Novi pristupi u otkrivanju psiholoških faktora rizika življenja u alkoholičarskim porodicama

Abstract

Kada su u pitanju psiho-socijalna, medicinska i pravna zaštita alkoholiĉara i ĉlanova njihovih porodica, evidentan je dugogodišnji i veoma ozbiljan angaţman ne samo struĉnjaka, već i celokupne društvene zajednice. O znaĉaju alkoholizma govori i ĉinjenica da su aktuelno vodeći psihoterapijski modaliteti i modeli porodiĉnog funkcionisanja ponikli iz rada sa ovim porodicama, a broj publikacija koje ukljuĉuju pojmove alkoholizam i porodica jeste impozantan. Pa ipak, podaci savremenih, opseţnih epidemioloških studija ukazuju na to da slika o štetnim efektima alkoholizma nije umnogome promenjena (Institut za javno zdravlje „Dr Milan Jovanović-Batut, 2008; World Health Organization (WHO), 2011). Sa pozicije doprinosa naše struke prevenciji alkoholizma, veoma znaĉajnom nam se ĉinila mogućnost prouĉavanja odnosa i povezanosti obeleţja porodiĉne strukture i funkcija sa zdravljem i dobrobiti individue. Stoga je naše istraţivanje imalo za cilj da oceni koliko odreĊeni modeli porodiĉnog funkcionisanja mogu doprineti utvrĊivanju psiholoških faktora rizika prisutnih u porodicama sa problemom alkoholizma. U istraţivanju su uĉestvovale porodice ukljuĉene u sistemsku porodiĉnu terapiju, zbog alkoholizma njihovog ĉlana (otac alkoholiĉar), kao i odgovarajuća grupa porodica iz nekliniĉkog konteksta. Sistemski model porodiĉnog funkcionisanja (Beavers et al., 1990) i poslednja revizija Cirkumpleks modela (Olson, 2008), kada su posmatrani odvojeno, pokazali 6 su se podjednako efikasnim. U situaciji konkurentne primene, Biversov model pokazao je najveću vrednost, kao i skale Zadovoljstva i Komunikacije Olsonovog modela. Model porodiĉnih procesa (Skinner, 2000), jedini je uspeo da zahvati individualni varijabilitet u opaţanju porodica, ali je dao i niz rezultata koji problematizuju njegove konceptualno-metrijske osnove. Rezultati našeg istraţivanja podsećaju na nuţnost psihometrijske provere modela koje nameravamo da primenimo u praksi, posebno ukoliko dolaze sa stranih podruĉja. Iz pozicije teorije, oni su dokumentovali sloţenost procesa koncipiranja modela porodiĉnog funkcinisanja i na njima baziranih instrumenata. Sa praktiĉnog stanovišta, podaci su dali razumnu osnovu za izradu preporuka za izbor modela, u zavisnosti od zadataka koji su pred kliniĉare postavljeni (dijagnostika, terapija, edukacija).

When psycho-social, medical and legal protection of alcoholics and their families is in question, a long-term and very serious engagement is evident, not only by experts but by the whole social community as well. On the significance of alcoholism speaks the fact that presently leading psychotherapy modalities and models of family functioning arose from working with these families and the number of publications that include terms alcoholism and family is impressive. Still, records of the contemporary, extensive epidemiology studies indicate that the picture of damaging effects of alcoholism hasn‟t been significantly changed. (Institute for Public Health „Dr Milan Jovanović-Batut, 2008; World Health Organization (WHO), 2011). From the position of our profession‟s contribution to the prevention of alcoholism, a possibility to study the influence of family structure characteristics and functions on the health and well-being of a person seemed very important. Therefore, our research had a goal of establishing to what extent certain models of family functioning can contribute to defining the psychological risk factors present within the families with the problem of alcoholism. The families that have participated in the research were those included in a system family therapy due to the alcoholism of a family member (alcoholic father) and corresponding group of families from non-clinical context. System model of family functioning (Beavers et al., 1990) and the last revison of Circumplex model (Olson, 2008) proved to be as equally efficient when they were observed separately. In a situation of concurrent application, the Bivers‟ model showed highest value, as well as the scales of Satisfaction and 2 Communication of the Olson‟s model. Model of family processes (Skinner, 2000) was the only one to cover the individual varability in observation of the families but also gave a stream of results that question its conceptual-metric base. Results of our research remind of a neccessity of psychometric testing of a model intented for practical use, especially if it comes from a foreign area. From a theoretical point of view, complexity of the process of model conception and upon it based instruments has been documented. From a practical point, the records have given a sound foundation for making recommendations for choosing a model, depending on the set clinical tasks (diagnostics, therapy or education).