The Family Assessment Device: An Update

The current study set out to describe family functioning scores of a contemporary community sample, using the Family Assessment Device (FAD), and to compare this to a currently help‐seeking sample. The community sample consisted of 151 families who completed the FAD. The help‐seeking sample consisted of 46 families who completed the FAD at their first family therapy appointment as part of their standard care at an outpatient family therapy clinic at an urban hospital. Findings suggest that FAD means from the contemporary community sample indicate satisfaction with family functioning, while FAD scores from the help‐seeking sample indicate dissatisfaction with family functioning. In addition, the General Functioning scale of the FAD continues to correlate highly with all other FAD scales, except Behavior Control. The cut‐off scores for the FAD indicating satisfaction or dissatisfaction by family members with their family functioning continue to be relevant and the FAD continues to be a useful tool to assess family functioning in both clinical and research contexts.     

Can the Family Assessment Device (FAD) Be Used with School Aged Children?

This article examines the usefulness of the Family Assessment Device(FAD) in assessing family functioning with school-aged children (under 12 years of age) compared to children 12 and older and mothers. FAD reports from 194 children with asthma (132 under 12 years; 62 12 years and older) were evaluated in comparison to mothers' FAD reports as well as mothers' reports on two other family functioning measures: the Family Inventory of Life Events (FILE) and the Impact on Family (IOF) scale, both relevant to functioning in families with children with asthma. Although FAD scale reliabilities were lowest in younger children (alpha = 48-.79), good concurrent validity was found with mothers' reports on the three different measures of family functioning. Older childrens' FAD scales showed good reliability (> .70) but poorer agreement with the various maternal measures. With modifications to make items more structured and simplified, the FAD could be tried with younger children, although documentation of improved reliability is needed before more widespread use with school-aged children is advocated. The measure already shows good agreement with maternal report in this younger age group, which likely would be strengthened with improved reliability. FAD reports in older children correlated less well with maternal measures, but may represent nonredundant information on family health from an independent perspective and are worth considering in addition to mothers' perspectives.     

Reliability and Validity of a Short Version of the General Functioning Subscale of the McMaster Family Assessment Device

The General Functioning 12‐item subscale (GF12) of The McMaster Family Assessment Device (FAD) has been validated as a single index measure to assess family functioning. This study reports on the reliability and validity of using only the six positive items from the General Functioning subscale (GF6+). Existing data from two Western Australian studies, the Raine Study (RS) and the Western Australian Child Health Survey (WACHS), was used to analyze the psychometric properties of the GF6+ subscale. The results demonstrated that the GF6+ subscale had virtually equivalent psychometric properties and was able to identify almost all of the same families who had healthy or unhealthy levels of functioning as the full GF12 subscale. In consideration of the constraints faced by large‐scale population‐based surveys, the findings of this study support the use of a GF6+ subscale from the FAD, as a quick and effective tool to assess the overall functioning of families.     

Family functioning, cultural orientation, and psychological well-being among university students in Lebanon

The author examined the relationship between perceived family functioning, the cultural orientations of horizontal and vertical individualism and collectivism, and psychological well-being in a group of 182 university students in Lebanon. Factor analysis of the present data from the 12-item General Functioning Scale of the Family Assessment Device (GF-FAD) resulted in the extraction of one general factor, accounting for 43% of the variance. On the basis of North American cutoff values, the author found that 60.5% of the university students perceived their family as healthy and that 39.5% perceived their family as unhealthy. Male students perceived their families as somewhat more dysfunctional than did female students. Muslim students perceived their families as more dysfunctional than did Christian students. As the author expected, family functioning was associated with the culture-related personality dimension of horizontal collectivism and with perceived psychological well-being. Overall, the findings supported the structure and usefulness of the GF-FAD in the Lebanese context and the importance of viewing family functioning from the perspective of individual cultural orientation.     

Identifying families at risk: exploring the potential of the McMaster Family Assessment Device

The Family Assessment Device (FAD) was given to a community sample of intact families with young children. Responses by mothers and fathers were analysed with a view to providing ways of indicating which families might benefit from preventive intervention.
Mother/father agreement was significant on five of the seven scales, with a failure to reach significance on Affective Involvement and General Functioning. The highest correlation between mothers and fathers was on the Roles scale (r = 0.53). However, mothers' means for Roles were significantly higher than fathers', indicating that mothers were less satisfied with family functioning in this area.
In addition to a family mean score greater than a cut-off value as an indicator of unhealthy functioning, present results suggest including those families whose respondents strongly disagree (indicated by scores lying on either side of the cut-off and a difference of more than two standard deviations). With this double criterion, Roles and Affective Involvement were the dimensions most frequently scored as unhealthy. Seventeen per cent of the families scored in the unhealthy range on four or more of the seven dimensions.
This paper considers how to decide where family intervention might be helpful and raises the question of whether screening families might be more widely undertaken, for example by health visitors, to identify those families who are at risk of family dysfunction.     

