Judith Lask

Detecting therapeutic improvement early in therapy: Validation of the SCORE-15 index of family functioning and change

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.

From family to relational SCORE-15: an alternative adult version of a systemic self-report measure for couples and LGB People

SCORE-15 is a self-report measure developed for systemic approaches to therapy. This article describes a pilot study designed to test the reliability and content validity of the original SCORE-15 for lesbian, gay and bisexual (LGB) adults in the UK. Quantitative data analyses conducted with an LGB sample (n = 59) and a non-LGB sample (n = 57) found sufficient temporal and internal reliability in the SCORE-15 but with some exceptions for the communication subscale. The content validity of SCORE-15 was checked via group discussions with two clinical professionals groups (n = 7) and a gay/bisexual men group (n = 8). An alternative adult version of SCORE-15 named the relational SCORE-15 or the R-SCORE-15 was constructed and its content validity was checked by the original clinical professionals and an additional professional group (n = 8). The R-SCORE-15 has content validity for clinical use with couples and LGB people in relationship therapy. Practitioner points SCORE-15 is a systemic self-report measure reliable for routine clinical use with LGB people and couples in the UK to measure relational changes. The use of the term family affects the content validity of SCORE-15 for LGB people and couples who may not regard family as their primary relationships. R-SCORE-15 is a recommended alternative to SCORE-15 for couples, LGB people and those who may not define significant relationships via biology or marital ties.

Measuring competence in systemic practice: development of the ‘Systemic Family Practice – Systemic Competency Scale’ (SPS)

Ensuring that practitioners are competent in the therapies they deliver is important for training, therapeutic outcomes and ethical practice. The development of the Systemic Practice Scale (SPS) is reported - a measure to assess the competence of novice systemic practitioners trialed by Children and Young Person’s Improving Access to Psychological Therapies (CYP-IAPT) training courses. Initial reliability assessment of the SPS with twenty-eight supervisors of systemic practice evaluating students’ competence using an online recording of a family therapy session is detailed. The SPS was found to be a reliable measure of systemic competence across training settings. Rating variability was noted, with training and benchmarking to improve rating consistency recommended. Further research using the SPS to further establish the reliability and validity of the scale is required.

Family and Psychiatric Illness: Family Therapy

This article is a revision of the previous edition article by J. Leff, volume 8, pp. 5298–5303,