Strengthening Family Function Through Family APGAR–Based Assertive Communication and Behavioral Contracting: A Family Nursing Case Report

Abstract

Background: Adolescent substance abuse may impair family functioning, particularly communication and behavioral regulation. This case report aimed to examine the implementation of assertive communication training using the I-Message technique and behavioral contracting to improve family functioning.

Methods: A descriptive single-family case report was conducted involving one family with an adolescent who had a history of substance abuse. Family functioning was assessed using the Family APGAR before and after a five-day intervention. The intervention consisted of assertive communication training using the I-Message technique and collaborative behavioral contracting.

Results: The Family APGAR score increased from 3 to 8, indicating improvement from severe family dysfunction to good family functioning. The mean adherence rate to the behavioral contract was 73.3%. The greatest improvements were observed in the domains of adaptation, partnership, affection, and resolve.

Conclusion: Assertive communication training combined with behavioral contracting was associated with improvements in family functioning by more open communication, collaborative problem-solving, and consistent parental monitoring. These findings suggest a potential functioning among families with adolescents who have a history of substance abuse.