Parent and adolescent stress and coping strategies in families with unemployed blue-collar breadwinners by Margaret Lester Colvin A thesis submitted in partial fulfillment of the requirements for a degree of Master of Science in Home Economics Montana State University © Copyright by Margaret Lester Colvin (1984) Abstract: The purpose of this study was to determine how blue-collar families with adolescents were coping with unemployment of the male breadwinner. Families with adolescents are extremely susceptible to financial hardships due to unemployment because this family life cycle stage is characterized by' escalating costs of children. In addition to unemployment provoking economic stress, adolescence is typically a time when parents and adolescents are redefining their roles to accommodate the needs of the developing youth. Data collected from 72 unemployed blue-collar families living in Butte, Montana revealed that families call upon various coping strategies in dealing with the normative growth of adolescence in conjunction with the non-normative event of unemployment. In addition, any particular coping strategy may be used to a greater or lesser degree by one family than by another. This research revealed that unemployed families coping most successfully appeared to have the ability to recognize specific aspects of the situation which could be altered and accept those areas which were not responsive to change efforts. These families tapped valuable external social supports, possessed effective communication skills and balanced family cohesion and adaptability dimensions.   PARENT AND ADOLESCENT STRESS AND COPING STRATEGIES IN FAMILIES WITH UNEMPLOYED BLUE-COLLAR BREADWINNERS by Margaret Lester Colvin A thesis submitted in partial fulfillment of the requirements for a degree ..f. Master of Science in Home Economics . . MONTANA STATE UNIVERSITY Bozeman, Montana March 1984 APPROVAL of a thesis submitted by Margaret Lester Colvin This thesis has been read by each member of the thesis committee and has been found to be satisfactory regarding content, English usage, format, citations, bibliographic style, and consistency, and is ready for submission to the College of Graduate Studies. yyi/ûL HZn Date ^ Chairperson, Graduate ittee Approved for the Major Department Date __Head, Mi /7" or Department Approved for the College of Graduate Studies Date Graduate Denn iii STATEMENT OF PERMISSION TO USE In presenting this thesis in partial fulfillment of the require­ ments for . a master’s degree at Montana State University, I agree that the Library shall make it available to borrowers under rules of the Library. Brief quotations from this thesis are allowable without special permission, provided that accurate acknowledgement of source is made. Permission for extensive quotation from or reproduction of this thesis may be granted by my major professor, or in her absence, by the Director of Libraries when, in the opinion of either, the proposed use of the material is for scholarly purposes. Any copying or use of the material in this thesis for financial gain shall not be allowed without my written permission. Signature n A/nh v Date ny>X- I , PiÔ / 9? iZ____ V ACKNOWLEDGEMENTS I would like to express my appreciation to the following people for their assistance and support for which I am forever grateful: Dr. Ramona Marotz-Baden, committee chairperson, for her expert knowledge and continued encouragement throughout this study and graduate school; Dr. Jeff Larson and Dr. Douglas Bishop, committee members, for their insight and assistance; Dr. Al Suvak, for his invaluable assistance with data analysis; Wanda Myers, for her excellent typing expertise; the Butte families who participated in this study and the machinists, operating engineers, electricians and teamsters union officials in Butte, whose cooperation made this study possible; and last but certainly not least to my husband, Scott, my parents, sister and brother for their unending encouragement, patience and love extended to me throughout graduate school and this research endeavor. vi TABLE OF CONTENTS Page LIST OF T A B L E S ................'.............................. viii LIST OF F I G U R E S ............................................... ix A B S T R A C T .................. x INTRODUCTION.................. I Statement of the Problem ................................ 2 Hypothesis........................................... 3 Need for the Study ......................................... 3 Definitions.................................. 4 Specific Objectives ...................................... 5 Assumptions ............................................... 5 Limitations........................ 6 METHODS..................................................... ■ . 8 S a m p l e ......................... 8 Instruments ......................... . . . . . . . 9 LITERATURE REVIEW . . . 11 Normative, Non-Normative Events and Family Stress . 11 The Unemployment Stressor ............................... 13 Unemployment and Family Life . . . . . . . . . . 15 Unemployment and Psychological Stress . 17 Coping ............................................ 18 The Efficacy of C o p i n g ............................ ... . 22 Development of Family Cohesion and Family Adaptability Dimensions..................................... 25 The Circumplex Model . ................... '............... . 31 Emperical Studies of Family Cohesion ................... 38 Emperical Studies of Family Adaptability ................ 40 Emperical Studies Combining Family Cohesion and Adaptability Dimensions ...................... 42 Adolescent Development .................................. . 44 Adolescents and Their Families . 49 Adolescent Stress . . . . ^ ................... 50 vii TABLE OF CONTENTS (Continued) Page RESULTS........................................................ 53 Placement in the Circumplex Model . . . . . . 53 Parental Coping Strategies ......................... . 58 Adolescent Coping Strategies ............................ 61 DISCUSSION ...................... ............ . . . . . . 65 Circumplex Model Placement ............................... 66 Husbands' Coping Strategies ............................ 68 Wives' Coping Strategies ..........................' 70 Adolescent Coping Strategies ............................ 74 Summary . 77 I m p l i c a t i o n s ............................................ 80. LITERATURE CI T E D .................. 82 A P P E N D I X ........................................ : . . . 91 > viii LIST OF TABLES Page 1. Frequencies and Percentages of Husbands, Wives and Adolescents in Each of the Three Regions of the Circumplex Model ............................................ 55 2. A Percentage Comparison of the Distribution in the Circumplex Model of the Unemployed Butte Sample with the National S u b sample ......................... 55 3. Internal and External Coping Strategy Mean Scores by Sex and Balanced and Extreme Circumplex Model Regions . ................... ............................60 4. Coping Strategy Mean Scores of Adolescents by Balanced and Extreme Circumplex Model Regions ...................... 63 ix LIST OF FIGURES Page 1. Double ABCX Model . ...................................... 31 2. Circumplex Model: Sixteen Types of Marital and Family Systems ............ . . . 