Mastering Family Challenges in Serious Illness and Disability

Mastering Family Challenges in Serious Illness and Disability

Medical Family Therapy & Behavioral Health Consultations

Serious illness and disability are among the greatest challenges families face. Ever-growing numbers of families are living with multiple chronic conditions over an increasingly longer life span. Nearly 50 percent of adult Americans have at least one chronic illness. A biopsychosocial-family-systems approach results in better health outcomes, more efficient use of resources and increased patient satisfaction.

When a family member develops a serious, chronic or potentially life-shortening illness or disability, the entire family system is impacted leaving no member untouched. Relational, psychological, emotional, and spiritual issues impact the patient, his/her spouse or partner, and the family as a whole. The psychosocial strains on the family can rival the physical strains on the patient. John Rolland in conceptualizing the Family Systems – Illness Model which describes the interaction between developmental phases of the family career and characteristics of the illness (onset, course, outcome and incapacitation) has stated; “Conventional treatments of serious illness may save the patient but cause irreparable harm to the family unit.”

When one member of a family is sick, the entire family is destabilized. Despair, helplessness, hopelessness, confusion, subjective incompetence and a sense of isolation cause both the patient and the family to withdraw from the challenges of illness management and adaptation. Emotional upheavals, the shock of diagnostic reports and lifestyle changes create tremendous resistance to treatment. All family members may find themselves on an “emotional roller coaster”. Shame, anger, guilt, burnout, and isolation can undermine family functioning just when the members need each other the most.

Medical family therapy is a way to help families through the emotional process. Medical Family Therapists work with individuals, couples, and families to address the psychological, emotional, and social/relational difficulties that often accompany the diagnosis, treatment and course of illness. Medical family therapists collaborate with physicians and other health care providers to improve their relationships with patients and their families and provide them with a comprehensive, integrative approach to health care. Focusing on strengths and resilience, Medical Family Therapists provide psychoeducation and support, enhance communication and adaptation, and work to increase the family’s sense of agency and communion.

Ronald Cohen, MD of discusses how the whole family is disrupted when one member becomes seriously ill.Regaining health is a cooperative effort. Medical family therapy offers patients and their families the opportunity to communicate accurately among themselves, express feelings, coordinate efforts, and delegate tasks. Close attention is paid to the role that medical illness plays in the life of the patient and in couple and family relationships. With chronic disorders, an overarching family goal is to deal with the developmental demands of the illness without family members sacrificing their own or the family’s development as a system over time.

Please feel free to ask any questions or to comment in the “Leave a Reply” box below. To request more information and/or schedule an initial consultation click here (

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Ronald B Cohen, MD, PC Ronald B. Cohen, MD
Bowen Family Systems Coach
1 Barstow Road, Suite P-10
Great Neck, NY 11021
(516) 466-7530
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  1. Jessica Jensen on October 8, 2012 at 6:33 pm said:

    This is a very interesting article. I am a newly graduated Mental Health Counselor (license eligible) and I am currently looking for work. I would love to get involved in this sort of work- counseling families of a member with a serious illness or disability. What route would you suggest I take?

    Thank you,


  2. Laura Nolan on July 23, 2015 at 3:15 pm said:

    It is in the midst of the crisis of a disability or illness that a family member does not have too many options to turn to. The family is taxed financially, with time constraints, limited options, emotionally taxing conditions, and with apparently too much at stake to actually do what it takes to care for one’s self or be able to afford help. How does one find the balance between caring for the current issue and for preserving one’s own health?

    Then there are those with long-term disabilities that can last a lifetime or at least the end of one’s life that drain the whole family. How can a family in such a circumstances approach their situation in a way that brings health, growth, and maturity? There is no doubt that it is hard, but I have learned that in all my struggles, if I approach it with the right attitude and faith, I end up better off and more mature than if I had not faced the situation.

    Ron, what kinds of insights can you give about these things?

    Laura Nolan

    • Ronald B Cohen, MD on August 24, 2015 at 4:50 pm said:

      Hi Laura,

      Families and individuals living with severe, chronic, potentially life-shortening illnesses or disability often have multiple, complex, and interrelated problems that emerge as part of the underlying disease processes. These issues impact their sense of personhood, diminish their sense of wellbeing, and impair their ability to realize their full potential.

      Medical Family Therapy, the aims of which are to improve function and quality of life, manage symptoms, focus on psychosocial aspects of care, and coordinate among myriad physicians and other care providers, helps patients and families maintain their dignity while achieving as much comfort and peace of mind as possible.

      As families often fail one another in important and painful ways, they can all benefit from relational therapy. A family-resilience approach helps foster positive adaptation within the context of significant adversity so families can acknowledge suffering, restore dignity, recover and grow. The process engages distressed families with compassion and respect to enhance their best qualities and reparative potential thereby helping families emerge strengthened, more resourceful, able to love fully and raise their children well. A positive outlook, hope, optimism, mutual support, empathy and collaborative problem solving expand the universe of accomplishable positive outcomes. When the entire family works to make the difficult journey together, the results are almost magical.


      — Ron

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