Typical Family Problems

 What are some typical family problems?

As in any complex system - a national economy, the space shuttle, or the typical American family - there are dozens of things that can go wrong. Family members should understand that these problems are extremely common. Virtually everyone struggles with some problem in their family, the big question is what can be done?

Below is a list of typical problems that Ward Halverson, a licensed clinical social worker and experienced family therapist, helps families solve. Following that list are some healthy approaches in general, and questions and answers from Ward about typical challenges that families face (please note that this web site offers a great deal of other information, located above):

  • Overall stress and hurrying
  • Trying to take on too much
  • Money management and income
  • Unemployment
  • Mental Illness in general
  • Impulse-control disorders
  • Anxiety
  • Depression
  • Trauma
  • School
  • Moving
  • Divorce and separation
  • Underage drinking

What can families do about problems, in general?

When people are ready to talk about family issues or conflicts, two essential ingredients are needed. First, there needs to be a willingness to work toward solutions. Second, there must be agreement that there is a problem and what the problem is.

Following are suggestions that can be followed during a decision process.

  • First, discuss and clarify how each person views the situation or problem.
  • Then suggest each person make a commitment to the problem and think about solutions.
  • Third, give each person a chance to state his or her priority values and particular needs. An hour or two, or a day later consider the alternatives.

Finally, examine the possible solutions to discover if you are willing to accept the results of one or another of the alternatives. There is an agreement when there is a goal for action and a willingness to follow through by committing time, money, and human energy to the action plan. Or, from this session you may need to re-clarify the problem, thus going back to step one. Have a trial period. This can be less threatening than a hard and fast decision. If there isn't a willingness to work on solutions to the problem, then you can only address the situation in ways that you can control. You can adjust your view, your involvement, or your reaction to the situation. Successful social decisions bring people closer together and improve future communication. For more information call a family counselor, spiritual advisor, or mental health service provider.

Problem-solving is the family's ability to resolve problems on a level that maintains effective family functioning (Epstein, Bishop, Ryan, Miller, & Keitner, 1993).


One of the keys to successful family functioning is the family's ability to solve problems. All families have problems to deal with. However, research indicates that competent families solve problems as they arise; whereas, families that avoid problem-solving, or seem incapable of dealing with many of their problems have more difficulties (Epstein, Bishop, Ryan, Miller, & Keitner, 1993).

Types of Family Problems or Issues

Problem-solving is the family's ability to resolve problems on a level that maintains effective family functioning (Epstein, Bishop, Ryan, Miller, & Keitner, 1993). Family problems come in all shapes and sizes. Some problems involve everyday decisions about money or transporting the children to and from school. These are called instrumental problems.

Other problems may be concerned with a family member's feelings and emotions and are called affective issues. Some problems may involve both. For example, getting a child to day care for the first time may require dealing with instrumental issues regarding transportation and affective issues regarding the child's fear of being left at a strange place for the first time.

Families with a problem-solving process in place are more likely to resolve both types of issues. It is important for families who become stuck and are unable to resolve an issue to learn and implement a problem-solving process.

The Problem-solving Process

Families who successfully and quickly resolve problems have developed skills to manage their difficulties. They are aware of the steps in the problem-solving process and they consistently implement them to resolve problems. Problem-solving is a process skill that, like other skills, can be learned by the family. The following six steps will assist you in establishing a problem-solving process in your family.

1. Problem Identification and Agreement The first step in the problem-solving process is problem identification. Knowing the real problem or issue is half the battle. Although this may seem like a simple first step, many families have difficulty with it. Many families tend to blame someone in the family for the problem. Instead, families need to define and agree on what type of problem they are dealing with. For example, is it an instrumental issue related to how the family accomplishes a task, or is it an affective (feeling and emotions) issue? In some cases it may be both. Families may identify the instrumental problem but miss the affective side and wonder why the issue wasn't resolved. A family member may feel his/her feelings were not heard or addressed and will not agree to go along with the solution until the hurt feelings are dealt with. Therefore, families must practice problem identification and agreement as the first step in problem-solving.

2. Creating Options and Alternatives The second step in the problem-solving process is creating options. By brainstorming, the family generates options or alternatives surrounding the identified problem. What are some things the family or family members can do to resolve the issue? What are some of the possible solutions to the problem? Make a list of your alternatives. Encourage brainstorming without evaluating the ideas until many options are on the table. The creative options step leads to effective solutions to problems. Options should take into account both instrumental and emotional issues and should include all family members who are affected by the issue.

3. Evaluate Alternatives Step three is evaluating the alternatives the family has generated. Ask what your family thinks of each of the options. Each family member should give his/her opinion of the idea. Eliminate the alternatives that the family is unwilling to try. The goal is to find an option that each family member will agree to consider. Next, decide whether or not the family has the resources to carry out the alternative. The goal is to find an alternative that each family member will agree to consider.