32 X ABSTRACT The purpose of this study was to determine how blue-collar families with adolescents were coping with unemployment of the male breadwinner. Families with adolescents are extremely susceptible to financial hardships due to unemployment because this family life cycle stage is characterized by' escalating costs of children. In addition to unemploy­ ment provoking economic stress, adolescence is typically a time when parents and adolescents are redefining their roles to accommodate the needs of the developing youth. Data collected from 72 unemployed blue-collar families living in Butte, Montana revealed that families call upon various coping strategies in dealing with the normative growth of adolescence in conjunction with the non-normative event of unemploy­ ment. In addition, any particular coping strategy may be used ito a greater or lesser degree by one family than by another. This research revealed that unemployed families coping most successfully appeared to have the ability to recognize specific aspects of the situation which could be altered and accept those areas which were not responsive to change efforts. These families tapped valuable external social supports, possessed effective communication skills and balanced fkmily cohesion and adaptability dimensions. ! I INTRODUCTION The recent high unemployment rate has had a deleterious effect on the family (Jahoda, 1979; Straus, Gelles, and Steinmetz, 1980). Since unemployment generally results in reduced income, maintenance of an established level of living or attainment of financial goals may be precluded. However, economic considerations are only preliminary to the discovery of what unemployment means in terms of family relations. The loss of employment may constitute a crisis that disrupts to a greater or lesser degree the functioning of family life (Angell, 1936; Cavan and Ranck, 1938). The unemployment situation and the disorganiza­ tion that accompanies it is followed by a period of adjustment. As adjustment to unemployment occurs, new roles are assigned, new functions defined and new goals prioritized within the family. The means by which the adjustment occurs and the degree to which adjustment is achieved varies from family to family (Angell, 1936; Cavan and Ranck, 1938; Hill, 1949). Undesirable economic change in the family, often ' a condition produced by unemployment, creates family stress (Pieroni, 1980). Family composition and stage in the life cycle are important considerations. Families with teenagers are extremely susceptible to financial hardships due to unemployment (Moen, 1982). Although these parents may be moving into their prime earning years, this life cycle stage is characterized by escalating costs of children, with many families preparing to provide 2 their adolescent with post-high school education. In addition to unemployment provoking economic stress at this stage, adolescence is typically a time when parents and teenagers are redefining their balance of togetherness and apartness to accommodate the needs of the developing youth. The normative growth and development of the adolescent, in conjunction with the non-normative event of unemployment, call for change in the family system, and hence are stressor events. Rather than dealing with a single stressor, the family is experiencing a pile-up of stressors (McCubbin and Patterson, 1981). Research by Angell (1936) and Cavan and Ranck (1938), exploring the effects of the depression on the interrelations among family members, has identified two family variables that helped identify whether the depression was extremely stressful or relatively benign. These two variables are family integration and family adaptability. Recent research on family cohesion (similar to integration) and family adapt­ ability headed by University of Minnesota researchers David Olson and Hamilton McCubbin has attested to the value of these dimensions for understanding and treating family systems. Olson and colleagues (1979) created the Circumplex Model for family cohesion and adaptability dimensions. They hypothesize that families with balanced levels of cohesion and adaptability would function better than families with extreme levels of cohesion and adaptability. Statement of the Problem The purpose of this study is to determine how blue-collar families with adolescents are coping with unemployment of the male breadwinner. 3 Hypothesis Parents and adolescents in families with unemployed male bread­ winners who are in the balanced region of the Circumplex Model, that is, those that have moderate amounts of cohesion and adaptability, will use different coping strategies than parents and adolescents in the extreme region of the Circumplex Model. Families in the extreme region are those that have high cohesion and high adaptability, low cohesion and low adaptability, high adaptability and low cohesion, or low adapt­ ability and high cohesion. Need for the Study Research on the effects of unemployment on blue-collar families is scarce. Most of the studies that do exist were conducted shortly after the Great Depression in the 1930's (Angell, 1936; Cavan and Ranch, 1938). Larson’s (1983: in press) study notes that "future studies need to be conducted with unemployed families to determine the dynamics of the changes in family relations when unemployment occurs. The studies should include an examination of the perceptions of children and adolescents of the unemployment experience." > Data for this study were collected in the mining town of Butte, Montana. In 1930, Mary Hawks wrote the following statement about Butte: When one speaks of the history of m i n i n g h e speaks of Butte, Montana, for the two are so closely connected as to be almost inseparable. Butte is completely dependent on the mining industry. Without it, Butte would be non-existent. Every event of any importance at all to Butte has been in some way tied up with the great industry. 4 With the development of the copper diggings, Butte evolved into a strong union community. Labor disputes between the unions and the mining companies were frequent occurrences, and although the number of miners employed fluctuated with supply and demand of the minerals, the mines remained the economic mainstay of the community. This was the case until 1978, when the Anaconda Company announced termination of the underground mining operations. Massive layoffs occurred, leaving over one thousand jobless by September of 1982, escalating Butte’s unemploy­ ment rate to 13.8% compared to 8.4% statewide (Missoulian, Sept. 19, 1982). About this same time the Anaconda Company released more devas­ tating news— closure of the Berkeley Open Pit. By June 30, 1983, all Anaconda Company employees were terminated, with the exception of security and maintenance personnel. Butte presented a rare opportunity to study the effects of unemployment on family relationships in blue-collar families. It was hoped that the findings of this research could be used to mitigate some of the negative consequences of unemployment, and prove useful in family intervention. Definitions 1) adolescent— individual aged 12-18 years 2) adaptation— the ability of a marital/family system to change its power structure, role relationships and relationship rules in response to situational and developmental stress (Olson et al., 1979) 5 3) cohesion— the emotional bonding that family members have toward one another and the degree of individual autonomy they experience (Olson et al., 1979) 4) coping— the overt and covert behaviors individuals use to prevent, alleviate, or respond to stressful situations (George, 1980:30) 5) crisis— the amount of incapacitatedness or disorganization in the family where resources are inadequate (Hill, 1949) 6) stress— a state which arises from an actual or perceived demand - capability imbalance in functioning, and which is characterized by a non-specific demand for adaptive behavior (McCubbin and Patterson, 1981) 7) stressor— those life events or occurrences of sufficient magnitude to bring about change in the family system (Hill, 1949) Specific Objectives 1) To identify and compare the coping strategies utilized by adolescents and parents in families with unemployed male breadwinners who are in the balanced region of the Circumplex Model with the coping strategies of similar families in the extreme region of the Circumplex Model. 2) To compare the coping strategies of the unemployed blue-collar families to a national sample of the general population. Assumptions I) Stress is present in everyday living but is subjective depending on the nature of the situation, the characteristics of the family 6 unit, and the psychological and physical well-being of its members (McCubbin and Patterson, 1981). 2) Adolescence is a time of considerable development in the areas of physical, psychological, social and cognitive growth. 