Conceptual Models

Waiting caregiverMultiple theoretical models and frameworks can serve as a basis for psychologists’ clinical services for caregivers. Although derived from practice concepts in varied settings, the models below all offer guidance for psychologists seeking to intervene effectively with caregivers.

Family Systems-Illness Model

Key concept:

A family’s functioning in the face of illness and disability is the outcome of the interaction of:

  • The family’s developmental stage
  • The illness “typology”, which is the expected course or trajectory of change over time

For further reading

Rolland, J. (1994). Families, illness and disability: An integrative treatment model. NY: Basic Books.

Person-Environment Fit Models

Key concepts:

  • Personal well-being is greatest when environmental demands match a person’s capabilities.

  • Environments can be modified to support higher-level functioning and improvements in well-being.

For further reading

Lawton, M. P. (1999). Environmental design features and the well-being of older persons. In M. Duffy, Handbook of counseling and psychotherapy with older adults (pp. 350-363). New York: Wiley.

Wahl, H., Fange, A., Oswald, F., Gitlin, L., & Iwarsson, S. (2009). The home environment and disability-related outcomes in aging individuals: What is the empirical evidence?. The Gerontologist, 49(3), 355-367.

Biobehavioral Model

Key concepts:

  • This model is an extension of structural family therapy’s approach to psychosomatic families.

  • It posits that family relational patterns and the individual’s biobehavioral reactivity interact to affect the health of children with illness and disability.

For further reading

Wood, B.L. (2004). One articulation of the structural family therapy model: a biobehavioral family model of chronic illness in children. Family Process, 16, 53-72.

Medical Family Therapy Model

Key concepts:

  • The goals of psychotherapy are to increase “agency” (taking active steps to improve one’s own well-being) and “communion” (sense of being supported)
  • Mental Health therapists need to learn the skills of collaborating effectively with physical health providers.

For further reading

McDaniel, S.H., Hepworth, J., & Doherty, W.J. (1992). Medical family therapy: a biopsychosocial approach to families with health problems. NY: Basic Books.

Stress and Coping During the Caregiver Career

Key concepts:

  • Caregiving is inherently stressful due to tasks and time demands, with secondary effects on other aspects of daily life.
  • Coping strategies can buffer or exacerbate the negative effects of stress.

For further reading

Aneshensel, C. S., Pearlin, L. I., Mullan, J. T., Zarit, S. H., & Whitlatch, C. J. (1995). Profiles in caregiving: The unexpected career. San Diego, CA: Academic Press.

Pearlin, L. I., Mullan, J. T., Semple, S. J., & Skaff, M. M. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30, 583–594.

Pediatric Psychosocial Preventive Health Model

Key concepts:

  • The majority of families with a child with cancer are competent, highly organized families.
  • Assessing a family’s level of universal, selective or indicated risk can help determine an appropriate intervention strategy.

For further reading

Kazak, A.E., Rourke A.T., Alderfer M.A., Pai A, Reilly A,F., & Meadows A.T. (2007). Evidence-based assessment, intervention and psychosocial care in pediatric oncology: A blueprint for comprehensive services across treatment. Journal of Pediatric Psychology 32, 1099-1110.

Illness Beliefs Model

Key concepts:

  • Family caregivers' experience of illness can be conceptualized in a biopsychospiritual framework.
  • The goals of psychotherapy are to foster “facilitative” beliefs to decrease caregivers' suffering due to illness and to discourage “constraining” beliefs which increase such suffering.

For further reading

Wright, L. M. & Bell, J. M. (2009). Beliefs and illness--model for healing. 4th Floor Press, Calgary, Alberta.