive mental health, well-being, and the
ability to thrive (World Health Organization, 2011). Most heartening is the
increasing attention to ways to promote resilience in individuals, families,
and communities (e.g., The Road to Resilience initiative of the American
Psychological Association, 2010; Delage, 2008; and the United Nations’
development of a global resilience tool [IRIN, 2009] to measure the ability
of a system to withstand stresses and shocks in an uncertain world).
The need for family resilience has never been more urgent, as families
today are buffeted by global economic, social, political, and environmental
upheaval. With devastating natural and human-caused disasters, the world
around us has become more hazardous and the future insecure. Yet all families have the potential for adaptation, reinvention, and positive growth. A
family resilience approach provides a positive and pragmatic framework
that guides interventions to strengthen vital family processes as immediate
problems are addressed. In this way, families become more resourceful in
dealing with unforeseen problems and proactive in averting future crises.
For helping professionals, the therapeutic process is enriched as we bring
out the best in families and practice the art of the possible.

Acknowledgments

T

his book is dedicated to the families everywhere who face serious
life crises or persistent adversity and forge remarkable resilience. They have
inspired my abiding interest in understanding core processes in family life
that promote positive adaptation: families who sustain an indomitable
spirit in the face of illness, disability, or loss; those who rekindle hope and
build connection and renewal out of trauma and tragedy rather than sink in
despair; those who transcend barriers of poverty, racism, and discrimination toward a positive vision rather than alienation; and those who respond
compassionately to the plight of others. My clinical teaching and practice
have been immeasurably enriched by what we have learned from families
that rebound and thrive.
Analogous to an understanding of core components in effective
therapeutic practice, our ability to help couples and families in distress is
informed by our understanding of the vital processes in effective family
functioning. I am grateful for the advances in our research, countering the
misguided search for a single invariant model or set of traits. As reflected in
the cover image for this volume, we have come to appreciate the many colors and strands in resilience that families weave as members come together,
forging varied pathways over time, dealing with their challenging situations, drawing on their available resources, and striving toward their future
hopes and dreams.
I am grateful to the families I’ve been privileged to know in my research
and practice, who have deepened my understanding of their suffering and
struggles and their capacity to adapt and grow stronger. They inspire my
best efforts and affirm my conviction in the human potential for healing and
positive growth out of scarring experiences. My work in community-based
xiii

xiv Acknowledgments

and international settings over the years has greatly enlarged my perspective and my appreciation of the importance of strong kinship and community networks in withstanding harsh conditions. Families with little material wealth have shown me the greater value of relational connections and
cultural and spiritual resources through troubled times.
I want to thank the dedicated staff at The Guilford Press for their work
in the production of this new edition. I most appreciate the thoughtful feedback provided by Senior Editor Jim Nageotte, the collaborative spirit of Art
Director Paul Gordon, and the helpful responsiveness of Senior Production Editor Jeannie Tang. In the face of ongoing turmoil in the publishing
environment, I applaud the resilience of my Guilford Press “family” for the
continuing high level of professionalism and commitment to first-rate professional books, thanks to the steadfast leadership of Guilford’s “founding
fathers,” Seymour Weingarten and Bob Matloff.
In my labor of love on this new volume, I have been deeply appreciative of my many valued colleagues near and far. As always, my kindred
spirits have been there for me; my heartfelt thanks to Celia Falicov, Monica
McGoldrick, and John Rolland for their incisive comments, thoughtful
reflections, and strong support. I am grateful for the many mentors who
have influenced my work. I have treasured the past 25 years of stimulating
exchange with the wonderfully diverse faculty and trainees at the Chicago
Center for Family Health and with the bright, enthusiastic students at The
University of Chicago. I look forward to future contacts, consultations,
and collaborations worldwide, to support all who are striving to advance
research, practice applications, and social policy to strengthen family resilience.
My family and the kinship of close friends have been a wellspring
for meaningful connection, joy, and resilience in my life. I miss, beyond
words, my cherished friend and collaborator throughout my career, Carol
Anderson, who died this past year, too suddenly and too soon. I thank my
husband, John, for his steadfast love. I admire my daughter, Claire, for
her “can-do” spirit, compassion, and deep commitment to international
humanitarian work. Above all, I am grateful to my parents for their loving
support and encouragement despite their own life struggles. I only wish
that while they were alive I had learned more about their lives to fully
appreciate their courage, perseverance, and resourcefulness. I carry their
indomitable spirit in my heart.

Contents

Part I.  Overview
 1. Foundations of a Family Resilience Approach
 2. Family Diversity and Complexity in a Changing World:

Varied Challenges and Pathways in Resilience

3
22

Part II.  Key Family Processes in Resilience
 3. Belief Systems: The Heart and Soul of Resilience

39

 4. Organizational Processes: Relational and Structural Supports

65

 5. Communication Processes: Facilitating Meaning Making,

Mutual Support, and Problem Solving

82

Part III.  Practice Applications
 6. Assessing Family Resilience: Useful Maps for Practice

and Research

101

 7. Practice Principles and Guidelines to Strengthen

Family Resilience

131

xv

xvi Contents

 8. Applying a Family Resilience Framework

in Community-Based Services

154

Part IV.  Facilitating Family Resilience
through Crisis, Transition,
and Persistent Challenges
 9. Challenges and Resilience over the Family Life Cycle:

A Developmental Systems Perspective

181

10. Loss, Recovery, and Resilience

206

11. Traumatic Loss and Collective Trauma:

Strengthening Family and Community Resilience

232

12. Serious Illness and Disabilities: Family Challenges

and Resilience

265

13. Nurturing Resilience in Vulnerable, Multi-Stressed Families 296
14. Reconnection and Reconciliation:
Healing Relational W
  ounds

327

Appendix 1.  Walsh Family Resilience Questionnaire

357

Appendix 2.  Developing Resilience-Based Genograms:
Outline and Sample Questions

359

Appendix 3.  Exploring the Spiritual Dimension

in Family Life: Sources of Distress and Resources

for Well-Being, Healing, and Resilience

366

References

368

Index

390

Pa rt I

Overview

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