Measuring Therapeutic Changes for a British Chinese Family UsingSCORE‐15

Abstract

This paper details the findings and reflections of family therapy treatment outcomes for a British-Chinese family using SCORE-15, a reliable and valid systemic outcome measure developed in the UK. It aims to examine the clinical usefulness of SCORE-15 through its application to a single case study. The two culture-specific treatments were conducted at the Marlborough Cultural Therapy Centre (MCTC), which was part of the Marlborough Family Service in London. MCTC was a mental health specialist service for ethnic minorities in their preferred languages that operated for 18 years within the mainstream mental health setting of the National Health Service (NHS). The overall family functioning was found to have improved and problem severity decreased, apart from some aspects rated by the mother. Reflections and discussions with the family with regard to the SCORE-15 findings facilitated understanding and feedback about clinical changes in the systemic intervention. Key Points1 SCORE-15 is a self-report measure designed to indicate crucial aspects of family life that are relevant to the need for therapy and for therapeutic change. 2 Therapeutic outcome of two family therapy treatments attended by the same British-Chinese family were analysed using a systemic outcome measure, SCORE-15. 1 3 SCORE-15 was administered at the first and penultimate sessions of treatment two, and discussed with the family twice, first at the end of treatment and another time during the process of involving them in this writing process. 4 Overall ratings on SCORE-15 fell between adequate and significant problem family functioning ranges and some changes were found between the start and end of treatment. 5 The findings from SCORE-15 were also compared and contrasted with the family's narrative account of the treatment outcomes.A narrative review conducted by Lappan, Shamoon, and Blow (2017) found up to 50% of clients prematurely drop out from psychotherapy. In one study 12% of clients terminated prematurely citing therapy as contributing to the worsening of their presenting issues, yet therapists were generally oblivious to the dissatisfaction or clinical deterioration regardless of clinical experiences. Clients generally censor their feedback when asked informally during sessions and therapists were only able to accurately identify unspoken negative clients' feelings towards therapy 50% or less of the time. Maintaining multiple therapeutic alliances is a challenge for family therapists given the complex and multiple interactions required with various family members in

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“…It consists of 15 items measuring family strengths, communication and difficulties; the additional questions in this measure were adapted for the clinicians to define the relational topic they shared in the group and their rating of group helpfulness. There are several published papers about adapting the family SCORE‐15 for various specific groups, languages and cultures for clinical and research purposes (for example, Limsuwan & Prachason, 2021; Teh et al., 2017; Teh & Lek, 2018). There are also studies addressing the scale's reliability, validity and clinical cutoff points (for example, Fay et al., 2013; Miller et al., 2022).…”