Practice Models for Nursing Practice with Families

Calgary Family Assessment Model (CFAM) and Calgary Family Intervention Model (CFIM)

Developed by Lorraine M. Wright, RN, PhD and Maureen Leahey, RN, PhD and described in ”Nurses and Families: A Guide to Family Assessment and Intervention” (2013). The book is now available in a  6th edition (May 2013). The book has been translated in 7 languages: Japanese, French, German, Korean, Swedish, Portuguese, and Icelandic.

Nurses and FamiliesSee blog posts about the CFAM and CFIM:

WebsiteFamily Nursing Resources

Websites for Japanese translation: Igaku Eizou Kyouiku Center Inc.Family Systems Care-Japan


“How To” Family Nursing Series. DVD’s present live clinical scenarios that demonstrate how to practice family nursing using the Calgary Family Assessment and Intervention Models.  Developed and demonstrated by Lorraine M. Wright, RN, PhD and Maureen Leahey, RN, PhD.

  • How to do a 15 minute (or less) interview (2000).
  • Calgary Family Assessment Model: How to apply in clinical practice (2001)
  • Family nursing interviewing skills:  How to engage, assess, intervene, and terminate (2002)
  • How to intervene with families with health concerns (2003)
  • How to use questions in family interviewing (2006)
  • Interviewing an individual to gain a family perspective with chronic illness:  A clinical demonstration (2010)
  • Tips and microskills for interviewing: Families of the elderly (2010)
  • Common errors in family interviewing: How to avoid & correct (2010)

The “How To” Family Nursing Series DVD’s have been translated into Japanese.

Website: Family Nursing Resources

Family Empowerment Nursing Model

Developed by Sayumi Nojima, RN, PHN, DSN, and described in “ Kazoku Enpawamento wo motarasu kango jissen [in Japanese].  This model is used in nursing education and practice in Japan.

Website (Japanese): Helusu Publisher’s Inc.

Concentric Sphere Family Environment Model [Kazoku Doushinkyu Kankyo Model]

Developed by Naohiro Hohashi, RN, PHN, PhD and his colleagues. This nursing theory/model takes a holistic approach to the environment that affects the family’s well-being. Based on this approach, the family assessment model, the family support model and others have been developed. This model is described in the nursing textbook, “Atarashii Kazoku Kangogaku” [in Japanese]. This model is being developed in Japan and is currently used primarily by Dr. Hohashi and his colleagues. For more information see the following publication:

  • Hohashi, N., & Honda, J. (2011). Development of the Concentric Sphere Family Environment Model and companion tools for culturally congruent family assessment. Journal of Transcultural Nursing, 22(4), 350-361. doi: 10.1177/1043659611414200


Family Health Model

Developed by Sharon Denham, DSN, RN and described in “Family Health: A Framework for Nursing” (2003). A free copy of the book is available from: The Family Health Model was created as a result of a comprehensive literature review, the author’s professional nursing practice, life experiences, and findings from a series of three qualitative research studies about ways Appalachian families defined and practiced family health within their households. This ecological model is a way to conceptualize the complex interactive relational systems relevant to families and their health. It is important to note that the Family Health Model is a model of family health, not merely a theory or model to explain the family or its functions. Thus, the context and variables are more inclusive than merely considering family processes. In other words, family health is influenced by the inter-related contextual aspects as well aspects linked with individual members and the family as a whole. Family health involves all members who reside in the household, but includes ways relationships and environments affect health over time. Findings from the qualitative research conducted by the author have provided evidence that indicate a need to conceptualize family health from ecological and process perspectives. Health or its absence can all be viewed from the model’s precepts and ways to consider clinical practice can be considered from a variety of perspectives.

For more information about the model, visit the Website and hear Dr. Denham provide an explanation of her model. In addition, the Diabetes: A Family Matter program and toolkit of materials have been developed from the concepts of the Family Health Model.

Family Health-Promoting Conversation Model

The Family Health-Promoting Conversation Model was developed in Sweden for advanced practice with families by Eva Benzein, R.N.T., Dipl.Nurse., Ph.D., Margaretha Hagberg, and Britt-Inger Saveman (Linneaus University and Umea University, Sweden). It uses a Family Systems Nursing theoretical foundation.

