Frontline Initiative Working with Families

Family systems:
A theoretical approach


Jennifer Reinke, M.A., LAMFT, CFLE has served as a DSP for five years and is currently a Graduate Research Assistant at the Institute on Community Integration at the University of Minnesota.

Our work as Direct Support Professionals (DSPs) often focuses on the individual. It often does not focus on the family as a whole. I wonder why this is. Ask any mom, dad, or sibling. You could also ask a grandparent, aunt, or uncle. I assure you they will agree that disabilities affect the entire family. Because disabilities affect entire families, it is appropriate to use a family systems lens. Family Systems Theory offers some ways to understand any family unit. This is regardless of culture or race. It is regardless of religion or family structure. It is also important to consider how our own families influence the way we provide support to the individuals and families we work with. 

Please consider the following concepts from Family Systems Theory. They can be used to better understand the families we work with.

  • Holism — Holism is the idea that the whole is greater than the sum of its parts. This means recognizing the entire family as a unit rather than simply looking at each individual. It also means considering all aspects of family’s lives. This includes their resources and religious beliefs. This includes stressors and the communities in which they live. I think this is the most important concept to keep in mind.

  • Interdependence — Interdependence means that family members can function independently. It also means that they depend on each other for some things. Interdependence is often difficult in families of children with disabilities. Sometimes people with disabilities may be entirely dependent on others for their basic needs.

  • Hierarchy — There are many subsystems within the greater family. Parents, siblings, and various generations are subsystems. Each subsystem has different amounts of power and influence. This affects the entire family. For example, parents generally have more power and decision-making authority than children. However, the nature of a child’s disability and their related needs may alter the amount of power and influence.

  • Boundaries — The boundaries of a family system are important. Boundaries help define who is in and who is out of the family. Families impacted by disabilities tend to have open boundaries. This may not necessarily be by choice. There are typically many therapists, caregivers, and other specialists involved. They come in and out of their homes and their lives. As DSPs, we can be sensitive to families’ desired boundaries. We can be respectful of their time and space together as a family.

  • Equifinality — Equifinality is interesting to me. It means achieving the same goal through different routes. For example, some children with disabilities have difficulty sleeping through the night. A common goal for their parents is for their children to sleep through the night. Parents can choose from a variety of different options. These are all in hopes of reaching the same goal. Options may include behavioral techniques such as token systems or relaxation techniques. Other options could be medication or a change in the child’s diet. Regardless of the chosen treatment, parents have the same goal of their children being able to sleep through the night. What are some goals of the individual’s family that you support? How are you supporting these goals?