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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 - these are first editions and we welcome feedback from users to assist in further developments.  Please email s.kennedy@aft.org.uk with any comments on these films or join our discussions by emailing aftSCORE+subscribe@googlegroups.com

  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

The SCORE resource pack

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. 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.
The SCORE development team is currently: Peter Stratton, Judith Lask, Reenee Singh and Isabel Ekdawi with Julia Bland and Chris Evans still advising the group. A larger group, taking on specific further developments has recently been formed as an extension of the AFT Academic and Research Committee and a further small group is working on the materials for CORC+ and CYP-IAPT.

Peter Stratton
p.m.stratton@ntlworld.com

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