3) According to Social Choice Theory, families are, in a sense, a system (Nye, 1982). What affects one member will have reverbera­ tions on the entire family unit. 4) On the basis of the affirmation of the Circumplex Model by Olson, Sprenkle and Russell (1979) and Olson, McCubbin, Barnes, Larsen, Muxen and Wilson (1983), this study assumes the following hypotheses of the Circumplex Model to be supported: I. Couples/families with moderate levels of cohesion and adapt­ ability will generally function more adequately than those with extreme levels. a) Couples/families without serious problems will tend to have more balanced scores on both dimensions. b) Couples/families with serious problems will; tend to have more extreme scores on one or both of these dimensions (McCubbin et al., 1982). Limitations Due to. time limitations, this study was cross-sectional rather than longitudinal. The data were collected and analyzed with no attempt to determine how any particular individual’s coping strategy changed in accordance with length of time of the husband's/fatherTs unemployment. A larger sample may have been desirable. However, that was impossible. Three of the seven labor unions who were asked to supply names of unemployed blue-collar men refused to cooperate with the author of this study. Of the 270 calls made to contact subjects for this study, 33 resulted in disconnected numbers. This indicated that the families had relocated or were unable to afford telephone service. In any case, they were unable to be reached. 7 METHODS Sample The sample consisted of intact blue-collar families with an unemployed husband/father with at least one adolescent. All husbands/ fathers had previously been employed by the Anaconda Minerals Company and were residing in Butte, Montana (population 37,000) at the time of the study. Names of unemployed blue-collar men were obtained* from the team­ sters, electricians, operating engineers and machinists labor unions. A total of seven labor unions were asked to provide names of unemployed blue-collar men; however, three unions refused to cooperate. The labor union officials from the three non-participating unions stated that it was forbidden by union policy to give out membership lists. There was no reason to believe that the participants in this study were in any respect different from those men in the unions who did not participate in this study. All 270 prospective subjects on the union rosters were contacted by telephone by the author of this study. Thirty-three of the calls resulted in disconnected numbers. This left a total of 237 families contacted. Eighty-eight families had no adolescents, 32 men had found work, 11 men had accepted disability or retirement benefits, 9 men were not married, I man had died, I had divorced since becoming unemployed, and 5 had teens but refused to participate in the study. This.left 90 families with adolescents who agreed to participate in the 9 research. These 90 families were 95 percent of the total population of families with adolescents in the four participating labor unions. Questionnaires were mailed to these families. The questionnaires had separate sections to be completed by the husband, wife and adolescent. Respondents were asked not to collaborate when completing the questionnaires. One week after the families received the question­ naires the subjects were telephoned to arrange a date for the author to pick up the completed questionnaires. In cases where the respondents had repeatedly forgotten to fill out the questionnaire, a stamped, self-addressed envelope was left with the respondents. Questionnaires from 73 families were returned to the author, a return rate of 70%. Data from 68 husbands, 67 wives, and 69 adolescents were used for final analysis. Of the 68 husbands, 26 percent were teamsters, 38 percent machinists, 19 percent electricians and 16 percent operating engineers. Instruments The questionnaires consisted of 3 parts. Part I on each question­ naire collected demographic data. Part II of each questionnaire was the Family Adaptability and Cohesion Evaluation Scales (FACES II) (Olson, Portner and Bell, 1982), a 30 item instrument which measures the two dimensions of the Circumplex Model, family adaptability and cohesion. Part III of the husband's and wife's questionnaire was the Family Oriented Personal Scales (F-COPES) (McCubbin, Olson and Larson, 1981). The 29 items in the F-COPES instrument identifies problem-solving and behavioral strategies used by families in response to problems and 10 difficulties. Part III of the adolescent's questionnaire was the Adolescent-Coping Orientation for Problem Experiences (A-COPE) (Patter­ son & McCubbin, 1981). This 54 item instrument identifies behaviors adolescents utilize in managing problems or difficult situations. A one-way analysis of variance was used to detect statistical differences. The questionnaires are presented in their entirety in the appendix. 11 LITERATURE REVIEW ' ) The following bodies of literature were reviewed: stress and coping, unemployment, cohesion and adaptability, and adolescence. The purpose of this study was to determine how blue-collar families with adolescents coped with unemployment of the male breadwinner. This study hypothesized that adolescents and parents in families with unemployed breadwinners whose characteristics placed them in the balanced region of the Circumplex Model would use different coping strategies than those families whose characteristics placed them in the extreme region. Current knowledge concerning each area of the literature review is requisite to the understanding of the effects of unemployment on blue- collar families with adolescents. Normative, Non-Normative Events and Family Stress Researchers have categorized two types of stressors: normative events and non-normative events. Normative events are those which evolve in the context of the family cycle. These are events which occur I in most families and sometimes serve as demarcation points for the life cycle stages. In families with children, these normative transitions are associated with major role changes and task realignments. Pearlin and Schooler (1978) have identified thirteen or more changes in major roles related to marriage, occupation and parenthood which are considered normative interacting with C (the definition the family makes of the event) + produces X (the crisis). This model focused primarily on the pre-crisis variables which account for differ­ ences in family vulnerability to a stressor event and whether and to what degree the outcome is a crisis for the family. In an attempt to incorporate the factor of a family's efforts 'over time' the Double ABCX model was conceptualized and developed by McCubbin and Patterson (1981:9). The Double ABCX' model uses Hill's original ABCX model as its foundation and adds post-crisis variables in an effort to describe: a) the additional life stressors and changes which may make family adapta- tion more difficult to achieve, b) the critical psychological and social factors families call upon and use in managing crisis situations, c) the processes families engage in to achieve satisfactory resolution, and d) the outcome of these1family efforts (McCubbin and Patterson, 1981). The Double ABCX model is the foundation and theory upon which the proposed research is built. 31 0 B I E X IS T IN G a N E W 1 R E S O U R C E S | t C O P IN G~r 0 c P E R C E P T IO N O F X + a A + b B P R E C R IS IS P O S T C R IS IS — t i m © — — .J_ t im e B O n a d a p I a t i o t T A D A P T A T IO N A x M A L A D A P T A T IO N > Figure I. Double ABCX Model. The Circumplex Model Guttman (1954) is credited with proposing the use of circumplex models. The circumplex order is "an order which has no beginning and no end, namely a circular order. A set of variables obeying such a law is called a circumplex to designate a circular order of complexity" (Guttman, 1954:260). Guttman states that all variables have equal rank, but there is a law of neighboring that holds. From a review of the literature in a variety of social science fields used to describe family functioning Olson, Sprenkle and Russell (1979) found that cohesion and adaptability were dimensions frequently used to describe marital and family dynamics. Simply defining the two 33 dimensions was useful but not very integrative, so Olson and colleagues (1979) developed a circumplex model of family cohesion and family adaptability. In this model different types of family systems can be delineated utilizing the various regions of. the model. The Circumplex Model (Olson et al., 