The Family Empowerment Scale (FES), a 34-item rating scale, was developed to measure empowerment in families with children who have emotional, behavioral, or mental disorders. This study investigated the psychometric characteristics of the FES in a sample of 228 families whose children had serious emotional disturbance or attention-deficit/hyperactivity disorder. The families rated each item on a 5-point Likert-type rating scale, and the ratings were subjected to a number of psychometric analyses.The results of factor analyses, with varimax rotation, provided a conceptually meaningful four-factor solution. Congruence between the four factors derived in this study and the corresponding factors in the original FES psychometric analysis was high, with congruence coefficients ranging between .88 and .98. Obtained internal consistency estimates of reliability ranged from .78 to .89 for the four subscales, and the split-half estimate of reliability for the FES was .93. The results indicate that the FES has robust psychometric properties and may be useful in assessing the empowerment status of families whose children are handicapped.

We present a brief historical overview of the prevalence studies of psychotropic drugs in individuals with mental retardation that were published between 1966 and 1985, and a more comprehensive review of the prevalence studies from 1986 to 1995. During the 1966 to 1985 period, typical prevalence rates of drug treatments in institutions (children and adults analyzed together) were found to range from 30% to 40% for psychotropic drugs, 25% to 45% for anticonvulsants, and 50% to 70% for psychotropic and/or anticonvulsant drugs (i.e., psychotropics, anticonvulsants, or their combinations). In the community during the same period, prevalence rates in children were typically 2% to 7% for psychotropics, 12% to 31% for anticonvulsants, and 18% to 33% for psychotropic and/or anticonvulsant drugs. For adults in the community, prevalence rates ranged from 26% to 36% for psychotropics, 18% to 24% for anticonvulsants, and 36% to 48% for psychotropic and/or anticonvulsant drugs. In contrast, during the 1986 to 1995 period, typical prevalence rates in institutions ranged from 12% to 40% for psychotropics, 24% to 41% for anticonvulsants, and 44% to 60% for psychotropic and/or anticonvulsant drugs. In the same period, the prevalence rates in the community (for adults and children analyzed together) ranged from 19% to 29% for psychotropics, 18% to 23% for anticonvulsants, and 35% to 45% for psychotropic and/or anticonvulsant drugs. An analysis of the patterns of medication use showed that patient demographic, physical, social, behavioral, and psychiatric variables, as well as a number of staff variables, were correlated with use of pharmacotherapy in the entire population of individuals with mental retardation. A substantial number of individuals with mental retardation appeared to be prescribed psychotropic medications that may have been inappropriate for their diagnosis.

Empowerment is a critical indicator of a family's ability to access and effectively utilize services to achieve desired outcomes for themselves and their children. The empowerment status of two groups of families, those with children who had serious emotional disturbance (SED) alone and those with children who had SED combined with attention-deficit/hyperactivity disorder (ADHD), were investigated. The Family Empowerment Scale (FES) was completed by a sample of 228 families. In addition, these families provided demographic data concerning family composition, race, education, income, membership in a parent support group, and the mental health status of their children. The demographic variables were entered into a multivariate analysis of variance model to predict the empowerment status of families across the four subscales of the FES. Statistically significant correlations were obtained between family empowerment and membership in a parent support group, mental health status of the child (SED alone versus SED with ADHD), gender of the respondent, and respondent education. The results indicated that membership in a parent support group was a strong predictor of family empowerment, particularly of the systems advocacy and knowledge dimensions of empowerment. The results of this study can be used by mental health services providers for designing services that maximize family empowerment.

This article describes two studies that evaluated training intended to improve the family friendliness of five components of the admissions treatment team process (Introduction, Meeting Management, Case Presentation and Discussion, Service Plans, and Tact and Technicalities) at an inpatient child and adolescent psychiatric hospital. In Study 1, we observed 18 case presentations and found that the ratings on family friendliness were low on Service Plans and Tact and Technicalities. Following three role-play training sessions, we found no statistically significant improvement. In Study 2, we used a multiple-baseline design across treatment team process components and enhanced the family friendliness of each component through mindfulness training. Follow-up observations at monthly intervals for 6 months showed continued high rates of family friendly services. Our study suggests that the mindful delivery of mental health services can produce long-term gains in the family friendliness of admissions treatment teams.

In systems of care, the term family friendly is used to describe services that are aligned with the needs of the families and delivered in a manner that shows professionals value and respect family involvement, empowerment, and cultural differences. The authors devised a 42-item structured observation instrument to rate the family friendliness of one component of the systems of care in Virginia for children with emotional and behavioral disorders (EBD) and their families. The instrument covers typical aspects of the meeting process, such as meeting management, case presentation, and formulation of service plans. It also allows for the collection of data on relevant characteristics of the meeting participants as well as demographic information on the children and their families. This instrument was used to rate the family friendliness of Family Assessment and Planning Team (FAPT) meetings, the purpose of which is to develop community-based service plans for children with EBD who are referred to the team. These teams meet in local communities and typically consist of representatives from the local juvenile court, education, health, mental health, and social service agencies. The authors observed 79 case presentations at 31 FAPT meetings in 7 localities. Although there were variations within, between, and among localities, the overall rating of family friendliness across all case presentations was good (63%). Improvements in the FAPT process are needed to assure increased family friendliness in the planning of services for children with EBD and their families.