4. Choose A Solution Once you have evaluated all the alternatives, decide as a family which idea or ideas you are willing to follow. This is known as the action plan. The action plan includes what the family is going to do, which family member is going to do it, and when it will be done. Once you have chosen a solution, write down a summary of it. This will help your family remember what the plan is supposed to do. Putting the plan in writing enables everyone to better understand the plan and their part in resolving the problem or issue. A written plan is also helpful for monitoring your familyºs solution, which is the next step in the problem-solving process.

5. Monitoring the Solution Monitoring the solution is critical to the problem-solving process. By monitoring the action plan, your family can keep track of their progress. This will remind you of what the family decided to do, which family member is going to do it, and when it will be done.

6. Evaluating the Success of the Plan The final stage in the problem-solving process is to evaluate the success of the family action plan. This stage involves reviewing what happened in order to learn from the situation. The review helps the family to make adjustments to the plan and to evaluate what worked and what didn't. Parents who teach problem-solving skills to their children promote resiliency in their children. Focus on Family Strengths Problem-solving is a key to successful family functioning. Research indicates that families who practice problem-solving techniques are more likely to pass this skill on to their children. Research has identified problem-solving as a factor that promotes resiliency in children (National Network for Family Resiliency, 1993). Problem-solving skills among family members will lead to more effective resolution of both instrumental and emotional family problems. Family Assessment Successful Healthy families periodically take inventory of their strengths and weaknesses and take steps to improve their home and family environment. Isnºt it time your family took an inventory of how well it is doing?

What about underage drinking?

Actually, about 10.8 million adolescents ages 12-20 are underage alcohol drinkers. That statement is not just an alarming statistic. It represents a real problem facing families, communities, and children every day. Children who drink are more likely to be victims of violent crime, have serious problems in school, and be involved in drinking-related traffic crashes. Alcohol use also is linked with youthful deaths by drowning, suicide, and homicide.

Why do teenagers do this, and what can parents do?

Kids are flooded with media messages that glamorize alcohol use, and they also may be pressured by peers to drink. However, parents have enormous influence on the choices their children make. If you're worried, as a parent, about what your child may be doing with alcohol, then it's time to open the lines of communication. Tell your teenagers what you expect from them if they are offered alcohol, are at a party where alcohol is being served, or the person driving them home has been drinking. Remind them of your rules and the consequences of breaking those rules. Communication with your child is the key to preventing underage alcohol use. This might be the time for a very serious "promise" to your teenager.

What kind of "promise" will be a good move for my teenager and our family?

Ward Halverson believes in making two promises to children when they're "old enough" to start taking such major life risks as drinking and driving (or getting in a car with a drunk driver) or either getting pregnant or getting someone else pregnant. In a safe, mutually-respectful setting, you can make a promise to your teenager. Tell him that if he's ever at a party where there's drinking and needs a ride home in order to avoid getting into a car with someone who's drunk, you'll pick him up. This means that you'll pick him up whenever and wherever. Most of all, you promise never to bring it up again. No repercussions, no consequences for making you get up in the night (most likely) and drive to some random place. The deal is that you'll simply pretend it never happened. Such a promise may go against the very grain of good parenting (and rightly so), but it might keep your child alive. The same sort of promise can be used to avoid teen pregnancy. You promise your daughter (or son) that if there's ever a time when a trip to Planned Parenthood or the family health provider is indicated, you'll take her. Again, no repercussions, no consequences. It's a secret between you and your teenager - the other parent doesn't have to know. Most importantly, this promise may prevent your child from becoming a teen parent, and you from becoming a grandparent. Even though - again - it goes against the basic grain of "accountable parenting" and good practice, it's for the ultimate good.

How does alcohol affect the typical teenager?

If effects the mind, first of all, in specific ways: Although initially alcohol feels like a stimulant by making her feel more lively, it ultimately acts as a depressant and causes sedation and drowsiness. Alcohol slows down her ability to think, talk, react, and make decisions as she normally would. This can lead to poor choices and risky behavior. Alcohol impairs coordination, causes memory lapses, and slows reaction time. If she drinks enough to get alcohol poisoning, her brain slows down so much that she can slip into a coma or even die.

Of course, alcohol also affects the body: Alcohol can damage every organ in his body, including his brain. Alcohol increases his risk for a variety of life-threatening diseases, including cancer. Drinking can cause nausea and vomiting. Drinking a lot at one time can lead to fainting, difficulty breathing, coma, and death. And because it affects coordination, if he is drinking-or is around people who are drinking-he has an increased risk of being seriously injured, involved in car crashes, or affected by violence.

Finally, alcohol affects a person's emotions. Alcohol depresses her central nervous system, making her feel less inhibited and less in control. This can lead to risky behaviors she would not do if she were sober. Alcohol is a depressant, or downer, because it reduces brain activity for everyone. But, if she is already depressed before she starts drinking, alcohol can make her feel worse. Some people become addicted to alcohol-they feel like they need to drink more and more to feel "okay."