Cross-national validity of dimensions of family functioning: First experiences with the Dutch version of the McMaster Family Assessment Device (FAD)

The present study describes the first psychometric findings obtained in The Netherlands with the Dutch version of the Family Assessment Device (FAD) which was originally developed in the Anglo-American cultural context. In a sample of community volunteers, confirmatory analysis (multiple-group method) provided evidence of factorial validity of the FAD measuring constructs. Only 3 out of 60 items were found to be biased and had to be deleted from their a priori defined scales. Reliability and homogeneity indices pertaining to each FAD dimension were good. Despite (very) high correlations among FAD factors/scales, further analyses were focused on determining their convergent and divergent validity which offered good support for such. A higher-order analysis which incorporated reliable scales of the FAD and the Family Environment Scale yielded a two-factor composition: General Family Functioning and Family Influence / Power and Integration. There was evidence to support the viewpoint that a general measure of family functioning may be utilized which is broader in terms of content than the already existing subscale measure termed General Functioning. In line with findings pointing to the ability of the FAD to distinguish between families of psychiatric patients and nonclinical families, the great majority of the FAD subscales, especially Problem Solving and General Functioning, were found to correlate with psychological symptom states as assessed with the Symptom Checklist-90-R. Specific subscales were found to be affected by educational level, while none were affected by sex, age, or religious affiliation. All in all, the findings confirm the further use of the FAD in the Dutch national context.     

Family of Origin and Current Relationship Influences on Codependency

This study investigated codependency in Caucasian individuals within the framework of Bowen's Family Systems Theory. The sample consisted of a group of couples, in which one member of the couple was a recovering alcoholic in an aftercare program, and a group of matched, comparison couples. Participants completed a demographic questionnaire, the Friel Co-dependency Assessment Inventory, and the Personal Authority in the Family System (PAFS) Questionnaire. The findings confirmed that codependency levels were higher in clinical than in comparison couples. Moreover, within the clinical group, there was little difference between alcoholics and their spouses with respect to dysfunction in their families of origin, current families, or their codependency levels. The findings further suggested that the etiology and function of codependency are different in clinical and nonclinical families. In the clinical sample, the family of origin and current relationship characteristics were related to codependency in patterns consistent with previous theory and research. For the nonclinical sample, however, the findings contradicted conventional codependency theory. The findings suggest that, in contrast to clinical populations, codependency in nonclinical populations has some links with favorable characteristics of family functioning.     

Longitudinal Associations Between Fathers’ Heavy Drinking Patterns and Children’s Psychosocial Adjustment

Psychosocial adjustment in children of alcoholics (N = 114) was examined in the year before and at three follow-ups in the 15 months after their alcoholic fathers entered alcoholism treatment, testing the hypothesis that children's adjustment problems will vary over time as a function of their fathers' heavy drinking patterns. Three unique patterns of heavy drinking in alcoholic fathers were identified through cluster analysis. The results demonstrated significant and meaningful associations between these drinking patterns in fathers and adjustment problems in children over time. Overall, children whose fathers remained mostly abstinent following their treatment showed lowest and decreasing adjustment problems, while children whose fathers continued and increased heavy drinking following their treatment showed greatest and increasing adjustment problems over time.     

The McMaster Model of Family Functioning: Observer and Parental Ratings in a Nonclinical Sample

The McMaster Model of Family Functioning defines seven dimensions, which may be assessed either by an observer applying a Clinical Rating Scale (CRS) to a semi-structured interview of the family and/or by family members completing a questionnaire, the Family Assessment Device (FAD). The present article applied both methods of assessment, as well as the Dyadic Adjustment Scale (DAS), to a nonclinical sample (N = 105 ). Interobserver reliability on the CRS was highly significant. Parent (FAD) vs. observer (CRS) agreement was also highly significant, except for Affective Responsiveness and Behavior Control, for which agreement was barely significant. When families were labeled as “healthy” or “unhealthy” according to cut-offs, agreement between observers and parents was high (87%), and disagreements illuminated dynamics of individual families. Finally, the DAS (completed by mothers) was significantly correlated with both the CRS and the FAD, particularly for General Functioning.     