1979) developed on family cohesion and family adaptability dimensions consists of a four by four matrix which forms sixteen cells, each of which identifies one of 16 types of marital and family systems. The four levels of cohesion from low to high are disengaged, separate, connected and enmeshed. The four levels for family adaptation from low to high are chaotic, flexible, structured and rigid. The four types in the central area reflect balanced levels of both adaptability and cohesion and are seen as most functional to family development. The four extreme types reflect very high or very low levels of adaptability and cohesion and are seen as most dysfunctional to family development (Olson et al., 1979). The central area which indicates a balance on both dimensions is conceptually similar to what Bronfenbrenner (1961) describes as a "theory of optimum levels." He maintains that healthy personality development in children requires a balance of parental support and control. The balance of support and control is hypothesized as moderate, which is the central area of the Circumplex Model. Although it is generally assumed that the central area of the model is most functional to individual and family development over time, it is possible that extreme family types can be functional at times for families. However, if this pattern of relating becomes a predominant 34 style across the family life cycle, it could be problematic for one or more family members due to an imbalance of one or both dimensions (Olson et al., 1979). Families change and adapt to normal transitions in individual members over time. The stage of the life cycle and composition of the family will influence which of the sixteen types characterizes the family system. Although there will always be variability in family systems at the same stage, families will cluster toward similar types at certain stages or transition points because they are dealing with similar developmental tasks (McCubbin and Patterson, 1981). To illustrate, McCubbin and Patterson (1981) predict that a non-problematic family with an adolescent will rank either separated or connected on the cohesion dimension, flexible or structured on adaptability, and plot in the central area. A problematic family with an adolescent will tend to be disengaged or enmeshed on cohesion, rigid or chaotic on adaptability and plot in the extreme areas. (Refer to diagram of the Circumplex Model on page 32.) One general hypothesis of the Circumplex Model is that there is a curvilinear relationship between the dimensions of cohesion and adapt­ ability and successful family functioning in the face of stressor events (McCubbin et al., 1982). The exception to this is noted below (see lc.) McCubbin et al. (1982) derived the following hypotheses from the Circumplex Model: I. Couples/families with balanced (two central levels) cohesion and adaptability will generally function more adequately than those at the extremes of these dimensions. 35 a) Couples/families without serious problems will tend to have more balanced scores on both dimensions. Couples/families with serious problems will tend to have more extreme scores on one or both of these dimensions. c) Couples/families with normative expectations that support behavior extremes on these dimensions will not develop problems as long as all the members accept these expectations. Couples/families will change their levels of cohesion and adapt­ ability to deal with situational stress and life changes in the family life cycle. a) Couples/families without serious problems will change their cohesion and adaptability to an adjacent type to deal with situational, transitional or developmental stressors. Couples/families with serious problems will either not change their cohesion and adaptability or will revert to the opposite extreme (on one or both dimensions) to deal with situational, transitional or developmental stressors. Positive communication skills will facilitate couples and families to balance.cohesion and adaptability. a) Couples/families with balanced, scores (two central levels) on cohesion and adaptability will tend to have more positive communication skills than those at the extremes of the dimensions. })J Couples/families at the extremes of the cohesion and/or adapt­ ability dimensions will tend to have more negative communication skills than those not at the extremes (McCubbin et al., 1982). 36 The Circumplex Model for cohesion and adaptability dimensions has been empirically validated in two separate studies by Russell (1979) and Sprenkle and Olson (1978). Sprenkle and Olson (1978) compared twenty- five clinic and twenty-five non-clinic couples on variables related to adaptability. Using the SIMFAM game, they found that under stressful circumstances, better adjusted couples had a more equalitarian leader­ ship pattern whereas the clinically treated couples had a wife- leadership pattern. Russell's study (1979) hypothesized that moderate family cohesion and moderate adaptability was more functional than either extreme. Russell's sample of thirty-one families was subdivided into those that had more and less difficulty with their adolescent. High family functioning was associated with moderate family cohesion and adaptability while low family functioning produced extreme scores on these dimensions. In plotting the two dimensions, Russell found that low functioning families fell into extreme areas, while most (10 or 15) high functioning families fell into the central area; no low functioning families fell into the central area. Her findings support the curvi­ linear hypothesis between family functioning and the circumplex dimensions. In 1978, Olson, Fortner and Bell developed The Family Adaptability and Cohesion Evaluation Scale (FACES), a 111 item self-reporting instru­ ment specifically designed to measure variables related to the cohesion and adaptability dimensions and to empirically test the Circumplex Model. Fortner's (1980) dissertation work compared fifty-five families (parents and one adolescent) in therapy with a control group of 117 non-problem families. She compared the two groups using FACES and the 37 Inventory of Parent-Adolescent Conflict (IPAC). As hypothesized, non-clinic families were more likely to fall in balanced areas of the Circumplex Model on cohesion and adaptability dimensions than clinical families. Bell (1980) also utilized FACES and IPAC to study 33 families with runaways and compared them with the same non-problematic families used in Fortner's study. Again, as hypothesized, significantly more non-problematic families fell in the balanced area as compared to the runaway families. Conversely, he found more runaway families than non-problem families at the extreme levels. In an attempt to overcome some of its limitations and develop a shorter instrument with .simpler sentences which could be used with children and those with limited reading ability, FACES II was developed. The original 111 item scale was reduced to 50 items and through factor analysis was further reduced to 30 items. FACES II contains sixteen cohesion questions and fourteen adaptability questions. There are two questions for each of the following concepts related to the cohesion dimension: emotional bonding, family boundaries, coalitions, time, space, friends, decision-making, and interests and recreation. There are either two or three questions for each of the six concepts related to the adaptability dimension: assertiveness, leadership, discipline, negotiation, roles and rules. In administering FACES II, each family member completes FACES II in terms of his or her perception of the family system. The individual scores can then b e . plotted so that it is possible to compare family members. Family scores can be obtained by summing individual scores. 38 Researchers tend to define problem families as those that voluntarily or involuntarily are involved in treatment programs. There is a body of clinical evidence that indicates families in such programs are often extreme in one or both dimensions of adaptability and cohesion. However, there are many families that fall at the extremes but function well and never seek professional assistance. There are also families who fall into the extremes, have problems, but seek no treatment. Unfortunately, most studies to date have concentrated on families receiving treatment; therefore, very little is known about those families who do not.'