The sick child: family complications.

Pediatric care for chronic illness necessarily involves the sick child's family. Effective medical care includes knowledge of the family as a social system and an understanding of the challenges that chronic illness in childhood brings to both the ill child and his family. Several potential difficulties may arise for the family, including overprotection of the ill child, the development of a split in the marriage as one parent cares exclusively for the ill child, and disruption of the remainder of family life. Specific characteristics of family interaction have been associated with varieties of medical difficulties and psychosocial maladaptation for the child. Pediatric care should include family interventions which enhance the family's ability to manage the chronic illness as well as improve their child's psychosocial status. Structural family therapy has been demonstrated to be effective in treating severe family maladaptation to chronic illness and in significantly improving the child's condition. The tenets of family therapy for maladaptation to chronic illness are also reviewed.