Family Systems Theory and Chronic Childhood Illness: Diabetes Mellitus

  • John Sargent
Part of the The Downstate Series of Research in Psychiatry and Psychology book series (DSRPP, volume 4)


Chronic illness in childhood presents many diverse challenges to the affected child, the family, and the medical care system. Psychosocial implications of the illness must be recognized and dealt with in conjunction with requisite physiological treatment. Coordination of the various helping professionals involved in a given child’s care is essential while working toward improvements in function for the child and his family. Several authors (Battle, 1975; Gliedman and Roth, 1980; Mattsson, 1972; Pless and Pinkerton, 1975; Straus and Glaser, 1975) have reviewed the needs of the child with chronic illness and his family and described their approaches toward effective health care intervention. Although these reports include many useful guidelines and important suggestions for health care professionals working with chronically ill children and their families, they do not present a conceptual framework to organize professional efforts. This paper will present a theoretical approach to chronic illness in childhood which stresses the system characteristics of the affected child’s family. I will also outline roles for health care providers which support and enhance the family’s ability to organize itself to meet the special demands of a chronic illness while maintaining effective function for its members in other spheres. This outline will draw chiefly upon the work of Minuchin (1970, 1974, 1975, 1978) and his colleagues (Baker and Barcai, 1970) with children with Juvenile Onset Diabetes Mellitus and their families.


Anorexia Nervosa Chronic Illness Diabetes Management Illness Management Family Meeting 
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  1. Baker, L. and Barcai, A. Psychosomatic Aspects of Diabetes Mellitus. In: 0. W. Hill (Ed.) Modern Trends in Psychosomatic Medicine Vol. 2, New York: Appleton-Century-Crotts, 1970.Google Scholar
  2. Battle, C. U. Chronic Physical Disease-Behavioral Aspects. Pediatric Clinics of North America 22: 525, 1975.PubMedGoogle Scholar
  3. Benoliel, T. Q. Childhood Diabetes: The Commonplace in Living Becomes Uncommon. In: A. L. Strauss and B. G. Blaser (Eds.) Chronic Illness and the Quality of Life. St. Louis: C. V. Mosby, 1975.Google Scholar
  4. Gallagher, E. B. Lines of Reconstruction and Extension in the Parsonian Sociology of Illness. Social Science and Medicine 10, 207, 1976.Google Scholar
  5. Garner, A. M. and Thompson, C. W. Juvenile Diabetes. In: P. R. Magrab (Ed.) Psychological Management of Pediatric Problems Vol. 1, Baltimore: University Park Press, 1978.Google Scholar
  6. Geist, R. A. Onset of Chronic Illness in Children and Adolescents: Psychotherapeutic and Consultative Intervention. Journal of American Orthopsychiatry 19: 4, 1979.Google Scholar
  7. Gliedman, T. and Roth, W. The Unexpected Minority-Handicapped Children in America. New York: Harcourt, Brace, Jovanovich, 1980Google Scholar
  8. Mattsson, A. Long Term Physical Illness in Childhood: A Challenge to Psychosocial Adaptation. Pediatrics 50: 801, 1972.PubMedGoogle Scholar
  9. Minuchin, S. The Use of an Ecological Framework in the Treatment of a Child. In: E. J. Anthony and C. Koupernik (Eds.) The Child and His Family New York: John Wiley and Sons, 1970.Google Scholar
  10. Minuchin, S. Families and Family Therapy Cambridge: Harvard University Press, 1974.Google Scholar
  11. Minuchin, S. and Minuchin, P. The Child in A context: A Systems Approach to Growth and Treatment. In: U. B. Talbot (Ed.) Raising Children in Modern America Boston: Little, Brown, 1974.Google Scholar
  12. Minuchin, S., Baker, L.., Rosman, B. L., Liebman, R., Milman, L, and Todd, T. A Conceptual Model of Psychosomatic Illness in Children. Archives of General Psychiatry 32: 1031, 1975.Google Scholar
  13. Minuchin, S., Rosman, B. L. and Baker, L. Psychosomatic Families-Anorexia Nervosa in Context. Cambridge: Harvard University Press, 1978.Google Scholar
  14. Parsons, T. The Social System New York: The Free Press, 1951.Google Scholar
  15. Parsons, T. Definitions of Health and Illness in the Light of American Values and Social Structure. In: E. G. Taco, (Ed.) Patients, Physicians and Illness New York: The Free Press, 1958.Google Scholar
  16. Pless, I. B. and Pinkerton, P. Chronic Childhood Disorder-Promoting Patterns of Adjustment Chicago: Yearbook Medical Publishers, 1975.Google Scholar
  17. Rosman, B. L., Minuchin, S., Liebman, R. and Baker, L. Family Therapy for Psychosomatic Children: Follow-up and Outcome. Presented at Meetings of the Academy of Psychosomatic Medicine, November, 1978.Google Scholar
  18. Sterky, G. Family Background and State of Mental Health in a Group of Diabetic School Children, Acta Paediatrica 25: 1, 1963.Google Scholar
  19. Strauss, A. L. and Glaser, B. G. Chronic Illness and the Quality of Life St. Louis: C. V. Mosby, 1975.Google Scholar

Copyright information

© Plenum Press, New York 1982

Authors and Affiliations

  • John Sargent
    • 1
  1. 1.Philadelphia Child Guidance ClinicPhiladelphiaUSA

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