. To summarize, research by Angell (1936), Cavan and Ranck (1938), Koos (1946) and Hill (1946) has been reviewed. The Double ABCX model developed by McCubbin and Patterson (1981) which is the foundation for this study, has been presented. The Circumplex Model of Marital and Family Systems (Olson et al., 1979) that hypothesizes moderate family cohesion and moderate family adaptability are more functional than either high or low extremes, has been discussed. The research cited and models presented have ultimately contributed to development of a Family Adaptability and Cohesion Evaluation Scale II (Olson, Portner and Bell, 1982). A review of empirical studies attesting to the value of family cohesion and family adaptability will now be presented. Empirical Studies of Family Cohesion Several studies have focused on family cohesion. Essentially, these studies have dealt with juvenile delinquent, schizophrenic and alcoholic families. These studies will be discussed. 39 David Reiss (1971) studied the cohesion dimension with normal, delinquent and schizophrenic families in an attempt to develop a theory of family consensual experience. The normal families fell at midpoint on the cohesion dimension, rated high on problem solving, and experi­ enced the environment as patterned, logical and masterable. Families with delinquent children fell at the lower end of the cohesion dimension arid rated low to moderate in problem solving. Individuals from delin­ quent families viewed rejection of their ideas as rejection-of self, and attempted to make decisions based on very little information. Schizo­ phrenic families achieved closure very early, regardless of how good the solution was, and were plotted at the high end of the cohesion dimension. For their study on juvenile delinquency, the Gluecks (1950) devised a three-class category of cohesion: I) good - strong "we feel good" as evidenced by cooperativeness, group interest, pride in home, affection for family members; 2) fair - elements of cohesion, but some members pulling apart from the family group; and 3) poor - unintegrated home adjustment, just a place to 'hang your hat,' self-interest exceeds group-interest. The study concluded that juvenile delinquents plotted at the low end of the cohesion dimension characterized by extreme individual autonomy and limited family identification. Sandberg (1969) also studied juveniles, comparing adolescents in India to those in the United States. The youth answered items con­ cerning family cohesiveness, decision making and autonomy. Results clearly showed that adolescents perceived greater cohesiveness in India and more self-decisiveness in America. Sandberg pointed out that the 40 greatest utility for his study was to point the way to more finely differentiated studies in the future. "These clearly significant differences in family cohesiveness, decision-making hierarchies, and adolescent independence need to be explored by more refined attention to specific areas of family behavior (Sandberg, 1969:406). In a one year follow-up of treatment outcome for ninety-two couples in which the husband was diagnosed and treated for alcoholism, family cohesion proved to be the best predictive dimension (Oxford et al., 1976). The composite measure of marital cohesion was based upon husband and wife reports of mutual affection, favorable spouse perceptions and metaperceptions, and optimism about the future of the marriage. These researchers think that by integrating the findings from the study with those of other studies on the influence of family variables on the outcome of conditions other than alcoholism, a general hypothesis would link a breakdown in the cohesiveness of. family relationships with unfavorable treatment outcomes. Numerous other studies, including those by Levinger (1965), Hawkins (1968), Birchler, Weiss and Vincent (1975), and Williams (1977), have utilized the cohesion dimension in various aspects of marital research. Most of these studies have supported the principles and hypotheses of the Circumplex Model, thus attesting to the value of the cohesion dimension. Empirical Studies of Family Adaptability Several studies have focused on family adaptability. Although the studies define adaptability in slightly different terms, they generally 41 support the curvilinear hypothesis between adaptability and family functioning. Tallman and Miller's study (1974) demonstrated the importance of examining role expectations as they related to leadership patterns. They found that role expectations become stabilized over the life cycle, emphasizing that normative role expectation will vary by class. It was hypothesized that families solve problems best when their power struc­ ture is constant with the normative pattern typical of their social class. Thus, as was expected, it was found that middle-class families function better in .equalitarian structures and blue-collar families function better in father-dominant structures. In an earlier work, Tallman (1970) suggests that more competent families may have greater leadership adaptability. Epstein and Santa-Barbara (1975) studied conflict behavior among clinically distressed couples. From observing couples' game playing strategy in a mixed-motive interaction game they concluded that the couples fell into one of the following conflict resolution strategies: 1) couples who resolved the conflict by adopting a cooperative strategy, 2) couples who managed the conflict in a.mutually destructive manner, or 3) couples who developed either a dominant-submissive relationship, or those who wavered between cooperating and competing and failed to attain any stable solution to the conflict. Kieren and Tallman (1972) defined adaptability as a spouse's ability to deal effectively with a problematic situation by changing roles and strategies in terms of new or modified assessments of the situation with which s/he is confronted. The adaptability dimensions were flexibility. 42 empathy and motivation. No relationship between a spouse's adaptability score and marital happiness score was found. Goldstein and Kling (1975) developed a family solidarity scale in which high scores represented interdependence and flexible role relationship, democratic decision making, and free communication. Some relationship between the scale and the other related family behaviors was found. Numerous studies have focused on the dimension termed flexibility, a concept closely related to family adaptability. Olson, Sprenkle and Russell (1980) found that flexibility has been operationalized primarily in two ways: I) the amount of intrusion, interruption, sarcasm or laughter in families or 2) randomness or relationship patterns such as who speaks after whom (assuming that a random order suggests flex­ ibility). Because of. difficulties encountered with these two measures, it is suggested that future studies not rely on these measures to access family adaptability (Olson et al., 1980). In summary, thd studies related to family adaptability indicate the importance of several family dimensions: power, discipline, negotiation, roles and rules. The studies generally support the curvilinear hypo­ thesis between adaptability and family functioning. Empirical Studies Combining Family Cohesion and Adaptability Dimensions Studies such as Angell's and Hill's indicate that advances can be gained by cross-partitioning the two dimensions of cohesion and adapt­ ability. Just as this study is attempting to build on the classic study by Angell (1936), the studies of McCubbin (1975, 77, 77, 79) and Boss (in press) built on Angell's (1936) and Hill's (1949) research. 