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Journal of Pediatric Psychology 14(2) pp. 293-314, 1989
© 1989 Society of Pediatric Psychology

research-article

Family Context in Pediatric Psychology: A Transactional Perspective

Barbara H. Fiese1 and Arnold J. Sameroff

Syracuse University, Brown University, Bradley Hospital

1All correspondence should be sent to Barbara H. Fiese, Syracuse University, Department of Psychology, 430 Huntington Hall, Syracuse, New York 13244.

The degree to which the family is seen as a significant contributor to child health conditions impacts directly on the successful functioning of the pediatric psychologist. A transactional model of family functioning is proposed for pediatric psychology. Development is considered to be the result of a three-part process that starts with child behavior that triggers family interpretation that produces a parental response. Family interpretation is presented as part of a regulatory system that includes family paradigms, family stories, and family rituals. Corresponding to the proposed three-part regulation model, three forms of intervention are discussed: remediation, redefinition, and reeducation. Clinical decision making based on this model is outlined with examples given from different treatment approaches. Implications for the treatment of families in pediatric psychology are discussed.

Key words: family context; transactional model; clinical decision making.


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