Family Context in Pediatric Psychology: A Transactional Perspective

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Abstract
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.