A Family Affair

A child is influenced by surrounding systems. The child with congenital heart disease exists within numerous systems which have significant influences on health and well-being including medical and family systems. This chapter highlights the significance of family functioning in predicting outcomes for the child, but notes that these parents and families themselves are at risk for negative outcomes. The nature of these outcomes is considered, together with the risk and protective factors which amplify or reduce such risk. Evidence is presented which suggests that it is not the severity of the disease which exacerbates risk. Rather, intra- and interpersonal processes within the family and transactions with the medical system which surrounds the family, appear important. Such factors related to parenting skills, collaboration in care, and degree of understanding of the child’s condition represent potential foci for interventions. The importance, and examples, of family-based interventions are discussed.