Development of Family-Centred Intervention Model in Improving Family Solidarity for Reconstituted Families: Using the Delphi Techniques

Introduction:

Adaptation for reconstituted families (RF) can be particularly challenging. The families may face loyalty conflicts, co-parenting issues, sibling rivalry, and children behavioural challenges. However, traditional family therapy, for instance systematic family therapy, may not sufficiently address the challenges encountered by RF due to the complexity of family system, role ambiguity, and weak family bonds. By using Delphi procedure, the current study aimed to develop a family-centred intervention model which facilitate helping professional to identify the unique needs of each family member in a RF and navigate the family through the challenges they faced systematically.

Method:

Delphi techniques were employed in developing the intervention model. Data were collected from eight subject matter experts (SMEs). Six of them are social workers working with RF and with a average caseload of forty and two were academia from University. Round one of data collection utilized panel discussion to understand the unique challenges of RF and identify necessary intervention features. Round two utilized a semi-structured interview to evaluate expert consensus towards the proposed intervention model. A focus group interview was conducted to evaluate the effectiveness four month after implementation. Qualitative data were collected and analysed using thematic analysis.

Results:

Data revealed that the commonly seen challenges in RF included difficulty adjustment in differently family rules, weak emotional bonds and association (i.e. important talks) between step-parents and step-children, couple conflicts, and sibling rivarly.

The panel discussion indicated three key features in the intervention model: (i) the guiding framework, (ii) intervention approach and (iii) intervention procedure. Family solidarity, which refers to the degree of cohesion between family members, was proposed. Eight panel participants agreed its importance to RF and can be enhanced in six dimensions, including associational (i.e. creating shared experience), affectual (i.e. showing appreciation), consensual (i.e. establishing family tradition), functional (i.e. improving communication and conflict management), normative (i.e. sharing decision-making) and structural (i.e. visiting other family members). Parent-child relationship and family cohesion can therefore be improved. By adopting a family-centred approach, it was agreed that all family members should be encouraged to participate to achieve systemic change. Five key components in the intervention procedure were proposed including screening, assessment, implementation, evaluation and graduation.

A total of one hundred and forty RF received services after implementation. In terms of adequacy assessment, SMEs reported that the model was accommodating in three aspects: effective case conceptualization, systematic intervention, and precise evaluation. Guided by the model, social workers were able to swiftly recognize the challenges a RF was encountering and provide appropriate family intervention.

Conclusion:

The study highlighted the uniqueness of RF and the importance of adapting framework of family solidarity in guiding clinical practice on facilitating family adaptation and fostering family cohesion of RF. The model was found to be effective in facilitate implementation of family-centred intervention. The model will be useful in revision of service framework provided for RF, and as guidance for clinical family practitioners.