There is a need for a measure of outcome in systemic family and couples therapy (SFCT) that reflects current theory and practice. To meet the needs of SFCT practice the measure needs to use self-report by family members, take a short time to complete and be easy to understand. The development of such a measure, called the SCORE, is reported in this article. Substantial piloting, consultation and review in terms of clinical judgement led to the construction of the SCORE 40 which has forty items about how the family functions, rated by family members over 11 years of age on a Likert scale, in addition to independent ratings of the family and its difficulties. The SCORE 40 is shown to be a viable instrument but is too substantial for everyday clinical use. In a research project to reduce and refine the measure and determine its psychometric properties the SCORE 40 was administered to 510 members of 228 families at the start of their first appointment for family therapy at clinics throughout the UK. The scale has good psychometric properties and could operate with either three or four dimensions. The analyses of these data, combined with data from a convenience sample of 126 non-clinical families, allowed a reduction to fifteen items while retaining most of the information provided by the SCORE 40. This version is offered with three dimensions of: (1) Strengths and adaptability; (2) Overwhelmed by difficulties; and (3) Disrupted communication. It is hoped that the ready availability of the SCORE 15 will encourage routine evaluation of outcomes in clinics as well as the SCORE being used flexibly for both therapy and research.

The SCORE index of family functioning and change is an established measure, with strong psychometric properties, of the quality of family life. We report the sensitivity to therapeutic change of the short form, the SCORE-15. Data are reported from 584 participants aged above 11 years, representing 239 families. All couples and families had been referred for systemic couples and family therapy, completing the form at start of the first session and close to the fourth. The SCORE-15 is shown to be acceptable with strong consistency and reliability. Change over only three sessions was highly statistically significant. Further validation is provided by improvements in quantified scores correlating significantly with independent measures provided by family members and by their therapists. The SCORE-15 is a proven measure of therapy and of therapeutic change in family functioning. It is therefore a routinely usable tool applicable to service evaluation, quality improvement, and to support clinical practice. Practitioner Points• The SCORE provides practitioners with brief descriptions of varied aspects of family interaction that have proven significance for many families who present for therapy. • SCORE-15 can be used with confidence to monitor and report proven indicators of progress in systemic therapy. • Because SCORE identifies clinically significant issues of family interaction it has many potential uses in therapy. • There are many new possibilities for therapists to undertake collaborative research.

No abstract

No abstract

No abstract