Formulating a Developmental Approach to Crisis Management for Families of People with ASD and Schizophrenia

For all families, developmental changes require greater family flexibility and add to the level of complexity within the family. Normative changes, such as those associated with adolescent development, can precipitate significant family stress. For those families who are also facing the challenges of a family member's disability and/or the emergence of a serious mental illness such as schizophrenia, normative developmental stressors can be exacerbated. An increase in family stress can trigger family crises, including episodes of family violence. When episodes of family violence do occur, it can be difficult for families to respond effectively for many reasons including a stigma associated with a family member's diagnosis (e.g. schizophrenia), stigma and shame associated with family violence, a lack of services, fears of law enforcement, and protective and interpersonal factors in the family.

Families of people with schizophrenia and ASD are often called upon to be very flexible in caretaking by adjusting to the needs of the system. However, what is less focused on is how development can intersect with family needs, requiring families to continually adapt to not only the needs of the system but also the developmental needs of both the family as a whole and each individual members. People living with schizophrenia have changing needs as they age from adolescence to adulthood. Likewise, individuals with ASD must negotiate developmental transitions, such as a desire more independence and autonomy, even as family members remain significant sources of structure and support. Alongside those changes are family members who are concurrently going through their own developmental transitions.

This roundtable seeks to take a developmental approach to supporting families in periods of crisis; with an emphasis on families navigating challenges associated with the specific stressors associated with schizophrenia and autism spectrum disorders (ASD). We use current literature and two qualitative data sets to illustrate the challenges that these families have throughout the lifespan span. We examine these experiences through the a multidimensional framework that includes neuropsychiatric, cognitive and physical development as well as through the lens of the family life cycle and the flexibility required of families as they negotiate developmental crises as those associated with the specific stressors of chronic health conditions. We discuss how this framework enables social workers to better support families as they continuously confront new realities and manage episodes of acute stress. In addition, we will discuss the subset of families of people with schizophrenia and ASD who experience interpersonal violence. We hope to better understand the resources and vulnerabilities of families both from individualistic and systems perspectives to better understand the need to formulate coping and crisis management strategies that are flexible in response to developmental needs.