Predictors of Family Functioning Within Alcoholic Families

This study assessed the effects of various predictor variables on dimensions of functioning within alcoholic families. Participants were 173 college student volunteers from alcoholic families who completed a measure of family functioning, demographic questions, and questions related to experiences in their families of origin. Child abuse, spousal violence, parental divorce, length of time living with an alcoholic parent, parental marital status, and parental availability and predictability significantly affected family functioning, whereas frequency of parental drinking did not. Results suggest that quality of parental interactions with children is more important for functioning in alcoholic families than frequency of parental drinking.     

Differences in the drinking behavior between alcoholic men and women in the Schwerin district]

The present paper demonstrates some typical differences in drinking behaviour between female and male alcoholics. We investigated especially the difference in quantities of consumed pure alcohol. The ratio of the mean consumption per year by women and men was 1 : 1,9. The difference in due to differences in the drinking habits and a different alcoholic tolerance in both sexes. Generally we found that in both family and society alcohol abuse is less tolerated in women.     

Observational couple assessment: a cross-model comparison

This study compared the clinical rating scales from the Circumplex Model (CCRS), the McMaster Model of Family Functioning (MCRS) and the Family Health Scales (FHS). A central purpose was to investigate whether observational rating scales designed to measure family functioning can also be used to assess couple functioning. One hundred and sixty-six drug abusing women, receiving primary drug treatment in two metropolitan drug agencies in the southwest of the US, and their partners were videotaped while engaged in three couple tasks prior to receiving any treatment. The main findings indicated that all three rating scales have: (1) sufficient interrater reliability; (2) good construct validity, as reflected in factor analyses; and (3) very good convergent validity. However, there was some concern about whether these scales are as discriminating when measuring couples as they are when assessing families.     

Family Environment in Inner-City African-American and Latino Parents/Caregivers: A Comparison of the Reliability of Instruments

Inner-city, African American and Latino youth are at higher risk for the development of obesity and type 2 diabetes. Interventions usually focus on changing physical activity and dietary behaviors, yet family environment has the potential to influence response to these interventions. We aimed to identify instruments that could reliably be used to assess the family environment of children from high-risk populations. Selected indices from four instruments were used; the Family Environment Scale (FES), the Family Adaptability and Cohesion Evaluation Scales IV (FACES IV), the Self-report Family Inventory (SFI), and the Family Assessment Device (FAD). Out of 15 indices evaluated, 9 were reliable in both ethnicities including FES cohesion, conflict and organization, SFI emotional expressiveness, conflict and family health/competence, FACES IV family communication and family satisfaction, and FAD general functioning. Perceived family environment characteristics did not differ significantly for inner-city African American and Hispanic families.     

Recollections of parental style and perceptions of current family functioning at age 50

It is hypothesized that recollections of an individual's parental behaviour towards them is associated with their view of their current family functioning. This hypothesis was tested for using data provided by 213 men and 270 women drawn at age 50 from the Newcastle Thousand Families Study. Relationships between retrospective reports of parental behaviour during childhood and perceptions of current family functioning at age 50 were investigated using a univariate regression analysis in order to explore the relationship between scores on the Parental Bonding Instrument (PBI) and the McMaster Family Assessment Device (FAD). Where a significant association was observed the relationship between subscale scores was further examined using a multivariate regression analysis including gender and self‐reported psychological well‐being (as measured by the General Health Questionnaire‐ GHQ) as covariates. Several statistically significant associations between PBI and FAD subscale scores were observed. Four of these remained statistically significant once gender and self‐reported psychological well‐being were adjusted for. In this population sample, aspects of recalled parental behaviour were associated with the health of current family functioning in several domains as reported by the FAD. These associations appear to be partly mediated by current psychological well‐being.     

A Spontaneous Request for Treatment by a Group of Adolescents

In this article, we build on our clinical knowledge in working with the adult children of alcoholics, examining the importance of the “alcoholic” family, past and present, to the current functioning of adults who grew up in such an environment. Specifically, we focus on key issues related to the development of family transference in the group therapy setting.     