43 McCubbin and Boss's research was on occupational (military and business) induced family separations, underscoring the central importance of family adaptability and cohesion. They found that the management of family stress involves maintaining a delicate balance between both individual development and growth and family unity and integration (Olson et al., 1980). Several studies have been conducted to determine the importance of family cohesion and family adaptability as' goals for family therapy and healthy family functioning. Fisher and Sprenkle (1977) conducted a study that was an empirical assessment of the goals of family thera­ pists. A list of goals was developed based on a theoretical clustering of family therapy literature into the dimensions of communication, adaptability and cohesion. The study concluded that the three dimen­ sions were important for creating an environment where family members could deal caringly and creatively with their differences. The Group for the Advancement of Psychiatry (1970) also conducted a survey of family therapists. From a list of 8 goals the therapists were asked to indicate the primary goals they had for family therapy. Seven of the eight goals related to cohesion, adaptability and communication, indicating the importance of the family dimensions as goals for family therapy, and useful for describing healthy family functioning. The empirical studies of family cohesion and adaptability mentioned above are only a brief view of the studies concerning the two dimensions. These studies are among those cited by Olson, Sprenkle and Russell (1980) in The Circumplex Model of Marital and Family Systems II: Empirical Studies and Clinical Intervention. The studies attest to the 44 value of the cohesion and adaptability dimensions. Many hypotheses in the Circumplex Model were based on findings from these studies. In spite of the diversity of operational and conceptual definitions, the curvilinear hypothesis between adaptability and .cohesion and family functioning was generally supported. Adolescent Development Adolescence is often considered a period of 'stress and storm.' The extent of trauma and disruption experienced by the majority of adolescents has often been exaggerated (Conger, 1977). Contrary to assertions of many influential clinicians, a considerable, body of data is accumulating to suggest that the typical teenager is a reasonably well-adjusted individual whose daily functioning is only minimally marred by psychological incapacity (Conger, 1977). In one study, over 11,000 ninth grade students were administered the Minnesota Multiphasic Personality Inventory Test. When the adolescents were examined for evidence of emotional disturbances, only between 10-20% fell in the range suggestive of possible psycho-pathology — about the same- incidence as for the adult population as a whole (Conger, 1977) . Although it may be that for the vast majority the stressors encountered during adolescence do not lead to a high degree of emotional turmoil, this is a time of considerable development in the areas of physical, psychological, social and cognitive growth. Puberty is that time in the life cycle at which the reproductive organs attain functional maturity, but the process actually involves the entire organism. Of all the developments that take place during 45 adolescence, the coming of sexual maturity is the most significant in its influence upon the behavior and interests of youth (Cole and Hall, 1970). The enhanced awareness of sexual feelings in the adolescent may and usually does result in masturbation. For some there is a preoccupa­ tion with masturbation when first discovered, while others may focus on it during periods of stress (Schimel, 1969). Masturbation, however, seems to be an age-appropriate, healthy discovery of one's own body. Along with sexual maturity comes various other types of physical changes. Among the many physiological changes that occur during adolescence are those in circulation, pulse rate, blood pressure and the chemical composition of the blood; changes in respiration and energy metabolism; and changes . in the excretory function (Horrocks, 1969). There is a normal variation of physical and sexual development, but clinical experience suggests that psychological experiences may influence the sequence of puberty changes. Physical growth and sexual maturity in both sexes may be retarded or hastened by emotional difficulties (Scribner, 1968). All the changes in the body, not only in sexual development and function, but also in physical size and strength call for the teenager to modify the mental image of himself/herself. The cultural stereotypes of what constitutes masculinity and femininity often make it difficult for teenagers to feel good about themselves if the development is slower, faster or just not what the stereotype prescribes. Various other factors as well may effect the self-esteem, including the state of home life, birth order, number of siblings, and economic prestige of the family (Rosenberg, 1965). 46 As a child moves through the developmental sequence s/he encounters a number of developmental tasks set by himself, his culture or biological factors. Havinghurst (1953) lists ten tasks of the adolescent period: 1) achievement of new and more mature relations with age- mates of both sexes 2) achievement of a socially approved masculine or feminine social role 3) acceptance, of one's physique and the effective use of the body 4) achievement of emotional independence of parents and other adults 5) achievement of the assurance of economic independence in the sense of feeling that one could make one's own living if necessary 6) selection and preparation for an occupation 7) preparation for marriage and family life 8) development of intellectual skills and concepts necessary for civic competence 9) the desiring and achieving of socially responsible behavior 10) acquisition of a set of values and an ethical system as a guide to behavior Erickson (1968) considers the problem of identity vs. identity confusion as a particular characteristic of adolescence. Erickson employed the concept of what he called "ego identity." Erickson believes ego identity implies a universal need to perceive oneself as somehow separate from others, no matter how much one may share motives, values and interests with others. Researchers have demonstrated an important relationship between parenting style and adolescent ego development. Bell and Erickson (1976) discovered that adolescents with high ego development have been found to come from families described as more flexible (adaptability), trusting (cohesion), and closer than families of adolescents with lower ego development. 47 The impressive gains in physical and psychological development that take place during .adolescence are accompanied by equally impressive intellectual and cognitive development. Assuming that there is a. ceiling set by heredity factors, in general adolescents showing IQ gains are most likely to come from socioeconomically favored environments, whereas those showing a decrease are most likely to come from culturally isolated environments or disadvantaged settings (Conger, 1977). Parents of children who show gains in IQ provide their children with accelera­ tion and encouragement for intellectual tasks and take a moderate, rationally structured approach to discipline (Conger, 1977). Mental ability as distinguished from IQ increases rapidly from birth to adolescence. According to Piaget, the adolescent becomes capable of "hypothetico-deductive" thinking. The process of deduction is no longer confined to perceived realities, but extends to hypothe­ tical statements. In problem solving, the adolescent tends to raise alternative hypotheses successively, test each against the facts and discard those that prove wrong. Younger children appear to fixate on the initial hypothesis. Also, unlike the younger child, the adolescent can "take his own thoughts as an object and reason about it" (Conger, 1977). Establishing true independence from parents during adolescence is seldom a simple matter because motivation and rewards for independence are strong as well as the desire to continue depending upon them. Relations both with same and opposite sex peers assume special importance as ties with parents become progressively emancipated. Because of the heightened importance of the peer group during 48 adolescence, motivation for conformity to values, customs and fads of the peer culture increase during this period. Adolescence is a peak time of sexual capacity and activity. Attempts to impose abstinence upon adolescents appears to have failed. Various levels of petting, necking and premarital intercourse and other more or