Remember, parents have more influence on their child's values and decisions about drinking before he or she begins to use alcohol. Talk to your child today.

What can parents do to be good role models?

The first step is to ask yourself who your child's best role models actually are? You might suspect friends or teachers, or a sports hero, but, interestingly enough, it's probably you. Whether you know it or not, you are a role model for your child. Research shows that an overwhelming number of young people look up to their parents and other family members as examples to follow. Nearly half of young women respondents say they look to their mothers as their role model, according to one online survey. Almost half of the teens in another survey say their role model is a family member, not a pop icon or sports star.

What does this mean for you? As a parent, you may have more influence for good than you thought you did. By setting a good example of healthy living, you can help your children make healthy life choices. You also can talk to them about the dangers of drug and alcohol abuse so they know where you stand on this issue. Youths who have positive role models are more likely to do well in school and have higher self-esteem; they also are less likely to abuse substances

You can set a good example by putting time and effort into your relationships with your child and other family members. Family life provides meaningful opportunities to demonstrate healthy behaviors every day. When you and your family show caring and respect toward each other, you provide excellent examples for your child to follow:

  • Talk openly, honestly, and respectfully; think before you speak, and acknowledge your child's point of view, especially when there is conflict.
  • Praise your child's positive qualities and behavior.
  • Spend time together regularly; do things your child enjoys.
  • Have family meals together and engage in family activities on a regular basis.
  • Make some family gatherings alcohol-free to show your children that you don't need alcohol to have a good time.

What about house rules?

Give your children guidance to make healthy choices and take responsibility for their actions by setting house rules. Household rules also remind you and other family members to model healthy behaviors for your child. You set a good example when you enforce rules consistently: it shows that you care, are reliable, and stand by what you say.

  • Don't allow your child to drink, smoke, or abuse other substances. You can make it official by writing a family contract. " Protect your children from alcohol or tobacco use within your family. For example, don't allow them to get a beer or a cigarette for you or other family members. " Never drink and drive or allow other family members to do so. " Set additional "house rules" for matters such as curfew, unsupervised time, homework, chores, driving, cell phones, Internet use, and entertainment including movies, television, and video games. " Set clear rules, and discuss in advance the consequences of breaking them. When your child breaks a rule, respond with an immediate consequence each time the problem behavior occurs. Calmly explain to your child why the behavior results in that consequence.

The consequences for breaking rules can be supportive so that the focus is on teaching rather than harsh punishment. For instance, if your child broke the family rule by staying at an unsupervised party, you might ground your child for some specific length of time; others might restrict instant messaging and have their child read online about the harmful effects of drugs. Each family has differing priorities when negotiating and agreeing on rules, expectations, and consequences for rules broken. The system you use doesn't matter so much, just whether it works.

On that same note, your values, opinions, and example carry more weight with your child than you may have thought. By providing a positive model for your child to follow, you set a good example on how to successfully navigate life's conflicts and negative messages-and to choose healthy behaviors that will follow into adulthood.

What about parental stress? How can I reduce the pressure on myself too?

Has your daily "to-do" list gotten so long that it no longer fits on a single piece of paper? Or do you have so much to do that you don't even have time to make a to-do list? You're not alone. Parents today are working longer hours and commuting greater distances to and from work. Their days don't slow down when they get home. Kids' after-school schedules can be jam-packed, making life busy-and often stressful-for parents. Why is there so much parental stress?

There is no single answer to this complex question. Many things increase or reduce stress among parents, including:

  • Having good childcare and knowing that their kids are safe during the hours when parents are away from them.
  • Facing major life events such as a divorce, death, and midlife crisis.
  • Having financial worries-from paying monthly bills to saving for a child's college education to giving financial help to aging parents.
  • Being unemployed or fearful of being laid off from work.
  • Facing nagging health problems.
  • Feeling the strain of caring for an aging parent, chronically sick child, or family member with special needs.
  • Parents, like kids, also may be trying to do more in a single day. Technology items like computers and cell phones were supposed to help us save time-and they do! But instead of savoring that extra time, parents often pack in more tasks and chores.

The mistake is trying to do more than the family is able to handle.

How does stress affect parents and families?

According to one study, parents (especially of older children) suffer from higher levels of depression than adults who do not have children. Parents often focus on caring for their children and forget to take care of themselves. When parents don't pay attention to their physical and mental health, they put themselves at risk for stress-related problems like tension headaches, chronic fatigue, and depression.

Research also shows that the emotional well-being of children is strongly linked to their parents' mental health. To put in plainly: Parents who are stressed out often have kids who are stressed out. Your kids learn how to cope with life's ups and downs by watching how you manage stress. If you manage it well, you'll not only feel better, but you'll be a model for your kids and teach them how to manage stress in their lives.

How can parents manage stress effectively?

