Psychiatric Annals

FAMILY PSYCHIATRY 

The Profile of Family Interactions

John G Howells, MD, FRCP

Abstract

To understand a person's life experience it becomes necessary to identify all his significant interactions (inside and outside his family) and to know the length and quality of each relationship.

Abstract

To understand a person's life experience it becomes necessary to identify all his significant interactions (inside and outside his family) and to know the length and quality of each relationship.

The Profile of Family Interactions (PFI) fists both the length and quality of each significant interaction in the life of a person in his formative years from birth to age 20 in two age periods, childhood and adolescence. It has been designed as a clinical tool, but can also be used outside that field.

An individual, throughout his life, is a member of a group; he interacts throughout his life experience with a number of people. His most important interactions are usually within his family of upbringing. This transaction within his preceding family usually dictates his degree of health or pathology.1,2 Damage to the psyche seldom results from one nuclear incident, but is usually due to adverse interactions over a period of time.

To understand a person's life experience it becomes necessary to identify all his significant interactions (inside and outside his family) and to know the length and quality of each relationship. Thus the pattern of transaction is identified. The Profile of Family Interactions (PFI) undertakes this task, in diagnosis.

Furthermore, in the psychotherapy of individuals, dyads, or families, it is necessary to deal with the material of each person's childhood. The PFI reveals the pattern of interactions in the childhood of each family member and is a useful aid in the therapeutic process. Most families and individuals can tolerate the PFI being always available for consultation during interviews and being amended through information obtained in the course of therapy. The PFI offers a standard format for recording data in research on individual and family development, on psychopathology, and on psychotherapy.

The PFI can be employed in many settings, e.g., medical practice, the school, remedial establishments, etc., to expose the pattern of the formative influences in the life of a person.

PUN OF THE PFI FORM

There are two forms - one for childhood up to 12 years and the other for adolescents up to 20 years. Along the top of the form (see example) are listed all the individuals with whom a child is likely to interact in his childhood. On the left side of the form is a span for each year of his childhood. On the right margin is an area for a brief summary of bis relationships at each year. At the bottom of the page is an area for a brief summary of the quality of each of his relationships. At the right corner is an area for a brief final summary. The adolescent form is exactly the same except that on the left side the age column extends from age 13 to age 20.

THE CLINICAL EXAMPLE

This concerns a boy, James Brown, who at age 18 is referred to a Family Psychiatric Clinic with a number of clinical symptoms arising from an assumed serious psychopathological state. It is found useful to map out his relationships in his first 12 years. Thus the PFI is undertaken. The PFI reveals the highly traumatic emotional environment in his first 8V2 years, especially from female figures. The PFI confirms the presence of a serious psychopathological state and the need for a careful diagnostic appraisal of his psychopathology. During the diagnostic interview the assessments made in the PFI can be adjusted in the light of more detailed information. The PFI acts as a guide in James' psychotherapy.

INSTRUCTIONS FOR USING THE PFI

I. Fill the spaces under "Interacting Individuals" with designation or name of person as follows:

1. Mother.

2. Father.

3. Substitute or additional mother in home (stepmother, relative, housekeeper, nanny, guest, etc.). Specify.

4. Substitute or additional father in home (stepfather, relative, employee, guest, etc.). Specify.

5. 6, 7. The siblings playing largest part in life of patient. Names.

8. Foster, adoptive, or other parent. Specify.

9. Close playmate or peer. Name.

10. School friend. Name.

11. Adult acquaintances outside home. Name.

12. Institutional care (including hospitals, boarding schools, hostels, etc.). Specify.

II. Items 5, 6, 7, 9, 10, and 11 are interchangeable.

III. Any empty area can be used for any relationship if correctly labeled, i.e., flexibility is to be expected in the use of the Profile.

IV. If there are more than 12 relationships, use an extra Profile. It is also possible to use one Profile for intrafamily relationships and another Profile for extra-family relationships.

V. Draw a line in color, a thin line, or a dotted line, in the middle of the appropriate column to indicate length of relationship with each listed person to the nearest ½ year. For items 8, 9, 10, 11, and 12, use a color different from other items or a thicker line, so that the care outside the family can be easily identified.

VI. The work can be undertaken by the subject, a clerical assistant, clinician, or other person.

VII. Under "Notes on Interactions" at foot of Profile:

1. Specify the relationship.

2. State its total length to nearest ½ year.

3. Rate its quality on a simple scale: very beneficial ( + + ), beneficial ( + ), neutral (0), harmful ( - ), very harmful (_ _).

VIII. Under "Notes on each year" at right of Profile:

1. State total number of relationships at that age.

2. Enlarge on any unusual circumstances, e.g., interruptions in relationships, etc.

IX. Space is available on the Profile for a brief summary at bottom right.

REFERENCES

1. Howells JG. Principles of Family Psychiatry. New York, NY: Brunner/Mazel; 1974.

2. Howells JG. Integral Clinical Investigation. London: Macmillan; 1982.

10.3928/0048-5713-19930901-10

Sign up to receive

Journal E-contents