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January 1964

The "Whole Family" Concept in Clinical Genetics

Author Affiliations

Robert L. Tips, MD, Dept of Pediatrics, Baylor University Medical School, Houston.; The clinical genetics program, upon which the concepts are based, was inaugurated at the University of Texas Medical Branch, Galveston, Tex (Drs. Lynch, McNutt, Tips) in the Departments of Anatomy and Pediatrics, from 1956-1959. Since then, the program has been extended in the Department of Anatomy of the University of Texas Medical Branch, Galveston (Dr. McNutt), in the Department of Internal Medicine at the University of Nebraska School of Medicine, Omaha (Dr. Lynch), and in the Department of Pediatrics of the University of Oregon Medical School, Portland (Dr. Tips) in cooperation with the Oregon Fairview Home, Salem (Dr. Smith). Most of the work embodied in the development of this report was accomplished by volunteer physicians, social workers, psychologists, technical assistants, photographers, and aides. The program was not substantially supported by any single research grant. Some of the data obtained from the program have been published and appropriate credit given to the specific research grant. Evolution of study procedures of the more than 600 families in Texas, Louisiana, Nebraska, and Oregon forms the basis of the concept included herein.

Am J Dis Child. 1964;107(1):67-76. doi:10.1001/archpedi.1964.02080060069010

As an extension of the "whole child" concept,1 the "whole family" concept is the practical application of modern genetic principles as they relate to the diagnoses, prognoses, and management of the child with genetic disease, of his immediate family unit, and of his entire kindred, including the normal and carrier (heterozygote) members.

The clinical geneticist in the modern concept accepts both the challenge to explore the significance of genetic factors in disease and the responsibility to aid families in recognition of the inherent emotional stress implied by this knowledge.2 Insight into the psychodynamics of the family milieu is essential in establishing an atmosphere conducive to alleviating the stresses. This implies a nondirective approach3-5 and is not a substitute for more analytically oriented psychotherapy should there be problems of such magnitude as to warrant it. Our experience demonstrates that delineation of genetic data in correlation with clear definition of