Make friends and build strong social networks. Studies have shown that having one or two close friends or even a large group of friendly acquaintances is vital to emotional health. Many people live far away from their extended family members, so look to friends to fill this emotional need. Being friends with other parents also can lead to timesaving benefits like carpooling to and from activities.

Prioritize your to-do list in order of importance. What has to get done today? What can be deleted? What can wait until tomorrow? What doesn't really have to be done? Tackle today's things first and then come up with a game plan for getting everything else done. You might have to say, "I won't have time to mop the floor until Saturday," but that's OK. Just having a plan for getting things done can help relieve stress.

Make sure your to-do list includes a little personal time for yourself. Have coffee with an old friend, take a bath, go for a walk, read a book, or take a nap. The goal is to do things that renew and energize you. Don't let yourself get run down! When you take time to revitalize yourself, you have more to give to others.

Sometimes there seems to be no time for parents to de-stress and parents may feel guilty about calling a timeout for themselves. What parent has time for a break when there is homework to help with, recitals to attend, practices to drive to, and work to be done? Moms and Dads spend most of their time trying to raise happy, healthy kids, but your kids want happy, healthy parents! If you're over-stressed, you're probably not at your best-and your kids know it. So, call a personal timeout and address the stress. You'll be helping yourself and your family.

Also, on a serious note, if you're constantly feeling overwhelmed, you may need professional help. Stress can lead to other health issues, so don't hesitate to talk about it with your family doctor or a professional like Ward Halverson.

Decision making by kids in families

What was he thinking? How could she? If you find yourself wondering what your teen was thinking, the answer may be "not much." Kids often make snap judgments based on impulse, especially when situations come up quickly, leaving teens with little time to sort through the pros and cons. Some of those hasty decisions may involve cheating in school; skipping class; using alcohol, tobacco, or illegal drugs; going somewhere or being with someone that you do not approve of; or driving too fast. But the consequences can include losing your trust, letting down friends, getting into trouble, hurting education and job prospects, causing illness or injury, or leading to other reckless behavior. Explaining Bad Decisions As for how he could do it, here are some common efforts to justify missteps: Because I wanted to. Enough said-this only works if you are alone on an island with no rules and only yourself to consider. Everybody does it. People often try to duck responsibility by showing that their actions-drinking alcohol, staying out too late, or sharing test questions-are in line with the values and likings of their social group. What else could I do? This excuse is a sign of failure to see all the available choices, such as leaving the party or not riding with a certain person. But I said I would. Once people decide on something, they tend to stick with it-keeping a date, hosting a party, bringing alcohol. No one likes to admit they're wrong, appear timid, or disappoint others.

Building a Foundation

To avoid decisions that are rushed and based on little more than a desire for fun and peer approval, teens need a solid basis for making wise choices. Setting Standards The first step a teen can take toward good decisions is to know herself. This calls for a set of rules about what she is willing or not willing to do. If her rules apply to a situation, then the decision will be automatic. Parents can show the way to good conduct through example and by promoting values-explaining them and showing how they fit specific choices. Starting early ensures that standards have deep roots, but it is never too late to lay out a guide for conduct. Developing Confidence When teens-or adults-are unsure of themselves, they are more likely to give in to social pressure. When a teen feels good about himself, it improves the odds that he will make good decisions. Parents can build teens' self-confidence by teaching them to think for themselves. Ask your teen for his opinion, even about small issues. Urge him to make decisions. Praise him for positive choices, and let him know that you appreciate him and his achievements. Expose him to activities, people, places, and ideas-doing so will broaden his outlook and help to limit the influence of peers. The likely result is a teen who doesn't worry about what others say, thinks things through, and chooses wisely. Asking Questions Even when a teen has personal rules, some choices may not be clear-cut. She may be torn by wanting to keep a promise or help a friend, or she may be tempted to make an exception because her actions seem like they won't be so bad. A few handy questions can cut through the fog of doubt. What's the Downside? Rewards such as fun, excitement, popularity, and asserting one's freedom are easy to see, but getting teens to focus on risks can be tough. Teens tend to think bad things can't happen to them. When teens do see risks, they may feel that the chances of getting caught or harmed are small. Because teens are "now-oriented," far-off consequences may carry little weight. So highlight 1) bad things that can happen right away and 2) things that teens dread such as looking foolish, smelling bad, losing friends, missing out on social events, and not being able to drive.

