Wright, L. & Leahy,M. (2009). The Calgary family assessthnt model. In Nurses and
families: A guide to family assessment and intervention. (5 ed., pp. 47-91). Philadelphia:
The Calgary Family Assessment Model (CFAM) is an integrated, multidimensional
framework based on the foundations of systems, cybernectics, communication, and
change theory and influenced by postmodernism and biology of cognition.
It is recognize as one of the four leading family assessment models in the world.
It has three major categories: SRUCTURAL, DEVELOPMENT, FUNCTIONAL,
each of them has subcategories, and they dont need to be all assess depending on
the FAMILY and depending on the POINT IN TIME, and because not all the
questions are appropriate for every family.
This diagram helps to conceptualize the three categories and its subcategories. It is
important for the nurses to go back and forth to able to draw together all of the
relevant information into an integrated assessment.
It is important to recognize that a family assessment is based on the nurses
personal and professional life experiences, beliefs, and relationships with those
being interviewed. itshould not be considered as the truth about the family but
rather one perspective at a particular point in time.
The focus of this model is less on the individual but more on the INTERACTION
among all the INDIVUDALS within the family.
Who is the family, what is the connection among family members with those
outside the family, and what is it the familys context.
The structural assessment has the three aspects where each of them has their own
subcategories: INTERNAL STRUCTURE, EXTERNAL STRUCTURE, and CONTEXT.
INTERNAL STRUCTURAL ASSESSMENT
Subcategories: Family composition, gender, sexual orientation, rank order,
Family = a group of individuals who are bound by strong emotional ties, a sense of
belonging, and a passion for the being involved in one anothers lives. Family is a
system or unit, members may or may not be related and may or may not live
together, the unit may or may not include children, there is commitment and
attachment among unit members, the unit caregiving functions consist of protection,
nourishment, and socialization of its members.
Term as couple, nuclear family or single-parent family specifies attributes of
membership, and they are not more or less families by reason of labeling.
Affection, strong emotional ties, a sense of belonging, and durability of
membership determine family composition.
Family is who they say they are, with this definition nurses can honor individual
family members idea about which RELATIONSHIP are significant to them and
their EXPERIENCE of health and illness.
It is not just the length of the relationship that is important, but also the quality of
Gays and lesbians often refer to their friendship network as family, and that for
many gay and lesbians this family is often as crucial and influential as their family
of origin and at times, even more so.
Their familys definition is more based on the familys conception of family rather
than on who lives in the household.
Changes in the family can be permanent as well as transient.
Losses tend to be more severe depending on:
o The younger some of the family members are
o The smaller the family
o The greater the numerical imbalance btw male and female members of the
The extent of the impact of a death on the family depends on the social and
ethnic meaning of death, the history of previous losses, the timing of the death
in the life cycle, and the nature of death.
Gender is important for nurses to consider because the difference in hoe men and
women experience the world is at the heart of the therapeutic conversation.
We can help families by assuming that differences btw women and men can be
changed, discarding unhelpful cultural scripts for both gender, and recognizing and
attending to hidden power issues.
The problem described both gender commonly include unspoken conflicts btw their
perceptions of gender this is, how their FAMILY, CLASS, SEXUAL
ORIENTATION and SOCIETY or CULTURE tell them that men and women
should fell, think, and behave and their own experiences.
Couples may desire to establish more equal relationship, with characteristics such
o Partners hold equals status (equal entitlement to personal goals, needs, and
o Accommodation in the relationship is mutual (schedules are organized
equally around each partners needs)
o Attention to the other in the relationship is mutual (equal displays of interest
in the others needs and desires by both partners)
o Enhancement of the well-being of each partner is mutual (the relationship
supports the psychological health of each equally)
It includes sexual majority and sexual minorities populations. Heterosexism, the preference of heterosexual orientation over other sexual
orientation, is a form of multicultural bias that has the potential to harm both
families and health-care providers.
o Queer = individual whose gender identity doesnt strictly conform with
societal norms traditionally ascribed to either males or female and who
defines themselves outsides of these definitions.
o Intersexed = individual with ambiguous genitalia or chromosomal
o Two-spirited people = Aboriginal with close ties to the spirit world and who
may or may not identify as being lesbian, gay, bisexual, or transgender.
It is useful to reflect critically on attitudes about sexual orientation. When comparing
lesbian couples with heterosexual couples, we use parallel terms as opposed to
Birth orders, gender, distances in age between siblings are important factors to
consider when doing an assessment.
Sibling position is an organizing influence on the personality, but it is not a fixed
influence. With time, multiple influences in addition to sibling constellation - timing
of each siblings birth, the childs characteristics, the familys idealized program for
the child, and the parental attitudes and biases regarding sex difference - can affect
Term used to discuss or mark the family systems level o