less tabooed sexual outlets are comparatively common among the adolescent population (Zelnik and Kantner, 1979). Teenage drinking is generally frowned upon by the adult population, which may be reason enough for many adolescents to try it at least once. A study done by the Cooperative Commission for the Study of Alcoholism found that 75% of all high school students had been drinking before graduation, a third with some regularity (Schimel, 1969). It seems that marijuana also is a substance often experimented with by teens (Schimel, 1969) As with alcohol, the preoccupation with, the excessive use of, and the interference with life brought about through marijuana are indications of an underlying problem and not the problem itself (Schimel, 1969). Adolescent development shows wide differences in various growth phenomena. Konopka (1973) lists items that impede this development: lack of nutrition, inadequate housing, poverty in general, and racial discrimination. She also lists violation of adolescent self-respect by the adult world and limited outlet for experimentation by youth as factors curtailing the developmental process. In summary, the adolescent period is characterized by physical, psychological, intellectual and cognitive development. Adolescence is a peak time for sexual activity, experimentation and peer interaction. 49 Although adolescents strive to differentiate themselves from their families, their families remain viable elements in the developmental process. Adolescents and their Families. Cross cultural research comparing adolescents’ perception of the family indicate that while youth in other societies' such as Israel view society as a direct extension of the family, American youth view the family as an institution unto itself (Becker, 1976). There is no doubt that an important aspect of life for the adolescent is identification with the family. Adolescence is a time of peer group interaction, but the family maintains a very meaningful and influential force in the life of the adolescent. There are three basic functions of the family that can never be fully replaced by the peer group or any other social structure over the course of a life-time. Olson, Sprenkle and Russell (1980) have developed a theoretical model providing a description of the three basic functions found in healthy families. First, the family provides a sense of cohesion. Family cohesion is defined as the emotional bonding that individuals have toward one another (Olson et al., 1979). At the high end of the cohesion dimension there is an overidentification with the family which is likely to enmesh the adolescent in his or her family. The low extreme of cohesiop results in a sense of disengagement or lack of caring by family members. Family adaptability is the second dimen­ sion and is defined as the ability of the family system to change its power structure, role relationships, and relationship rules in response to situational and developmental stress (Olson et al., 1979). As with cohesion, adaptability is a continuum. Adolescents who experience rigid 50 (low adaptability) family types are likely to internalize a rigid interaction style, while too much adaptability may create a chaotic style. Thus, the central levels of both cohesion and adaptability are hypothesized as more conducive to family functioning than the extremes. The central area of the cohesion dimension is most viable for family functioning because individuals are able to experience and balance being independent from, as well as connected to their families (Olson et al., 1980). Likewise, with the adaptability continuum, a balance of stability and change appears most functional to individuals and family development (Olson et al., 1979). The third dimension for healthy" family functioning is communication, the means by which family members interact and negotiate differences (Olson et al., 1980). In summary, the family provides the adolescent with a sense of cohesion and adaptability. A balance of these two dimensions plus effective communication appears to be most conducive to positive family functioning. Adolescent Stress. The studies discussed in this section demon­ strate that different events create various degrees of stress for adolescents. The studies also specify differences in male and female adolescents in dealing with stress. Yeaworth and colleagues (1980) have developed the Adolescent Life Change Event Scale. These researchers hypothesized that there is a great deal of variability of perceptions of life stress events among adolescents. Differences in maturity and culture make it doubtful that all adolescents will perceive life stress events in a like manner and very doubtful that their perceptions will be the same as the perceptions 51 of adults. When asked to rate various life change events in terms of amount of stress created, adolescents, like adults, rated events related to death and separation as being most stressful. Events dealing with family problems were also generally given high stress scores, i.e., "family member having trouble with drinking" and "parent losing a job." School failures also represented high stress items for adolescents. Burke and Weir (1978) revealed clear-cut differences between male and female adolescents on a number of stress-related dimensions. Females discussed a wider array of problems with their peers than did males. Both male and female adolescents seemed to favor mothers over fathers as helpers and peers over parents. Female adolescents reported greater stress in their lives, particularly in such areas of concern as. acceptance by peers, relationships with the opposite sex, feelings of isolation and loneliness, and disagreement with parents. Although females reported receiving significantly more social support from peers, they also reported poorer emotional and physical well-being. It can be concluded that adolescents view events dealing with death and separation as most stressful, followed by events concerning family problems. Female adolescents experience more stress in their lives than their male counterparts. Although female adolescents receive more social support from their peers, they are in poorer psychological and physical health. In summary, adolescence, characterized by physical, psychological, cognitive and intellectual growth, can be a time of increased stress for youth and their families. Female adolescents reported greater stress in their lives than did their male counterparts. Balanced levels of family 52 cohesion and family adaptability in combination with effective communi­ cation skills appear to provide the optimal setting for dealing with adolescent problems. 53 RESULTS Placement in the Circumplex Model This section first presents the placement of the respondents in the three regions of the Circiimplex Model. A comparison of the distribution in' the Circumplex Model of the unemployed Butte sample to a national subsample is presented. The results concerning parental coping strategies and adolescent coping strategies follow. The Circumplex Model for family cohesion and adaptability dimensions consists of three regions: balanced, mid-range and extreme. Respondents in the study were placed in the Circumplex Model on the basis of their scores on FACES II. To be in the balanced region a respondent's scores on both dimensions must be in the balanced range. In the mid-range the respondent's score for one dimension is in the balanced range while the score for the other dimension is extremely high or extremely low. In the extreme region respondent's scores on both dimensions are either extremely high or extremely low. According to. the authors of the Circumplex Model, families with balanced levels of cohesion and adapt­ ability will function more adequately than those with extremes of the two dimensions. FACES II (Olson, Fortner and Bell, 1982), the instrument used to measure the two dimensions of the Circumplex Model, family cohesion and adaptability, was scored according to . the format provided by its authors. Responses were obtained from fathers, mothers and adolescents 54 living in Butte, Montana. In all families, fathers were blue-collar workers currently unemployed because of the closure of the Butte mining operations by the Anaconda Minerals Company. According to individual scores, each respondent was plotted into the balanced, mid-range or extreme region of the Circumplex Model. The frequencies and percentages of husbands (N=68), wives (N=67) and adolescents (N=69) in each of the three regions of. the Circumplex Model are presented in Table I. More of the husbands (37%), wives (42%) and adolescents (45%) fell in the extreme region than in either of the other two regions. The next largest percentage of husbands (34%) and wives (33%) fell into the balanced region whereas this region contained the smallest percentage of adolescents (13%). The smallest percentage of husbands (29%) and wives (25%) were in the mid-range. Of the adolescents, 42% were mid-range in the Circumplex Model.