Teen Warning Signs

The teen years can be tough for both parent and child. Adolescents are under stress to be liked, do well in school, get along with their family and make important life decisions. Most of these pressures are unavoidable and worrying about them is natural. But if your teen: is feeling extremely sad, hopeless or worthless, these could be warning signs of a mental health problem. Mental health problems are real, painful and can be severe. They can lead to school failure, loss of friends, or family conflict. Some of the signs that may point to a possible problem are listed below. If you are a Parent or other caregiver of a teenager, pay attention if your teen: Is troubled by feeling: very angry most of the time, cries a lot or overreacts to things; worthless or guilty a lot; anxious or worried a lot more than other young people; grief for a long time after a loss or death; extremely fearful-has unexplained fears or more fears than most kids; constantly concerned about physical problems or appearance; frightened that his or her mind is controlled or is out of control. Experiences big changes, for example: does much worse in school; loses interest in things usually enjoyed; has unexplained changes in sleeping or eating habits; avoids friends or family and wants to be alone all the time; daydreams too much and can't get things done; feels life is too hard to handle or talks about suicide; hears voices that cannot be explained. Is limited by: poor concentration; can't make decisions; inability to sit still or focus attention; worry about being harmed, hurting others, or about doing something "bad"; the need to wash, clean things, or perform certain routines dozens of times a day; thoughts that race almost too fast to follow; persistent nightmares. Behaves in ways that cause problems, for-example: uses alcohol or other drugs; eats large amounts of food and then forces vomiting, abuses laxatives, or takes enemas to avoid weight-'gain; continues to diet or exercise obsessively although bone-thin; often hurts other people, destroys property, or breaks the law; does things that can be life threatening. To find help, discuss your concerns with your teen's teacher, school counselor or others such as a family doctor, psychiatrist, psychologist, social worker, religious counselor or nurse.

A Paradigm Shift From Lines To Circles: Twelve Characteristics of a Family System

1. Organized around interactions and within a hierarchy of interrelated subsystems. In the family, the executive subsystem is that of the parents; the sibling subsystem is that of the children. Invisible boundaries--unspoken rules about who does what with whom--are drawn around each (and around the immediate family itself) so that each subsystem can carry out its family-stabilizing tasks while remaining connected to the others. One of the most common family problems is a weak boundary between subsystems. A woman making several calls a day from work to instruct her teenagers on how to dress for school, what to say when they turn in homework, and so forth indicates overinvolvement with the sibling subsystem; a man who calls or visits his mother every time he argues with his wife shows a weak boundary between the immediate and extended families.

2. Wholeness: the system is greater than sum of the parts. In therapy it's quite common to see, say, a little boy suddenly make everyone laugh at precisely the moment the therapist is asking the uncomfortable parents how their marriage is going. Without knowing it, the boy, usually prompted by some subtle signal from his parents, protects the family by taking the heat off them and their fragile relationship. The therapist, seeing the family operating as a whole (self-preservation through distraction) rather than as isolated individuals (Mom, Dad, the son), might then comment on the behavior and praise the family for being so resonant and close-knit.

3. Each part of the system affects all others. I've never seen a family with an alcoholic member, but I have seen alcoholic families in which the member who drinks controls the whole family with his behavior. His unavailability, bad health, violence, unpredictability, and self-contempt distort every interaction between family members. The whole family learns to (mal)adapt itself to his drinking--via maneuvers like denial, bailing him out of jail if he drinks and drives, calling in sick for him if he's hung over, walking carefully when he's drunk and angry, unconsciously nominating one child to stand in for him and parent the family...Family therapists use the term IP--Identified Patient--because a dysfunctional family member generally means a destabilizingd family system.

4. Interrelations emphasized more than components; systemwide ripples ("these cause each other") emphasized more than linearity (this causes that). Whatever its components, unresolved stress between parents reverberates down through all family interrelations and normally results in coalitions, emotional parent-child alignments against the other parent and perhaps other children. Example: Mom is a rageaholic, so when she explodes, Dad and Brother console one another and perhaps agree that she's nuts. A linear approach would emphasize Mom's upbringing and lack of anger management skills and thereby ignore the coalition process itself and reinforce its tendency to scapegoat, whereas a systems approach would focus on the present-time context of Mom's explosions, looking at the interractions leading up to it and encouraging Dad and Mom to work out new, nonescalating ways to talk and negotiate--perhaps in couples therapy--rather than blaming her or him or failing to confront and defuse alliances forming elsewhere in the family.

5. Circular (mutual, reciprocal) causality: emphasizes present, process. Linear causality: emphasizes past, content. When a couple in session argues about how it started, I let them know I'm more interested in where it's going: "How will you resolve this here?" With many alcoholics, inherited biology and family stress and low self-esteem and other dynamics all play a part; what counts for the alcoholic isn't looking for causes so much as cutting the feedback circles that maintain drinking. A good clinician will refer the client to AA, consider hospitalization, assess for suicidal intent, advise a physical, ask about weapons in the home, and work on both family and individual levels with interventions aimed at interactions (arguments, nagging, money problems, abuse) that presently maintain the alcoholism.

6. Calibration: setting of a present-oriented, systemwide range limit around a comfortable emotional "bias." A typical situation: an unintense family with a cool emotional atmosphere unconsciously selects a member to turn up the heat; brother and sister start fighting. This turns into an argument between the parents, the drama escalates, and then, before it gets too hot, a child who plays the role of family ambassador calms everybody down. In that family the bias, the emotional level setting, is too low; a good dose of constructive intensity might recalibrate the bias and make explosions unnecessary.

