Developing a Systems Model for Family Assessment
Daniel V. Papero, PhD, MSSW
In personal conversations, Murray Bowen often floated the idea of a system of family diagnosis or assessment. He believed that it would be possible to create a family diagnostic system that could be used alongside or even in place of the DSM. In the book Family Evaluation, Michael Kerr proposed a general schema for such an assessment. Although several attempts have been made to informally follow the Kerr proposal, none has been extensively tested and validated.
In 2011-2012, the NIMH began development of the Research Domain Criteria (RDoC), “…a research framework designed for studying the full range of human behavior from normal to abnormal based on biology, behavior, and context.” (NIMH RDoC Publications accessed September 28, 2017) The RDoC moves away from the categorical classification model of the DStM to a dimensional or continuum model. It currently comprises five domains, or areas of functional continua, and proposes two additional ones. The current domains are: (1) negative valence systems, (2) positive valence systems, (3) cognitive systems, (4) systems for social processes and, (5) arousal/modulatory systems. Two proposed additional domains include neurodevelopment and environment.
The RDoC use of dimensions led the author to consider a new approach to family assessment that differs from the Kerr model. Beginning with Bowen’s conceptualization of the family as a system and his focus on the functioning of that system as it faces adaptive challenges and the accompanying anxiety and stress, it becomes possible to develop a dimensional model of family system functioning. That model includes five dimensions ranging from optimal to dysfunctional: resourcefulness, tension management, connectedness and integration, systems thinking, and goal structure. At this point, a systems model for assessing family functioning remains a preliminary proposed schema. Further development will require the creation of a working group to develop, refine, and test the sub-dimensions within each domain, a process not yet begun.