Family context in pediatric psychology from a transactional perspective: family rituals and stories as examples

Reviewed the transactional model as applied to the family context of pediatric psychology. A three-part sequence of child behavior, parent behavior, and family interpretation was used to describe developmental adaptation and transitions. It was proposed that families are regulated by practices that are proximal to the child's experience and representations that are more distal to the child's experience. Family practices are examined through family routines and rituals. Family representations are examined through family stories. Case examples of low birth weight premature infants and an adolescent referred for repeated hospitalizations due to diabetic ketoacidosis were presented to illustrate the model. Guidelines for the practicing pediatric psychologist are presented to assess family organization through family rituals and family meaning-making in the telling of family stories.