The family

The family only represents one aspect, however important an aspect, of a human being's functions and activities—A life is beautiful and ideal, or the reverse, only when we have taken into our consideration the social as well as the family relationship.

Havelock Ellis 1922

Little Essays of Love and Virtue

Working with families is the basis of family practice. Families living in relative harmony provide the basis for the good mental health of their members and also for social stability. However, the traditional concept of the nuclear family where the wife stays at home to care for the children occurs in only about 15% of Australian families, and approximately 40% of Australian marriages end in separation. This results in many psychosocial problems that family doctors will have to address.

Family therapy is ideally undertaken by general practitioners, who are in a unique position as providers of continuing care and family care. It is important for them to work together with families in the counselling process and to avoid the common pitfalls of working in isolation and assuming personal responsibility for changing the family. Bader 1 summarises working with families succinctly:

From the perspective of family therapy, working with families means avoiding the trap of being too directive, too responsible for the family's welfare, with the result that the family becomes overly dependent on the general practitioner for its health and development. From the perspective of family education, working with families means developing the skills of anticipating guidance, helping families to prepare, not only for the normal changes occurring as the family develops, but also for the impact of illness on the family system.

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