Only recently have we begun to examine systematically the effect of dysfunctional children on other family members. This article addresses several issues: (1) It presents two models of family stress, the ABCX and the social ecology model, and discusses how they can be employed for a systematic mapping of known key variables that, in complex interplay, appear to influence the family's ability to cope with a dysfunctional child. (2) It reviews evidence from our own work and research by others related to the main elements of the ABCX model of family stress. (3) It offers an outline of what appear to us to be the key methodologic considerations for improving quality of research in this area. (4) It provides a few recommendations to clinicians working with families of severely dysfunctional children based on the evidence and our clinical experience.
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