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is 50 years old (generativity versus stagnation) and the father of six children. Frank is irresponsible,reckless, manipulative, selfish, but also funny and charismatic. Frank has been an alcoholic since he was 15 years old. His wife left the family when the oldest daughter was 15 years old. Frank does not work, but somehow earns money illegally or through strange jobs. All of his money goes to alcohol or drugs. Frank does not partake in raising his children nor contributes financially. He continues to live in the house as he pleases, and is a burden to his children, his friends, and does not have one trusting relationship.

Al o l

: According to DSM IV, substance abuse or alcoholism is defined as meeting the following criteria: 1. Results in failure to meet major role obligations at work or home 2. Results in recurrent substance-related legal problems 3. Use continues despite social or interpersonal problems (Kaakinen, Coehlo, Duff, & Hanson, 2010) . Numerous clinical studies have found alcoholism to be a “family illness, “ that is substance abuse and family problems coexist. Studies have also concluded that family involved treatments produce better outcomes in reduced alcohol use and in improved family function (Klostermann & O’Farrell, 2013)

Fi n

is 21 years

old and the eldest child; intimacy versus isolation. She is the “mother” of the group and has sacrificed her own goals and essentially her life to raise her siblings. Fiona sees raising her siblings as an obligation and does not attempt to achieve any of her own goals or aspirations. She is very promiscuous , sleeps with numerous men, and loves to “go out” when she can (Ward, 2014) .

is 15 years old; Phi p “Lip” is Ian Deb identity vs role the second eldest and 17 years old; identity vs role Confusion. He is “wicked” smart and does very well in school with little to no effort. He makes money by tutoring and taking the SAT for other students. Lip smokes cigarettes and drinks beer daily. Though he is very intelligent, he does not explore college and is unsure of his future path(Ward, 2014). .

confusion. Ian is part of ROTC in school and plans to join the military when he is 18. Ian is secretly gay, and is having an affair with a married man. Ian is afraid to come out to his family and friends and often makes up stories about girls to uphold his “cover.” Ian exemplifies “role confusion” as he is unsure of his sexuality (Ward, 2014)

is 12 years

old; industry versus inferiority. She is spunky, stubborn, and very maternal. She often babysits her 2 year old brother Liam and even creates a “babysitting business” by watching other children in her house. She is the only child that has not given up on her father Frank. She will often take care of him when he comes home drunk and leave coffee by him in the morning (Ward, 2014)


is 10 years

old; industry versus inferiority. He is the troublemaker in the family. He is usually torturing animals, “blowing” things up, and is always in trouble at school for disrespecting teachers and bullying other children (Ward, 2014).

Li m is two years

old; autonomy versus shame and doubt. He is the only African American child, and is not the biological child of Frank. Liam is loosely supervised by all of his siblings and many times is brought along to school and work if no one is home to babysit (Ward, 2014).

Fam Dy a c The children of the Gallagher family have a close nit bond, united their father’s alcoholism and their estranged mother, Monica.. All six children are unable to rely on their parents emotionally financially, and for basic needs. In attempts to avoid being separated by social services, Fiona, the oldest daughter dropped out of high school to raise her five siblings. Fiona manages most of the finances and household; however, all of the siblings work or somehow find money to pay rent and bills; the older ones contribute more. Fiona is respected and her siblings rely on her when help is needed, yet she does not enforce structure or discipline in the house as she continues to attempt to live a normal life and make ends meet. All of the siblings rely on each other for support and somehow keep eachother “afloat� in the most dire circumstances.

Cul Com ca Tra The Gallagher’s are in stage five The most important part of Duv

F mi D v o m

. In this stage, the family consists of teenagers whose responsibility continues to grow and they begin to have more freedom (Kaakinen et al., 2010). This is true of the Gallagher family; however, all of the children have had “adult” responsibilities at a very young age and have had far too much freedom. Unfortunately, all of the Gallagher children have been forced to “grow up” and their development was sacrificed in order to survive .

a healthy family is communication (Kaakinen et al., 2010).Trust and honesty is evident throughout the Gallagher family, excluding Frank. Despite their upbring they somehow find a way to bring humor and play into their everyday life, a way they often show affection. Despite disagreements, they continue to support one another (Kaakinen et al., 2010).

