Clinical Family Assessment: Applying Structured Measurement Procedures in Treatment Settings*

Abstract

This article describes the use of a battery of structured family measurement procedures to conduct systematic, comprehensive assessments of families who enter treatment. The measures are derived from family research and include self-report questionnaires and structured observation of family interactions. The assessment is multimodal, and examines the entire family unit, the marital subsystem, the individual family members, and the larger social context affecting a family. Two case examples are presented which demonstrate how the structured assessment data are combined with clinical theory and other information about a family to generate initial hypotheses about the functioning of the family system and likely avenues for therapeutic intervention.

Couple and Family Assessment

“…Clinician rating systems can be used in clinical interviews that are standardized or unstandardized (Carlson & Grotevant, 1987). Floyd et al (1989) provide good examples of how clinicians can utilize behavioral observations and ratings in a clinical context.…”

“…In choosing a couple or family assessment strategy, clinicians should first determine what aspects of family functioning are most likely to be relevant to the goals of prevention and treatment that are of most interest (Floyd, Weinand, & Cimmarusti, 1989;Heyman, 2001). This involves several dimensions: (1) the members of the family who are being evaluated; (2) the methods of the assessment that have been selected; and (3) the methods of examining the family system by using all these sources of information (Dakof, 1996;Davidson, Quinn, & Josephson, 2001;Heyman, 2001).…”

“…However, family-oriented practitioners frequently do not use formal family assessments in their practices (Boughner, Hayes, Bubenzer, & West, 1994;Bray, 1995b;Floyd et al, 1989;Mash & Foster, 2001;Snyder et al, 2005). Evaluations conducted before prevention or treatment intervention begins can provide a rich source of information about the family and can be used to develop initial hypotheses about problem areas, causes of problems, and potential areas of strengths.…”

A constructive alternative to family assessment

“…A few have emerged which are research-based (Beavers, 1981;Beavers and Voeller, 1983;Epstein, Bishop and :Levin, 1978;Floyd, Weinand and Cimmarusti, 1989;Fristad, 1989;Khston and Bentovim, 1982;Lee, 1988;Olson and Craddock, 1980). In either case, they are informed by the particular theoretical stance and needs of the therapist/ investigator (Hansen and Keeney, 1983).…”

“…The observations are usually structured (Floyd, Weinand and Cimmarusti, 1989;Watzlawick, 1966) or categorized (Beavers, 1981;Beavers and Voeller, 1983;Lee, 1988), the results providing the focus for the assessment. However, there is more to assessment than meets the eye.…”