Sweden family nursing bookThe model is described in the new book: Att möta familjer inom vård och omsorg “Meeting with Families in Health and Community Care” (2012) [in Swedish] available from  Studentlitteratur.

NEW PUBLICATION: Benzein, E., Olin, C., & Persson, C. (2014).  ‘You put it all together’ – families’ evaluation of participating in Family Health Conversations.  Scandinavian Journal of Caring Sciences. Advance online publication. doi: 10.1111/scs.1214

 Framework of Systemic Organization

Developed by Marie-Luise Friedemann, RN, PhD and described in “ The Framework of Systemic Organization” (1995).  Website:

The practical application of Dr. Friedemann’s theoretical framework has largely been taken up in Europe for the last 25 years. She has written a book in German that is now in its 3rd edition. Her framework is integrated in many nursing school curricula throughout German-speaking Europe. One Bachelor program at the Evangelische Fachhochschule Berlin, the first in Germany, is entirely based on Friedemann’s framework.  Dr. Friedemann’s ideas have also influenced family nursing care in Switzerland, Columbia (and across Latin America), and the Philippines. She consults with hospitals, home health agencies, hospices, and nursing homes.

A extensive bibliography of Dr. Friedemann’s publications is included on her Website

Friedman Family Assessment Model

Developed by Marilyn M. Friedman, RN, PhD and described in “Family Nursing: Research, Theory, & Practice”, 5th edition (2003) edited by Friedman, Bowden, and Jones. An earlier edition of this book was translated into Japanese in 1996 but is currently out of print.


Family Life Skill Index [Kazoku Seikatsu Rikiryo Moderu]

Developed by Setsu Shimanouchi and her colleagues. This model is described in  “Kazoku Seikatsu Rikiryo Moderu” [in Japanese]This model is primarily used  in Community Health Nursing education and practice in Japan.

Website: Igakusyoin Publisher’s Inc.

Illness Beliefs Model

Developed by Lorraine M. Wright, RN, PhD and Janice M. Bell, RN, PhD and described in  Beliefs and Illness:  A Model for Healing” (2009). This is an advanced practice model with a focus on illness beliefs of patients, families, and health care providers that uses a Family Systems Nursing theoretical orientation. A Kindle version of the book is also available and a Japanese translation was published in 2011.

Beliefs book coverFor a free download of the Table of Contents and Chapter 1 of the book, click here

Japanese translation (2011) by N. Kobayashi & K. Matsumoto.  Japanese title: “Yamai no Kunou wo Yawarageru Kazoku Sisutemu Kango”. Websites for Japanese translation: Family Systems Care-JapanNihon Kangokyoukai Publisher’s Inc.

An earlier version of this book was developed by Lorraine M. Wright, RN, PhD, Wendy L. Watson, RN, PhD, and Janice M. Bell, RN, PhD and called:  Beliefs: The Heart of Healing in Families and Illness (1996).  It was translated into French, Japanese, and Swedish.

Recent publication: Bell, J.M., & Wright, L.M. (2011).  The Illness Beliefs Model: Creating practice knowledge for families experiencing illness suffering.  In E.K. Svarvarsdottir & H. Jonsdottir (Eds.), Family nursing in action (pp. 15-51). Reykjavik, Iceland: University of Iceland Press.

WebsiteIllness Beliefs Model

McGill Model of Nursing

Developed at McGill University by Moyra Allen, RN, PhD and Mona Kravitz, RN, PhD, this practice model was first called Situation-Responsive Nursing or Complemental Nursing.  Dr. Moyra Allen and colleagues offered refinements which were described as the Developmental Model of Health and Nursing.  Dr. Laurie Gottlieb and faculty and students at McGill University offered refinements which were named the McGill Model of Nursing which emphasizes collaborative partnership and a strengths perspective. For more information see the following publications:

  • Gottlieb, L.N., & Rowat, K. (1987). The McGill Model of Nursing: A practice derived model. Advances in Nursing Science, 9(4), 51-61. PMID: 3111351
  • Gottlieb, L.N., & Gottlieb, B. (2007).  The Developmental/Health Framework within the McGill Model of Nursing: “Laws of nature” guiding whole person care.  Advances in Nursing Science, 30(1), E43-E57. PMID: 17299275