7. Self-regulating via feedback loops--negative (toward stability) and positive (toward change)--that maintain the bias. Every seasoned drug and alcohol counselor knows that when one member of the family stops drinking or using, the family will subtly try to push him back into his old vices--not because they want him sick, but because families, like other organisms, naturally resist changes that might further destabilize the system. So one day the husband says to his abstaining wife, "Why not skip your AA meeting tonight so we can catch a movie?" Or the mother of a teen who's quit using congratulates him on finding a job--in a head shop. Introducing positive (= system-changing) feedback loops into these families might include warning them about enabling, relapses and resistance to change and examining what family members gain from having a malfunctioning member (control? A scapegoat? Distraction from other conflicts? Someone to rescue?).

8. Synergy: interractions and feedback loops add to each other as they combine (a dynamic expression of wholeness). Battery normally begins with emotional or verbal abuse (name-calling, shouting, intimidation, shaming) and escalates over the years from pushing and shoving to beatings and even murder. Abuse gives rise to more abuse, violence to more violence: destructive synergy. In constructive synergy, however, a batterer uses a batterer's group to learn and master rage-control techniques; those enhance his self-esteem; his wife praises his efforts and trusts him more; he feels good about that and shows her more empathy; the two get problems out on the table instead of hiding them; both grow; their affection deepens; their children carry the resulting relationship blueprint into their own relationships. Therapists prime this process by helping clients consciously relate and capitalize on growth-producing thoughts, feelings, and interactions ("Now that you stopped drinking, he feels safer telling you about his sadness; you empathized, so he is listening to you more often and with greater care...good work! How will you keep this rolling?")

9. Equipotentiality ("equal in the beginning"): things with the same original conditions can go different ways; members of the same family system can share a very similar upbringing but turn out to be very unlike each other. Even twins eventually take different roads, grow into individuals with their own insights and values, habits and preferences. Consciousness guarantees that what we choose to make of our original conditions is more important than the conditions themselves. The abuse survivor who owns the pain moves on; the one who won't becomes a chronic victim and will probably get into revictimizing situations. Therapists who realize this assume that a client can and should take full responsibility for the work of healing no matter how dangerous or abusive that client's environment may have been.

10. Equifinality (equal in the end): things with different original conditions can turn out the same. I'm an adoptee who grew up with one sister and Lutheran parents, still together, of North European descent; the man who mentors my work with batterers wasn't adopted and grew up with a brother and Catholic parents, both Italian, who divorced; and yet our values, professional goals, criticisms of traditional therapy, and counseling philosophy are very similar and in all important points the same. When I work with clients, I never assume that a violent survivor who grew up in South Central L.A. will be less serious about growth and change or less capable of working toward it than a more "adjusted" client raised in a good home by loving parents. In the end, we are what we make of what we were given.

11. Living systems and all they bring with them--equipotentiality, equifinality, wholeness, feedback loops, and all the other system-enhancing processes--move forward through key "horizontal" (brought about by time and change) transitional stages. Symptoms occur when vertical stressors (old issues, past mistakes, emotional legacies) impinge on the system during a transition. Families are likeliest to be conflicted and symptomatic when key horizontal transitions like marriage, the birth of children, children going to school, children moving away from home, changes of jobs, etc. coincide with a resurfacing of vertical stressors like old emotional baggage. Example: a workaholic husband driven to succeed by high internalized standards (Rogers's "conditions of worth") that equate esteem with production (vertical stressor) puts in even more overtime to stuff the loneliness he feels when his eldest son leaves for college (horizontal stressor). Worried about his health, escalating stress, and increasing distance from her, his wife suggests that they see a family therapist. Part of the therapeutic agenda would include giving the family tools for negotiating the "empty nest syndrome" while helping the husband get in touch with his mourning, examine his expectations of himself, and reconnect with his family.

12. First-order changes are those that help the system stay at its current level of functioning. Second-order changes restructure the system to bring it to a different level. Teaching family members how to use "I" statements and listen empathically demonstrate first-order changes that enhance the family's current functioning. Coaching a widow through the loss of her husband, helping a couple let go of the last child to leave the nest, and restructuring an alcoholic family to eliminate drinking are second-order changes that alter the family fundamentally, bringing it to an entirely new structure and psychological place.

