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SCORE-15 Index of Family Functioning and Change

SCORE is a self-report outcome measure designed to be sensitive to the kinds of changes in family relationships that systemic family and couples therapists see as indications of useful therapeutic change. It is intended to be serviceable in everyday practice; short, acceptable to clients and usable across the full range of our work - the full range of presenting problems, the clientele, and the formats of work: including individual, couple, family and multi-family groups. It is free to use.
AFT has, since 2006, supported the research group developing the SCORE outcome measure. The main version consists of 19 questions (15 scales, four self-descriptions) which take less than 10 minutes for family members to complete.

AFT have produced a series of training films to explain about the use of SCORE - we have recently added a new SCORE-15 brief interview describing the use of SCORE-15 with a family. You can also see a new interview by Martin Gill with Professor Peter Stratton here, on latest developments with SCORE.  

  1. Overview of SCORE
  2. Paper data processing version without a spreadsheet
  3. Calculating an individual SCORE using a spreadsheet 
  4. Group data input using a spreadsheet
  5. Using SCORE 15 in action with a family
  6. SCORE 15 brief interview with a family (new November 2016)

The SCORE resource pack

  • SCORE-15
  • Introduction and scoring SCORE-15 - a practical guide to administering SCORE-15 for clinical and research use
  • SCORE-15 Clinical data scoring template - Excel spreadsheet for entering the data of a couple/family (up to 6 members), with averages calculated and graphs shown. Helpful for supporting clinical work with a specific couple or family.
  • SCORE-15 individual data scoring template - Excel spreadsheet for entering the data of a single respondent and having averages calculated. 
  • SCORE-15 individual scoring template guide – instructions for using the template for single respondent (see above)
  • Instructions for Excel group data entry – a guide to entering group data
  • SCORE-15 group data entry  – Excel spreadsheet for entering group data and having essential averages calculated. An SPSS template is also available on request. Contact p.m.stratton@ntlworld.com.
  • Administering Measures to Families – guidance on issues that arise when applying progress measures (inc SCORE-15) to families
  • Child SCORE– for children 8 – 11 years
  • Relational SCORE -  alternative adult version for adult couples, LGB people and those who may not define significant relationships by biological or marital ties. Please note that this version currently has only content validity checked with professionals in the UK with either experiences working with couples or LGB people but it needs further studies to determine its reliability, validity and clinical sensibility. Please email us (yang.systemic@gmail.com) should you have interest in taking this further.
  • SCORE email discussion group - for SCORE users to compare notes and solutions
  • Online survey for SCORE users to report their experiences, good and bad.  SCORE users are also invited to email project lead Prof Peter Stratton. He says, 'Knowing the range of experiences in practice will be essential as we continue to try to make the SCORE project as helpful as possible.’
  • SCORE Translations

With AFT support, the SCORE has now been accepted by the CAMHS Outcome Research Consortium (CORC) . This significant development means SCORE can be used by any CAMHS and data can be submitted to CORC for us to use in its development. SCORE will soon be available in more languages for use with many families for whom comprehension of written English is problematic.


SCORE development updates
The SCORE is now established as a proven measure of family functioning (Carr &Stratton 2017). We have completed the research to establish its validity as an index of therapeutic change (Stratton et al, 2013, Journal of Family Therapy). A full account of its development is published in the Journal of Family Therapy (Stratton, Bland, Janes & Lask 2010).  
Successive articles in Context describe something of the lengthy process of getting the SCORE to this point. The final version of the SCORE 15 is available to download, along with other SCORE resources.
In the 2010 issue of JFT, Alan Carr’s team reported a substantial independent investigation based on the SCORE 40 which provides further validation of our approach (Cahill et al, 2010). 
SCORE can be read in terms of second order change; structural change; change in the stories the family members have about their family; change in systemic processes within the family; in an orientation to solutions; improvements in relation to hopefulness, agency, hostility, risk, blaming, well-being, happiness and so on.
The current achievement is that we have a short version of SCORE – SCORE-15 - which has 15 descriptions of aspects of family life and process, along with other indicators of the state of the family, all on one sheet of A4. The research that created the SCORE-15 showed that the earlier 40 items were all useful, so the SCORE 40 measure is also available from Peter Stratton as a more detailed, probably research, instrument. Alan Carr and his group in Dublin took the same SCORE 40 and have created a 29 item version that is entirely compatible with, but more detailed than, our 15 item short form.


SCORE-15 can be used as an overall measure of family functioning but will also generate ‘sub-scale’ scores from the 5 items on each of three dimensions:
• Strengths and adaptability
• Overwhelmed by difficulties
• Disrupted communication

Child SCORE-15 was created by Tom Jewell (Jewell et al 2013 Family Process, in early view) . Work is continuing to develop a version for use with adults with learning difficulties. Versions in other languages will be available soon. Judith Lask and Reenee Singh are leading the project to create culturally sensitive versions of SCORE-15 for different cultural groups. French, Bengali, and Norwegian versions are being developed primarily in the UK, while 16 European countries, co-ordinated for EFTA by Mina Todoulou, are engaged in their own translations and validation study using the same protocol as the UK project.
The SCORE project has been funded by AFT as a major contribution to establishing a research base for Couple, Family and Systemic Therapy in the UK. We are pleased to say that, under the auspices of Julia Bland, we also obtained a 3 year grant from the South London & Maudsley NHS Trust to continue the work.
A Research Activation Google Group (RAG) has been formed to take forward SCORE initiatives including establishing a validated couples version.  If you would like to be a member of this group please contact s.kennedy@aft.org.uk.

Peter Stratton
p.m.stratton@ntlworld.com

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