Next ASWB exam content item for your consideration: The impact of physical and mental illness on family dynamics. This is in the HBSE section. It's a little vague, but let's take a look at the topic and how it may appear on the social work exam.

The Impact of Illness on Families

The impact of physical and mental illness on family dynamics can be profound and multifaceted--and very different family to family, depending upon preexisting family dynamics. Here are some ways in which family life can be affected:

  • Emotional Strain: Coping with a loved one's illness, whether physical or mental, tends to lead to increased stress, anxiety, and depression among family members. They may experience a range of emotions, including sadness, guilt, anger, and frustration.

  • Role Changes: Illness can disrupt established family roles and responsibilities. For example, a parent who becomes ill may no longer be able to fulfill their role as the primary caregiver, leading to shifts in responsibilities among other family members.

  • Financial Burden: Medical expenses, loss of income due to illness-related work absences, and the cost of caregiving can place a significant financial strain on families. This can lead to difficulties in meeting basic needs and may require adjustments to lifestyle and spending habits.

  • Communication Challenges: Illness can sometimes lead to breakdowns in communication within the family. Family members may struggle to express their feelings or may avoid discussing difficult topics related to the illness, leading to misunderstandings and resentment.

  • Social Isolation: Families may become socially isolated as they prioritize caregiving responsibilities and face stigma or discrimination related to the illness. This can further exacerbate feelings of loneliness and alienation.

  • Changes in Family Functioning: Illness can alter the dynamics within the family unit, leading to changes in how decisions are made, conflicts are resolved, and support is provided. Family members may need to adapt to new routines and ways of interacting with each other.

  • Impact on Children: Illness in a parent or sibling can have a profound impact on children, affecting their emotional well-being, academic performance, and social relationships. They may feel anxious, confused, or neglected, and may require additional support and reassurance from adults.

The nature and severity of the illness, the availability of support networks, and the resilience of family members all impact how these affects are felt. It is ideal for families to recognize the challenges they face and to seek help when needed to navigate through difficult times.


Let's consider an example to illustrate how mental illness can affect family dynamics:

Sarah is a mother of two young children, and her husband, John, has recently been diagnosed with severe depression. John's depression has led to significant changes in their family dynamics:

  • Increased Stress and Burden: Sarah feels overwhelmed by the demands of caring for John, managing the household, and taking care of their children. She worries about John's well-being and struggles to balance her caregiving responsibilities with her own needs.

  • Changes in Roles and Responsibilities: Before John's diagnosis, he was actively involved in parenting and household tasks. However, his depression has made it difficult for him to fulfill his usual roles and responsibilities, leaving Sarah to take on more responsibilities and make decisions on her own.

  • Emotional Strain and Coping Mechanisms: Sarah experiences a range of emotions, including sadness, frustration, and guilt. She often feels helpless and wonders if she could have done more to support John. To cope with her feelings, Sarah tends to avoid discussing John's depression with friends and family, fearing judgment or misunderstanding.

  • Communication Challenges: Sarah finds it challenging to communicate with John about his depression. He often withdraws and refuses to talk about his feelings, leaving Sarah feeling shut out and unsure of how to support him effectively. This lack of communication leads to tension and misunderstandings between them.

  • Social Isolation and Stigma: Sarah and John feel isolated from their friends and extended family members, who don't fully understand the impact of John's depression on their family. They worry about being judged or stigmatized, so they withdraw from social activities and keep John's illness a secret from others.

  • Financial Strain: John's depression has led to frequent work absences and decreased productivity, resulting in a loss of income for their family. They struggle to afford John's therapy sessions and medications, leading to financial stress and uncertainty about the future.

  • Impact on Children: Sarah and John's children notice changes in their parents' behavior and sense tension in the household. They feel confused and scared, not fully understanding why their dad is often sad and distant. Sarah worries about the impact of John's depression on their children's emotional well-being and tries to provide them with reassurance and support.

On the Exam

Social workers tend to know this material from experience--it doesn't require additional study. On the exam, the topic may look something like this:

  • How might the impact of a parent's mental illness differ between younger and older children in the family?
  • A social worker is working with a family where one member has been diagnosed with schizophrenia. Which of the following is a potential impact of schizophrenia on family dynamics?
  • A social worker is providing support to a family whose elderly parent has been diagnosed with Alzheimer's disease. Which of the following is a potential impact of Alzheimer's disease on family dynamics?

Get questions from all corners of the exam content outline (plus answers, rationales, and suggested study links!) when you use SWTP's full-length practice tests.

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May 13, 2024
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