Irish norms for the SCORE‐15 and 28 from a national telephone survey

In this study a 29‐item version of the systemic clinical outcome and routine evaluation (SCORE), which contained all items from the SCORE‐15 and SCORE‐28, was used to develop norms for both the 15 and the 28 versions of the SCORE from the same sample. In a random digit dialling telephone survey, a stratified national random sample of 403 adults living in the Republic of Ireland and Northern Ireland completed the SCORE and brief measures of family and personal adjustment. Using receiver operating characteristic curve analyses, cut‐off points for the SCORE‐28 and 15 were found to identify families of children with significant emotional and behavioural problems. We also established 90^th percentile points and percentages of cases falling above each scale point for both versions of the SCORE. Confirmatory factor analyses showed that, for both versions of the SCORE, the data fit the three factor solutions found in previous studies. The SCORE scales also had significant correlations with measures of family, parental and child adjustment, and negligible correlations with socioeconomic variables and social desirability response set.     

Psychometric evaluation and normative data of the Swedish version of the 10‐item perceived stress scale

The perceived stress scale (PSS) has been translated to several languages and validated in many cultures. The longer 14‐item version (PSS‐14), has been translated to Swedish and validated for Swedish use. However, the Swedish version of the shorter 10‐item version (PSS‐10) has not been validated before. Therefore, the aim of this study was to evaluate the Swedish version of the PSS‐10 with regard to reliability and validity, and to provide normative data. Data from 3,406 individuals who took part in the Västerbotten Environmental Health Study in Sweden were used. The respondents constitute a random sample, aged 18 to 79 years, and stratified for age and sex. They responded to the Swedish version of the PSS‐10 as well as to the hospital anxiety and depression scale, and the Shirom Melamed burnout questionnaire for assessment of construct validity. The results show that the PSS‐10 provides approximately normally distributed data, has good internal reliability (Cronbach's alpha 0.84), and has good construct validity with anxiety (r = 0.68), depression (r = 0.57), and mental/physical exhaustion (r = 0.71). The favorable psychometric properties of the Swedish version of the PSS‐10 suggest use of the instrument for assessing perceived stress in Swedish and similar populations.     

The Effectiveness of Functional Family Therapy in Reducing Adolescent Mental Health Risk and Family Adjustment Difficulties in an Irish Context

To evaluate the effectiveness of Functional Family Therapy (FFT) 42 cases were randomized to FFT and 55 to a waiting‐list control group. Minimization procedures controlled the effects of potentially confounding baseline variables. Cases were treated by a team of five therapists who implemented FFT with a moderate degree of fidelity. Rates of clinical recovery were significantly higher in the FFT group than in the control group. Compared to the comparison group, parents in the FFT group reported significantly greater improvement in adolescent problems on the Strengths and Difficulties Questionnaire (SDQ) and both parents and adolescents reported improvements in family adjustment on the Systemic Clinical Outcomes and Routine Evaluation (SCORE). In addition, 93% of youth and families in the treatment condition completed FFT. Improvements shown immediately after treatment were sustained at 3‐month follow‐up. Results provide a current demonstration of FFT's effectiveness for youth with behavior problems in community‐based settings, expand our understanding of the range of positive outcomes of FFT to include mental health risk and family‐defined problem severity and impact, and suggests that it is an effective intervention when implemented in an Irish context.     

Rivers of milk and honey ‐ an exploration of nurturing the self in a Russian context

This paper is an exploration of the relationship between nurturing in all its contexts ‐ among them, the nursing couple and the therapeutic relationship ‐ and the evolution of an individual self. The ideas are illustrated by a case vignette of a Russian patient. An attempt is made to show that when the self as an integral unity of body and soul is addressed in the analytic setting, ‘nutritional dreams’ emerge as expressions of the self‐in‐action. Certain psycholinguistic features of the Russian cultural context are described which suggest a link of meaning between development of the self and secure parenting. This linguistic association may facilitate the process of self‐centering.     

Developing an indicator of family function and a practicable outcome measure for systemic family and couple therapy: the SCORE

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.     

Elucidating the psychosocial context of ‘post‐concussion syndrome’ (PCS): a case study from post‐Milan systemic family therapy

The literature on post‐concussion syndrome (PCS) following mild head injury includes biopsychosocial formulations. However, it is contended that the complexities of the psychosocial remain conceptually underdeveloped. An engagement with this complexity is presented via a case study from post‐Milan systemic family therapy. The work described is with grandparents, a mother and daughter. The latter two both initially experienced PCS following a road traffic accident, yet demonstrated contrasting outcomes in the year post‐injury. Implications for family therapy services and the wider literature are discussed.     

