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Most couples undertake the serious business of parenting with the belief that they will be able to provide their children with emotional and financial security. The major shifts in family life associated with social and economic changes have made these goals much harder to achieve. An increased emphasis on the desire for individual fulfilment may result in parents making decisions which they hope will improve their own lives, but which their children do not always view as positive. There have been frequent and simplistic attempts to explain the growing insecurities shown by children in educational and social settings simply by blaming changing family structures. Paediatricians, when faced in practice by children presenting with a range of difficulties, will be well aware of the wide range of influences at work in producing “symptoms” or aggravating an organic disorder.
The media, in its crusade to explain family values in language that ascribes to a “black or white formula”, has somehow demanded that allegiance be paid to one side or the other of an often acrimonious debate: either the nuclear family is the only answer for children, or that one family group can be as supportive to children and as effective as any other. Family professionals know the truth to be more elusive and complex. Acknowledging that family breakdown is disadvantageous to children has, in some way, become associated with a “right wing” reactionary view of society and has thus made the discussion of possible remedial action more difficult. We might hope that primary prevention may be assisted by the swing of the pendulum away from its present emphasis on personal freedom and fulfilment back towards responsibility and duty, neither of which are mutually exclusive. This paper presumes no such swing, but addresses issues of secondary prevention.
Doctors will wish to assist this …
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