Afterword: Challenges for Family Practitoners

Afterword: Challenges for Family PractitionersEdith A. Lewis, Guest EditorIn the preceding pages, contributors have offered glimpses of families engaged in the growing activity of transracial adoption, strategies for working with family members in a medical setting, the use of diagnostic and intervention tools such as genograms, the changing nature of grandparenting, and recognizing the myriad roles family practitioners may play in influencing the course and content of the family intervention. All of these articles offer valuable information for those working with Michigan's 1.3 million families (National Center for Children in Poverty, 2004). Throughout this issue, readers have been encouraged to place families within the numerous interacting contexts that give meaning to their lives. Without doing so, we risk designing interventions for families as we wish they were, rather than as they are. How might family practitioners address the changing realities of families whose life situations differ so much from their predecessors in historical and herstorical time? I suggest that the experiences of the families we have met in these pages leave us with three overarching questions that challenge our ongoing scholarship and practice:* Where do we need to focus our energies as family practitioners and researchers who are mindful of the group, community, societal and global influences on family life? * What or whom have we consistently neglected in our overall theory and practice endeavors? * What roles might we play in improving the overall well being of families within their social, political, historical contexts? Challenge 1: Where Do We Need to Focus Our Energies? Even with the range of innovative practice methods available to family practitioners, some families and their members continue to experience major threats to their overall well being. Almost one-third of Michigan's 2.4 million children live in low-income families. Only 18 percent of those low-income families have unemployed parents. The majority (48%) of low income families has at least one adult who is employed full-time year-round (National Center for Children in Poverty, 2004). The consequences of this poverty were identified in the first example provided in the introduction to this issue. Associated with such poverty is an increased probability of homelessness and serious housing problems (National Low-Income Housing Coalition, 2004). Parents who wish to work may find it extremely difficult to play an active role in their children's lives and meet the demands of the low-wage, service sector jobs our nation has been generating for the last 10 years (Malveaux, 2004). As our colleagues in family studies have demonstrated, children with supportive parents become healthier adults. We need to know how to increase the probability that parents will be able to provide the support their children need now in order to meet the future needs of the state and nation.Offering some insight into this challenge, Bishof and his colleagues (this issue) identified four situations in which their medical family practice model can yield optimal results: (a) for those families combating chronic childhood illnesses; (b) for those whose spouses have chronic illnesses; (c) for family involvement in promotion/prevention activities; and (d) for the ongoing care of the aging. As the number of the aging increase in Michigan, considered by Tilove (2004) as one of the "Heartland" states, will we be cognizant that diverting major resources to the aging will leave us with fewer resources for children? For the 20 percent of Michigan's population whose families exist on incomes 9.2 times lower than those who represent the top 20 percent (National Center for Children in Poverty), attention to Bishof and colleagues' four effective practice entry points could make the difference between continued lives of ill health with lowered lifetime earning potential or a method of ensuring that even those without adequate health insurance could continue to live as contributing members of our society. …