13. Overall, human systems tend to work best when subsystem boundaries are clear (neither too open nor too closed), interactions are clear and nonrepetitive, lines of authority are visible, rules are overt and flexible, changing alignments replace rigid coalitions, and stressors are confronted instead of pushed onto scapegoats. Yes, there really are families--and extended families and neighborhoods and even companies--that work this way: members are clear about what to expect from one another and neither intrude nor distance themselves, they speak openly and affectionately to one another, they know who's in charge of what, they know and can talk about what is permitted and what isn't, their roles and favorites are flexible and changing, and they feel comfortable and safe getting problems and hurt feelings out in the open where everyone can work on them. When enough families succeed at this, perhaps the systemic impact on whole nations will become irresistible. As Confucius noted long ago:

If there be righteousness in the heart, there will be beauty in the character. If there be beauty in the character, there will be harmony in the home. If there be harmony in the home, there will be order in the nation. If there be order in the nation, there will be peace in the world.

Three Blended Family Problems

Conflicts for blended families fall in six different categories. If you enter the "state of blended-family-parenthood" without prior discussion, planning and agreement with your spouse-to-be, you will certainly be caught by one or more of these conflicts. And, frankly, even the best planned, discussed, and agreed-upon-in-advance blueprints will meet with some problems such as the six discussed below. It's the nature of the beast: blended family!

1. Unrealistic expectations of marriage.
Belief that romance will conquer all.
Belief that marriage will "jumpstart" his/her life.
Belief being married will solve all problems, including loneliness.
Belief that life will continue to be like the courtship phase was.
Belief that romance will stay alive in a marriage unaided, or even with lots of help.

2. Unrealistic expectations of a blended family.
Belief that a blended family will be immediately loving: the instant family myth.
Belief that stepchildren will love you.
Belief that the stepchildren will respect and/or obey you.
Belief that a blended family will be like a nuclear family.
Belief that the biological parent, your spouse, will support you in ways that are not happening.
Belief that the biological parent, your spouse, will see your side.
Belief that the biological parent, your spouse, will intuitively know what you want--that he/she can read minds.
Belief that the stepchildren will be fair to you.
Belief that the stepchildren can think like adults.
Belief that the biological parent, your spouse, will want to function as a team.

3. One spouse is not involved in the care of his/her children.
One partner, say dad, seemed very involved with this children while the couple were dating. After marriage, however, Dad seems to forget about the children. Stepmom takes on most of the care. In fact, Dad and the world seem to expect that this will be the case.
One partner, say mom, turns over the care of her boys to stepdad or vice-versa.
One partner wants authority without involvement.

Child and Adolescent Mental Health

Mental Health Is Important
Mental health is how people think, feel, and act as they face life's situations. It affects how people handle stress, relate to one another, and make decisions. Mental health influences the ways individuals look at themselves, their lives, and others in their lives. Like physical health, mental health is important at every stage of life. All aspects of our lives are affected by our mental health. Caring for and protecting our children is an obligation and is critical to their daily lives and their independence.

Children and Adolescents Can Have Serious Mental Health Problems

Like adults, children and adolescents can have mental health disorders that interfere with the way they think, feel, and act. When untreated, mental health disorders can lead to school failure, family conflicts, drug abuse, violence, and even suicide. Untreated mental health disorders can be very costly to families, communities, and the health care system.

Mental Health Disorders Are More Common in Young People than Many Realize Studies show that at least one in five children and adolescents have a mental health disorder. At least one in 10, or about 6 million people, have a serious emotional disturbance.¹ The Causes Are Complicated Mental health disorders in children and adolescents are caused mostly by biology and environment. Examples of biological causes are genetics, chemical imbalances in the body, or damage to the central nervous system, such as a head injury. Many environmental factors also put young people at risk for developing mental health disorders. Examples include: Exposure to environmental toxins, such as high levels of lead; Exposure to violence, such as witnessing or being the victim of physical or sexual abuse, drive-by shootings, muggings, or other disasters; Stress related to chronic poverty, discrimination, or other serious hardships; and The loss of important people through death, divorce, or broken relationships. Signs of Mental Health Disorders Can Signal a Need for Help Children and adolescents with mental health issues need to get help as soon as possible. A variety of signs may point to mental health disorders or serious emotional disturbances in children or adolescents. Pay attention if a child or adolescent you know has any of these warning signs: A child or adolescent is troubled by feeling: Sad and hopeless for no reason, and these feelings do not go away. Very angry most of the time and crying a lot or overreacting to things. Worthless or guilty often. Anxious or worried often. Unable to get over a loss or death of someone important. Extremely fearful or having unexplained fears. Constantly concerned about physical problems or physical appearance. Frightened that his or her mind either is controlled or is out of control. A child or adolescent experiences big changes, such as: Showing declining performance in school. Losing interest in things once enjoyed. Experiencing unexplained changes in sleeping or eating patterns. Avoiding friends or family and wanting to be alone all the time. Daydreaming too much and not completing tasks. Feeling life is too hard to handle. Hearing voices that cannot be explained. Experiencing suicidal thoughts. A child or adolescent experiences: Poor concentration and is unable to think straight or make up his or her mind. An inability to sit still or focus attention. Worry about being harmed, hurting others, or doing something "bad". A need to wash, clean things, or perform certain routines hundreds of times a day, in order to avoid an unsubstantiated danger. Racing thoughts that are almost too fast to follow. Persistent nightmares. A child or adolescent behaves in ways that cause problems, such as: Using alcohol or other drugs. Eating large amounts of food and then purging, or abusing laxatives, to avoid weight gain. Dieting and/or exercising obsessively. Violating the rights of others or constantly breaking the law without regard for other people. Setting fires. Doing things that can be life threatening. Killing animals.