Pragmatic post‐structuralism (II): an outcomes evaluation of a stopping violence programme

This paper reports features of a distinctly post‐structuralist ‘outcome evaluation’ of a New Zealand stopping violence programme for men who have assaulted their spouses. Through analysis of pre‐ and post‐programme interviews it was found that the men's accounts of their violence shifted as a consequence of their participation in and exposure to the programme's discursive resources. Overall the men's accounts demonstrated movement towards taking greater ownership and responsibility for their actions. However this trend was not universal and was mitigated through other pre‐programme discursive resources. Copyright © 2001 John Wiley & Sons, Ltd.     

Systemic psychotherapy as an intervention for post‐traumatic stress responses: an introduction,theoretical rationale and overview of developments in an emerging field of interest

The purpose of this article is to critically examine the literature to provide a rationale for including systemic family therapy (SFT) in the psycho‐social treatment of people suffering the impact of post‐traumatic stress (PTS). Attention is drawn to the relatively underdeveloped academic literature on PTS and the family. The impact of PTS is conceptualized within a psycho‐social framework and the current evidence base for psycho‐social interventions for PTS responses is described, highlighting the opportunity and need to undergird this area of daily practice. The impact of PTS on the family at multiple levels is identified, emphasizing its recursive nature. The case for SFT is articulated and a range of models of family intervention for PTS briefly reviewed, concluding with an emphasis on Walsh's key processes in family resilience as a framework for practice.     

Psychometric Properties and Responsiveness to Change of 15‐ and 28‐Item Versions of the SCORE: A Family Assessment Questionnaire

The SCORE (Systemic Clinical Outcome and Routine Evaluation) is a 40‐item questionnaire for completion by family members 12 years and older to assess outcome in systemic therapy. This study aimed to investigate psychometric properties of two short versions of the SCORE and their responsiveness to therapeutic change. Data were collected at 19 centers from 701 families at baseline and from 433 of these 3–5 months later. Results confirmed the three‐factor structure (strengths, difficulties, and communication) of the 15‐ and 28‐item versions of the SCORE. Both instruments had good internal consistency and test–retest reliability. They also showed construct and criterion validity, correlating with measures of parent, child, and family adjustment, and discriminating between clinical and nonclinical cases. Total and factor scales of the SCORE‐15 and ‐28 were responsive to change over 3–5 months of therapy. The SCORE‐15 and SCORE‐28 are brief psychometrically robust family assessment instruments which may be used to evaluate systemic therapy.     

Validation Study of the Orientation Model: A Dual‐Process Assessment Framework

The orientation model is a multidimensional dual‐process assessment framework composed of 4 empirically validated instruments of cognitive processing, attachment, empathy, and introspection. It lends counselors a flexible means to assess client processing patterns relevant to clinical practice. The author used 375 participant responses to determine whether selected subscales align with analytic and experiential dual processes. Results suggest that the orientation model can serve as a dispositional framework for counseling practice. Implications and directions for future research are suggested.     

Improving executive functions in 5‐ and 6‐year‐olds: Evaluation of a small group intervention in prekindergarten and kindergarten children

Research suggests a central role of executive functions for children's cognitive and social development during preschool years, especially in promoting school readiness. Interventions aiming to improve executive functions are therefore being called for. The present study examined the effect of a small group intervention implemented in kindergarten settings focusing on basic components of executive functions, i.e., working memory, interference control and cognitive flexibility. A total of 135 children enrolled in Swiss prekindergarten (5‐year‐olds) and kindergarten (6‐year‐olds) were involved. Results revealed that the small group intervention promoted gains in all three included components of executive functions: prekindergarten children substantially improved their working memory and cognitive flexibility processes, whereas significant training effects were found for the kindergarten children in interference control. Implications of these findings for early intervention programs and for tailoring preschool curricula are discussed, particularly with respect to children's school readiness. Copyright © 2011 John Wiley & Sons, Ltd.     

Client crying in the context of family therapy: an exploratory study

This study explores the crying episodes of twenty‐eight clients treated at a family therapy service in a community centre. The crying episodes were associated with some significant elements: the time of appearance, the content and triggering factor, the interpersonal context of sessions and the emotions clients had for the therapist, as well as the therapy's outcome (end of treatment and the satisfaction of clients). Crying was much more frequent during the first session. It occurred more frequently when there was another family member present. The proportion of clients who cried during the treatment was significantly higher for clients who completed it successfully. Clients who cried perceived the therapist, in all cases, as a kind person who never got annoyed with them. Crying could be considered a type of behaviour that helps the therapist to create a safe context and foster the therapeutic alliance.