^ One objective, of this study was to compare the responses of the unemployed blue-collar families who participated in this study to a sample of the general population. The present study was compared with a national study because it was not possible to obtain an employed sample comparable to the unemployed sample in Butte, Montana. The national sample used for comparison consisted of 1140 married couples and families from 31 states (Olson et al., 1983). These couples and families were obtained from a stratified, randomly selected sample from A family mean Z score can be obtained by combining parent and adoles­ cent responses. However, this score which classifies the family as a unit as Balanced, Mid-Range or Extreme was not used in this research. 55 Table I. Frequencies and Percentages of Husbands, Wives and Adolescents in Each of the Three Regions of the Circumplex Model Regions of Husbands Wives Adolescents the Circumplex (N=68) (N=67) (N=69) Model . f % f % f % Balanced 23 34 22 33 9 13 Mid-Range 20 29 17 25 29 42 Extreme • 25 37 28 42 31 45 Table 2. A Percentage Comparison of the Distribution in the Circumplex Model of the Unemployed Butte Sample with the National Subsample. I Regions of Parents Adolescents National Unemployed National Unemployedthe Circumplex Model Subsample Sample Subsample Sample Balanced 53 34* 47 13* Mid-Range 32 27 34 42* Extreme 15 39* 19 45 *Statistically significant at P<.05. 56 seven stages of the life cycle. Two hundred sixty-one of these families had adolescents. The unemployed Butte families with adolescents were compared with this subgroup of the national sample. A comparison of the distribution in the Circumplex Model of the unemployed Butte sample with the national subsample is presented in Table 2. Chi-square was used to detect statistical differences. As Table 2 shows, a significantly larger percentage of parents (53%) and adolescents (47%) in the national survey were in the balanced region. A significantly larger percentage of parents (39%) and adolescents (45%) in the unemployed sample were in the extreme region whereas this area contained the smallest percentage of parents (15%) and adolescents (19%) in the national survey. Thirty- two percent of parents and 34 percent of adolescents in the national subsample were in the mid-range, compared to 27 percent of parents and 42 percent of adolescents in the unemployed sample. These differences were not unanticipated since the national subsample was essentially a normal sample and the Butte sample was under stress due to unemployment. This alone could account for differences between the unemployed sample and the national subsample in their distribution in the Circumplex Model. The average age of husbands in the national subsample was 43 and of wives, 40 years. The average age of the unemployed husbands was 42 and of wives, 41 years. Twenty-five percent of the families in the national survey lived in a metropolitan area with more than 100,000 people, 18 percent in large towns, 14 percent in small cities, 14 percent in rural areas and 13 percent on. farms. All of the unemployed families lived in Butte, Montana, whose population is approximately 30,000. The most frequent occupation for 57 men in the national survey was professional. Eighty percent of the total subsample of husbands in the national survey were employed full time. All of the Butte unemployed men were blue-collar workers with 37 percent being unemployed 1-6 months, 21 percent 6 months to I year, 16 percent I year to years, 21 percent 1% to 2 years, and 6 percent unemployed 2 years or more. Thirty percent of the wives in the national sample and 36 percent of wives in the unemployed sample worked full time. All but 3 percent of the husbands and 2 percent of the wives in the national survey had at least a high school diploma. All but 20 percent of husbands and 22 percent of wives in the unemployed sample had at least a high school diploma. In the national subsample 32 percent of husbands and 19 percent of wives reported 4 years or more of college. No husbands and only I percent of the wives in the unemployed sample reported 4 years or more of college. Even when fully employed, the Butte sample may never have functioned as adequately as the national subsample because- of the type of occupation and their level of education. It can be concluded that differences in life style, especially education and occupation, as well as the unemployment stressor faced by the Butte sample appear to explain the differences in the distribution of the unemployed Butte sample and the national subsample in the Circumplex Model. It is also possible that social desirability may have affected some of the respondents' answers to certain questions in the questionnaire. A case in point is the issue of reported effect of unemployment on the Butte families. In response to the question, "What effect has 58 unemployment had on your family?" fifty percent of unemployed husbands, 42 percent of their wives and 46 percent of their adolescents stated that it had no effect. Thirty-two percent of unemployed husbands, 42 percent of wives and 26 percent of adolescents stated it brought them closer together as a family. Only 6 percent of unemployed husbands, 0 percent of wives and 12 percent of adolescents stated it pulled them apart as a family. Yet the data in Table 2 indicate that the unemploy­ ment stressor and the "pile up" of stressors associated with the husband’s/father's job loss has effected the unemployed families so that as a group they do not function as adequately as the national subsample. However, the responses to the previously mentioned question given by the unemployed husbands, wives and adolescents suggest that unemployment has had either no effect or has brought their families closer together. One interpretation of this discrepancy is that unemployment has had more of a detrimental influence on family functioning than the unemployed families are willing to consciously admit either to themselves or to the researcher of this study. Parental Coping Strategies Parental coping strategies were measured by the Family Oriented Personal Scales (McCubbin, Olson and Larson, 1981). This instrument consists of 5 subscales tapping two dimensions of family interaction: internal family strategies and external family strategies. Internal coping strategies refer to the ways individual members deal with difficulties by using resources within their own families. Two conceptual scales, Reframing and Passive Appraisal, make up the 59 internal family dimension of F-COPES. The Reframing subscale contains 8 items designed to elicit the family's ability to redefine stressful events in order to make them more manageable. The Passive Appraisal subscale contains 4 items designed to elicit the family's ability to adopt a passive approach. By using a passive approach responsibility and self initiative are minimized for dealing with difficulties. External coping strategies refer to the behavior family members employ to acquire resources outside their families. Three conceptual subscales, Acquiring Social Support, Seeking Spiritual Support, and Mobilizing the Family to Acquire and Accept Help comprise the external dimension of F-COPES. The Acquiring Social Support subscale contains 9 items designed to elicit the family's ability to actively engage in utilizing resources from relatives, friends, neighbors and extended family. The Seeking Spiritual Support subscale contains 4 items 1 designed to elicit the family's ability to acquire sp