Parental Stress

Rearing happy well-adjusted children is quite an accomplishment for any parent. Knowing that you are effective with your children and can meet their needs contributes to parents' feelings of satisfaction. Hard work, responsibility, demands for time and attention are also part of parenting. This is the part of parenting that causes stress to mount and makes us feel caught and sometimes overwhelmed by demands constantly made upon us. The demands of a child are especially strenuous on new parents. It's a terrific adjustment to bring a baby home from the hospital and begin to take care of it. A new parent may feel particularly worried and unsure. It's as if society suddenly says, "You're a parent now. We haven't told you much about how to parent but go to it and do the best you can." Most jobs require a training period to acquaint you with new job responsibilities. But for the job of parenting, little education is available. Parental uncertainty doesn't necessarily disappear as children grow. Just as we learn what to expect of an infant, the child becomes a toddler. Parental stress may increase if parents are unable to change their expectations and demands as children grow. Children change the most rapidly during the first two years of life and as they reach adolescence. Therefore parents may experience high levels of stress during these time periods unless they learn to adjust to a changing child. Parents need to realize that they are not magically equipped with "parental love" or a "mothering instinct" which enables them to automatically love and care for babies and children. It takes time, patience, experience, and effort to build a positive parent-child relationship and become an effective parent. In addition to feeling inadequate about how to parent, mothers and fathers may sometimes be bothered by feelings of resentment. No one ever told you it would be like this. Taking care of children demands so much time and energy that it's not always possible to do some of the other things that are important to you. Interruptions come at the most inconvenient times. No matter how tired or ill you feel, children's needs must be met. These feelings of resentment and anxiety are entirely normal. However, we must take care not to take them out on our children. When we begin to blame our children for our problems, it is time to seek help and make some changes in our lives. When the pressures of parenting become great, they can cause us to overreact. Sometimes pressures are self-imposed because we try to run such a tight ship that neither we nor our children can relax. When you feel uptight with your children, ask yourself: Do I expect too much -- must they always stay clean, keep their room spic and span, stay quiet, or meet my demands immediately? Can they do it their way sometimes? Does it really matter or must it always be my way? Do they always have to act like adults? Why can't I let them be children? Have I talked to anyone about my feelings? Have I talked to the children about theirs? It is important for parents to sometimes make changes in order to cope with the daily demands of being a parent. Sometimes it helps to relieve tension when you: Talk to friends or spouse about your frustrations. Tell your children what makes you angry and what behavior the child needs to change to reduce your anger. Leave the room for a short time when you are losing control. You can deal more effectively with children and situations when you have time to collect your thoughts and calm down. If you are a new parent, have a relative, friend or paid help come in for the first few weeks. Take some time for yourself when children are sleeping. Relax and forget what you should be doing. Stress and strain are not conducive to good parenting. All of us need to find a way to relieve pressure, so it is not taken out on our children. When things are going well, parenting can be a satisfactory experience. It's important that you share your positive feelings with your children, too. Let them know that you feel good about the way the day is going. Tell them when their behavior is making you happy. Make sure they know you appreciate the good things they do. Say thank you and remember to treat yourself and your children to something special when they are doing well.

Comprehensive Services through Systems of Care Can Help

Some children diagnosed with severe mental health disorders may be eligible for comprehensive and community-based services through systems of care. Systems of care help children with serious emotional disturbances and their families cope with the challenges of difficult mental, emotional, or behavioral problems. To learn more about systems of care, call the National Mental Health Information Center at 1-800-789-2647, and request fact sheets on systems of care and serious emotional disturbances, or visit the Center's web site at http://mentalhealth.samhsa.gov Finding the Right Services Is Critical To find the right services for their children, families can do the following: Get accurate information from hotlines, libraries, or other sources. Seek referrals from professionals. Ask questions about treatments and services. Talk to other families in their communities. Find family network organizations. It is critical that people who are not satisfied with the mental health care they receive discuss their concerns with providers, ask for information, and seek help from other sources. Important Messages About Child and Adolescent Mental Health: Every child's mental health is important. Many children have mental health problems. These problems are real, painful, and can be severe. Mental health problems can be recognized and treated. Caring families and communities working together can help. Information is available; call 1-800-789-2647.

Overall stress and hurrying
Trying to take on too much
Money management and income
Mental Illness in general
Impulse-control disorders
Divorce and separation
Underage drinking

Impulse-control disorders:
Intermittent Explosive Disorder