Dysfunctional Family Processes Nursing Diagnosis and Nursing Care Plan

Dysfunctional Family Processes Nursing Care Plans Diagnosis and Interventions

Dysfunctional Family Processes NCLEX Review and Nursing Care Plans

Dysfunctional Family Processes is a nursing diagnosis that refers to the family’s inability to function due to multiple internal conflicts.

There are many instances of abuse, concealment, and apathy or denial in this setting. Children’s emotional needs are overlooked in these situations because the parent’s needs/demands hold priority.

Signs and Symptoms of a Dysfunctional Family

• ineffective communication
• verbal or physical abuse
• reversal of roles (parentification)
• rejection
• hopelessness
• lack of identity
• absence of parental-child boundaries
• dependency
• alcohol abuse
• incapacity to express and accept a wide variety of emotions
• agitation
• isolation
• self-blame
• conflicts over communication or control
• unresolved grief
• prolonged resentment
• anger
• unhappiness
• guilt

Types of Dysfunctional Family

• Pathological Family. This type of dysfunctional unit is represented by either parent’s substance abuse, alcoholism, or mental illness, often leading to dysfunctional children since they are deprived of even the most basic bodily and mental necessities. Reversed family roles are common in this setting. And because of their dysfunctional parents, children are more in charge of their daily life.
• Chronic Conflict Family. When family members are constantly arguing, the situation can become extremely stressful for everyone. As a result of these poor encounters, family conflicts may implode.
• Chaotic Family. Parental neglect and abuse are common in a chaotic family setting. These families are characterized by a lack of consistency. When it comes to family dynamics, it can be challenging to identify what is expected of everyone when parents come and leave on a regular basis. When they are present, their parenting abilities are inadequate, or they are the ones who cause harm to the children. Children who have witnessed domestic abuse may also suffer the same devastation as those who have been abused themselves. Childhood trauma and neglect can alter the developing brain, placing children at risk of developing mental health problems and substance dependence.
• Dominant-Submissive Family. These families, also known as authoritarian families, are governed by an authoritarian parent who has no respect for the opinions or feelings of others in the family. Depending on the severity, punishment for mistakes might involve scolding, spanking, or any other type of physical discipline. As tyrants, parents impose their will on their children with very little regard for their well-being and create the rules in accordance with their views.
• Emotionally Detached Family. Marked by a lack of affection and warmth, this type of dysfunctional family is frequently associated with a person’s social position or cultural upbringing. These are families that don’t talk about feelings. Children learn to suppress their feelings due to parental indifference and lack of empathy. This can lead to a string of failed relationships since they are unable to open up to others. Additional implications include feelings of unworthiness, fear of abandonment, academic difficulties, and psychological difficulties (personality disorders).

Dysfunctional Family Roles

• Enabler. This codependent role is also termed “the caretaker .” The enabler of the family is the individual who strives to keep the family together despite its dysfunction. This role can be taken on by a child (acting as a surrogate parent), especially if the parent or caretaker is exhibiting troubling behavior (e.g., mental illness, substance abuse, instability). Parentification occurs when a child assumes parental responsibilities such as housekeeping, meal preparation, or the care of a younger sibling. By taking on the role of enabler, the family is spared from going into conflict or crisis since he/she is there to shield and cover up dysfunctional conduct.

• Mastermind. The opportunist child exploits the family’s dysfunction to achieve what they want.
• Hero. Like the caretaker or enabler, the family hero typically assumes responsibility for making it appear as though the family looks normal or without problems. They often mask the inner struggles to make up for the dysfunctional home life. In many cases, they are the only ones in the family who have a deeper knowledge of the family dynamics (or what goes behind closed doors), yet no matter how hard they try, no one else will listen. Extremely self-sufficient and responsible, the hero is frequently a perfectionist, an overachiever, or someone who appears to have it all. They must continually demonstrate their strength of character to succeed.
• Mascot. In a way, the mascot serves as a comical member of the family. To cope with or distract from the stresses of family life, they often resort to humor and mischief. They are referred to as the cute ones or the jester and frequently strive to be the family’s center of attention, frequently entertaining them to make everyone feel better.

A toddler who feels helpless in the face of family conflict, violence, or other unpleasant dynamics may attempt to diffuse the situation by stepping in. However, the clowning of a mascot is only a temporary consolation. In the long run, they may develop anxiety or depression. Mascots are more likely to be involved in abusive relationships in an effort to save the other person.

• Lost Child. This person (also referred to as the quiet one) usually prefers to maintain a low profile and spend their time alone and away from their dysfunctional family. They are better described as being invisible or loners since they try to make themselves appear little and quiet as much as possible. Moreover, they deliberately avoid conflict in order to keep the peace. Thus, their needs are frequently overlooked or ignored.

• Scapegoat. As the family’s “black sheep” or “problem child,” the scapegoat is the one who is blamed for any misbehavior. This family member causes trouble and appears to be stubborn, unfriendly, and angry due to the child’s choice to portray the rebellious character. Often, the scapegoat is the person who talks about or acts out the problem that the family is attempting to conceal.