Website: McGill Nursing Model

Dynamic Model of Family Assessment and Intervention (MDAIF)

Developed by Maria Henriqueta Figueiredo, RN, PhD, and described in “Modelo Dinâmico de Avaliação e Intervenção Familiar: Uma abordagem colaborativa emEnfermagem de Família” (2012) [in Portuguese].  The Dynamic Model of Family Assessment and Intervention (MDAIF) was co-developed and validated through research conducted in the Portuguese primary health care context.  In 2011, the Portuguese Nursing Profession Regulator decided to adopt MDAIF as the theoretical framework for Family Health Nursing for use by Portuguese nurses who care for families. The model is based on the theoretical assumptions of the Calgary Family Assessment Model (Wright & Leahey, 2009; 2013). The MDAIF defines the concepts of Family Health, Family Environment, and Family Nursing. A multidimensional matrix includes Structure (household income; residential building; safety precaution; water supply; pets); Development (marital satisfaction; family planning; adaptation to pregnancy; parental role); and Functioning of the family system ( caregiver role; family process).


Strengths-Based Nursing (SBN)

Evolved from the McGill Model of Nursing

Strengths-Based Nursing (SBN) foundational roots are Nightingale and the McGill Model of Nursing. SBN develops, extends, and re-conceptualizes elements of the McGill Model of Nursing resulting in a more integrated, in-depth philosophical vision and pragmatic approach to family nursing. SBN is a value driven approach to guide nursing action in caring for persons and families that is founded on principles of: 1-Person/family centered care; 2- Empowerment; 3-Health promotion and healing; 4- Collaborative partnership; 5-Innate capacities for health and healing. SBN works with the person and family’s inner strengths and outer resources to maximize level of functioning and well-being to promote health and create conditions for healing.

Strenths based nursingReferences:

Gottlieb, L. N. (2013). Strengths-based nursing care: Health and healing for persons and family. New York, NY: Springer.

Gottlieb, L. N. (2014). CE: Strengths-Based Nursing.  American Journal of Nursing, 114(8), 24-32. doi: 10.1097/01.NAJ.0000453039.70629.e2

Gottlieb, L. N., & Ponzoni, N. (in press). Strengths-Based Nursing: A value driven approach to practice. In J. J. Fitzpatrick & A. L. Whall (Eds.),  Conceptual models of nursing: The international imperative (8th ed.). Toronto, Ontario, Canada: Pearson.


Related publications:

Gottlieb, L. N., Gottlieb, B., & Shamian, J. (2012). Principles of Strengths-Based Nursing. Leadership for Strengths-Based Nursing Care: A new paradigm for nursing and healthcare for the 21st century. Journal of Nursing Leadership, 25(2), 35-46.

Gottlieb. L. N., & Benner, P. (November 2013). Strengths-Based Nursing: Moving beyond deficits in nursing practice and nursing education. Educating Nurses Newsletter. Retrieved from

Watanabe & Suzuki Family Assessment Model

Developed by Hiroko Watanabe, RN, MS and Kazuko Suzuki, RN, PHN, PhD. This model is described in many books written by Watanabe et al. The most frequently cited textbook is “Kazoku kangogaku. Riron to Jissen” [in Japanese]. This model is used extensively in nursing education and practice in Japan.

Website (Japanese): Nihon Kangokyoukai Publisher’s Inc.

Trinity Model

Developed by Lorraine M. Wright, RN, PhD and described in “Spirituality, Suffering, and Illness:  Ideas for Healing” (2005). This is an advanced practice model that focuses on beliefs, illness suffering, and spirituality using a Family Systems Nursing orientation.

Spirituality book coverThe book has been translated into Portuguese and Japanese. Website for Japanese translation: Igakusyoin Publisher’s Inc.

A DVD related to the Trinity Model has been developed by Lorraine M. Wright, RN, PhD: Spirituality, suffering, and illness: Conversations for healing (2007) and is available from: Dr. Lorraine Wright.

Website: Spirituality, Suffering and Illness