Failure to find differences in drinking behavior as a function of familial risk for alcoholism: a replication

Groups of high-risk (alcoholic fathers), middle-risk (second-degree alcoholic relatives) and low-risk (no first- or second-degree alcoholic relatives) male college students were compared with respect to drinking behavior, sociodemographic variables, personality, cognitive functioning, and mental health and drug use problems in themselves and in family members. The groups differed significantly on only one of a number of sociodemographic variables. No significant group differences were revealed in drinking behavior, or alcohol-related symptoms or consequences. High-risk subjects reported significantly more childhood attentional and social problems than did low-risk subjects. No group differences were found with respect to other childhood problem behaviors, cognitive functioning, subject or family drug use, or mental health problems. The findings are discussed in terms of the questions they raise concerning the results of high-risk studies and the contribution of genetic factors to alcoholism.     

Individualized behavior therapy for alcoholics: a third year independent double-blind follow-up.

An independently conducted double-blind study providing third year follow-up data for 53 of 70 male alcoholics who served as subjects in an experiment evaluating “Individualized Behavior Therapy (IBT)” techniques is reported. In the original study, subjects were initially assigned to either a controlled drinking or non-drinking (abstinence) treatment goal, and were then randomly assigned to either an experimental group receiving IBT or a control group receiving conventional state hospital treatment oriented towards abstinence. Previously reported results showed that IBT subjects functioned significantly better than control subjects throughout the first year of follow-up. Second year follow-up results found that IBT subjects treated with a controlled drinking goal functioned significantly better than their respective control subjects on a variety of measures, including drinking behavior. Differences between IBT subjects treated with a non-drinking goal and their control subjects did not retain statistical significance during the second year of follow-up. The independently determined follow-up data showed that during the third post-treatment year, subjects in the experimental groups generally functioned better than their respective control subjects. Comparison of the controlled drinking experimental group with its control group showed the significantly better functioning of subjects in the experimental condition on a number of drinking and other life functioning measures. Comparison of the non-drinking groups indicated only one possible difference on the drinking related measures involving a trend for subjects in the experimental condition to abstain more than those in the non-drinker control group. On other life functioning measures, however, subjects in the non-drinking experimental condition showed consistent improvement over their respective control subjects. Both of the controlled drinking groups reported more controlled drinking days than the non-drinking groups throughout the third year follow-up period.     

A community-reinforcement approach to alcoholism

Several theoretical approaches to alcoholism exist. An opérant reinforcement approach was used in the present study to develop a new procedure that rearranged community reinforcers such as the job, family and social relations of the alcoholic such that drinking produced a time-out from a high density of reinforcement. The results showed that the alcoholics who received this Community-Reinforcement counseling drank less, worked more, spent more time with their families and out of institutions than did a matched control group of alcoholics who did not receive these procedures. This new approach appears to be an effective method of reducing alcoholism. An analysis in reinforcement terms is presented of the etiology, epidemiology, and treatment of alcoholism.     

Culturally Sensitive Family Assessment: An Evaluation of the Family Assessment Device Used with Hawaiian-American and Japanese-American Families

This article reports the results of a study of the McMaster Family Assessment Device (FAD) used with samples drawn from two non-Anglo ethnic groups: Hawaiian-Americans and Japanese-Americans living in Hawaii. The results showed that the FAD appeared to make appropriate assessments of Hawaiian-American study participants' families and inappropriate assessments of Japanese-American study participants' families. Results also suggested that cultural norms regarding family functioning may vary according to socioeconomic status. FAD modifications are suggested.     

Treating paternal alcoholism with learning sobriety together: effects on adolescents versus preadolescents.

The purpose of this study was to determine whether Learning Sobriety Together, a treatment for substance abuse that combines behavioral couples therapy and individual counseling, had comparable secondary benefits on the internalizing and externalizing behaviors of adolescent versus preadolescent siblings living in homes with their alcoholic fathers (N = 131) and their non-substance-abusing mothers. During a 17-month assessment period, the association between parents' functioning (i.e., fathers' drinking as determined by percentage of days abstinent and parents' dyadic adjustment) and children's adjustment (as rated by mothers, fathers, and children's teachers) was stronger for preadolescents than for their adolescent siblings, particularly in terms of children's externalizing behaviors. Interventions that reduce paternal drinking and improve couple functioning may serve as an important preventative intervention for preadolescents in these homes, whereas adolescents may need more intensive interventions to address internalizing and externalizing symptoms.