Since violence is their sole way of communicating, they usually find themselves in trouble at school. The defiant child and the weak child are both subtypes of this group, where the former is more likely to engage in conflict and self-destructive behavior. Parents who single out and criticize their children in a way that resembles bullying may be to blame for this personification.

Related Factors to Dysfunctional Family Processes

• Economically marginalized families
• Substance abuse in the family
• Lack of problem-solving skills
• Intimacy dysfunction
• Family history or genetic predisposition to substance misuse

Treatment for Dysfunctional Family Processes

Being aware that one’s family is dysfunctional can be helpful, but it isn’t enough to break the cycle.

• Individual therapy
• Group therapy. Learn healthy strategies to express feelings and connect with people. Explore new ways of relating in a group setting.
• Recovery program. Provides direction, coaching, and support for individuals undergoing recovery. Support services are developed and implemented by peers who have faced and overcome the same experience (substance dependence).
• Family therapy

Prevention of Dysfunctional Family Processes

• Recognize dysfunctional family patterns and allow time for reflection
• Refuse to be a part of a toxic environment
• Stay informed about dysfunctional families
• Establish a new support system

Dysfunctional Family Scenarios

• Addiction. This scenario comes in two circumstances:

(1) Having an affair. For example, a husband takes advantage of his wife’s late-night shifts to fulfill his fantasies. These extramarital affairs may result in a child being born.

• Control. A spouse explicitly prohibits his wife from socializing with male acquaintances or coworkers outside of the workplace. Emotionally manipulating her into feeling bad every time she joins for lunch, dinner, break, or happy hour may result in her agreeing to discontinue attendance.
• Perfectionism. Parents expect their children to earn straight A’s in school, participate in at least two extracurricular activities, and volunteer at least once a week for a local charity.
• Lack of diversity. Following in the footsteps of a family member, like being a lawyer or a physician, and trying to keep the family’s legacy alive.
• Conflict. Bickering over what to eat for supper, what to watch on television, and where to go on a holiday.
• Abuse. Resorting to physical and verbal abuse as a form of punishment, such as hitting the child when the mother/father is drunk.
• Poor communication. Refusing to acknowledge or express one’s emotions (isolation). Putting up a brave face in front of others. Ignoring and blaming negative feelings.
• Fear. The wife/mother becomes physically aggressive if something triggers her. Her anger outbursts make children feel terrified and unsafe.

Dysfunctional Family Processes Nursing Diagnosis

Nursing Care Plan for Dysfunctional Family Processes 1

Nursing Diagnosis: Dysfunctional Family Processes related to a change in the patient’s health status secondary to bipolar disorder, as evidenced by alteration of communication patterns, problem-solving participation, and incapacity to cope with the crisis.

• Family members and significant others will actively communicate their need for support and information.
• Family and significant others will demonstrate a better understanding of the condition by attending bipolar support groups.

Nursing Care Plan for Dysfunctional Family Processes 2

Perinatal Loss

Nursing Diagnosis: Dysfunctional Family Processes related to loss of a child secondary to perinatal loss.

Desired Outcome: The family members will take an active role in resolving the crisis and demonstrate personal involvement in their care.

Nursing Care Plan for Dysfunctional Family Processes 3

Substance Abuse

Nursing Diagnosis: Dysfunctional Family Processes related to a genetic predisposition to addictions secondary to substance abuse, as evidenced by anger, disturbed family dynamics, impaired communication, refusal to get help, and dependency.

• The family will communicate awareness of the dynamics of enabling behaviors.
• The family will reduce self-destructive behavior and partake in individual family programs.

Nursing Care Plan for Dysfunctional Family Processes 4

Nursing Diagnosis: Dysfunctional family processes related to a change in the patient’s health status secondary to schizophrenia, as evidenced by refusal to engage in decision-making, alteration of stress-reduction behaviors, lack of awareness about the condition, and community support groups, and alteration of mutual support.

Desired Outcome: The family and significant others will be involved in the discharge planning process and will attend at least one family support group.

Nursing Care Plan for Dysfunctional Family Processes 5

Eating Disorders (Anorexia and Bulimia)

Nursing Diagnosis: Dysfunctional family processes related to situational crisis, secondary to eating disorders (Anorexia and Bulimia), as evidenced by unmet familial obligations, unclear family rules and functions, and discord amongst family members.

Desired Outcome: The family and significant others will be involved in the discharge planning process and will attend at least one family support group.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon

Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon

Disclaimer:

Please follow your facilities guidelines, policies, and procedures.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

Anna Curran. RN-BC, BSN, PHN, CMSRN I am a Critical Care ER nurse. I have been in this field for over 30 years. I also began teaching BSN and LVN students and found that by writing additional study guides helped their knowledge base, especially when it was time to take the NCLEX examinations.