Adapting Coping Theory to explain the concept of Adjustment

This article describes the development of a proposed unifying theoretical framework for the concept of adjustment as understood by health social workers. This arose from an exploratory study (Nilsson, 2002) aimed at elucidating social workers' understanding of Adjustment to Health Condition and Adjustment to Hospitalisation as Indicators for Intervention. The findings of that study demonstrated that adjustment was conceptualised as a complex, multi-dimensional process including the key inter-related themes of coping, emotion, subjective meaning, integration, adaptation, support, family focus, and process orientation. Participants were, however, unable to identify a unifying meta-theory to explain the described critical inter-relationships between these concepts. The proposed explanatory framework is based substantially on Folkman's (1997) revision of Lazarus and Folkman's (1984) theory of 'coping as a mediator of emotion' and also incorporates important aspects of family systems theory as described by McCubbin and McCubbin (1996). This framework has the potential to assist social workers to better understand and assess the crucial contributory aspects of adjustment-related issues and thus improve client-focused clinical practice.