/Rel o / on

The Gallagher’s do not partake in a rich culture, but do live in the south side of chicago, a low income area. Violence and drug use is common in this area. Due to the nature of their environment, the Gallagher’s have become “hardened” and partake in the “tough attitude” that many of their neighbors exhibit as well. Frank has mentioned that the family is catholic; however, they do not practice . They do celebrate traditional holidays such as Thanksgiving and Christmas together.

St e g s The Gallagher children, despite their alcoholic father and non existent mother utilize each other for support both financially and emotionally. While their alcoholic father has proven to be a burden, it forces the children to confide in each other for survival. Despite any burden or dilemma, the Gallagher children remain flexible and adapt as a team. They will go to great lengths in order to stay together. Even with the greatest of challenges, they always manage to find a solution together; they are resilient.

Cha n Though the Gallagher’s certainly have strengths as a family, weakness also exists. The family as a whole lacks coping mechanisms. Fiona turns to men for nurturing, while Ian engages in an affair and hides his sexuality with the worry of being another burden. While they all have overcome adversity, they have yet to witness a positive role model. Each of them, particularly Fiona never had the opportunity to experience childhood; they have been forced to grow up and survive on their own. With this, their home is unstructured and chaotic. They do manage to solve problems, but it is often illegal, violent, or through manipulation.


“Fam Sy em T


explains that a family is composed

of “systems” designed to maintain stability; the systems may adapt or become maladaptive according to change. Families change in response to stress from both internal and external environments. One key aspect is that any change in one family member affects all members of the family. The nurse’s responsibility is to assist the family in adapting to change, restore stability, and ultimately achieve the possible highest level of functioning (Kaakinen et al., 2010). The Gallagher family has had to adapt due to their uninvolved parents. They have adjusted their roles in order to maintain a sense of stability. Fiona has been removed of her daughter role and has assumed a parental role; she feels responsible for her siblings and her siblings rely on her. The older children have lost trust in Frank, his behavior has caused them to become jaded and they have become emotionally unstable. Despite their mistrust, they continue to allow him in the house and the younger ones help him to bed and clean up after him. This is their attempt at restoring stability and equilibrium; unaware that they are supporting his drinking habit. Frank continues to disappoint them and selfishly places his needs above everyone's. The Gallagher clan adapts their roles , stripping away their childhood in order to maintain some stability. Additionally, Frank manages to disrupt any stability ’ they have formed such as stealing money and calling Child Social Services. Due to their emotional lability and inability to form healthy relationships the Gallagher’s remain dysfunctional.

Nur Outcome 1: By the end of the session, all five older Gallagher children and Frank will list at least one thing they learned about alcoholism (Ackley et al., 2017).



Outcome 2: By the end of the session, all five older children and Frank will identify three healthy coping behaviors that family members can practice to improve family functioning (Ackley, Ladwig, & Makic, 2017).

Outcome 3: By the end of the session, Frank and children will verbalize one external resource they can go to for help (Ackley et al., 2017).

Intervention : Provide a list of resources ( school Intervention : Educate the Intervention: Encourage family counseling, support groups, family on alcoholism ( members to seek individual symptoms, causes, effects counseling and educate them on hotlines, websites etc) that address alcoholism and and treatments, and the alternative coping strategies. familial support. effect it can have on Rationale: Interventions which families) (Daley, 2013) include education, information, Rationale: Family members Rationale : Education and behavior-skill development experience a wide range of emotions; this burden can allows the family to facilitates coping (Ackley et al., be reduced through effectively support the 2017) education, and identifying family member with with other families alcoholism (Daley, 2013) experiencing similar issues (Daley, 2013).

References Ackley, B. J., Ladwig, G. B., & Makic, M. B. (2017). Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care (11th ed.). St. Louis, Missouri: Elsevier. Daley, D. C. (2013). Family and social aspects of substance use disorders and treatment. Journal of Food and Drug Analysis , 21, S73-S76. Kaakinen, J. R., Coehlo, D. P., Duff, V. G., & Hanson, S. M. (2010). Family Health Care Nursing (4th ed.). Retrieved from Klostermann, K., & O’Farrell, T. (2013). Treating Substance Abuse: Partner and Family Approaches. Social Work in Public Health, 28, 234-247. 10.1080/19371918.2013.759014 Ward, S. L. (2014). Pediatric Nursing Care Best Evidence-Based Practices . Philadelphia, PA: Davis Company. Pictures*e2fuK4-7LoXNxeyI.jpg

Gallagher's Nurs 480  
Gallagher's Nurs 480