Family Assessment: Current Issues in Evaluating Families.

The proliferation of marital and family practice and research has increased the recognition of the importance of reliable and valid assessments of family functioning. During the past two decades there have been significant developments that have facilitated the assessment of family relationships and functioning and have resulted in a rich cadre of family measures (Boughner, Hayes, Bubenzer, & West, 1994; Filsinger, 1983; Fredman & Sherman, 1987; Grotevant & Carlson, 1989; Halvorsen, 1991; Jacob & Tennenbaum, 1988; Touliatos, Perlmutter, & Straus, 1990). This article reviews and discusses applied issues and methods for evaluating families. The focus of this review is on the assessment of family relationships and functioning and will not specifically address the marital relationship, which is the topic of another article in this collection (see Bradbury article). Despite the development of good family measures, family oriented practitioners do not regularly make use of standardized or formal family assessments in their practices (Boughner et al., 1994; Floyd, Weinand, & Cimmarusti, 1989). There are several reasons for this. First, a major problem with family assessment is the lack of a unified theory of family functioning (Bray, 1995). There is no consensus about the definition of healthy or dysfunctional family relationships or even the key processes that need to be assessed. There is also no agreed upon diagnostic system, such as the Diagnostic and Statistical Manual (DSM-IV) or International Classification and Diagnostic (ICD-9) systems for individuals. Although there is work in progress on developing marital, family, and relational diagnoses and methods, there is not a consensus about the best measures or central factors for family assessment. Second, many family practitioners view family assessments as empirically-based, structured methods that do not have direct applicability or utility in clinical practice (Boughner et al., 1994; Floyd et al., 1989). This outlook may be due to a general lack of education and training in formal family assessment methods. Further, these methods are frequently viewed as static measures of family functioning that do not capture the dynamic processes and change within family systems. This perspective is promulgated by family clinicians who argue against an empirical, standardized approach, and instead value contextual, social constructivist, or qualitative views of family functioning (Anderson & Goolishian, 1988; Fraenkel, 1995). Third, most of the available family measures and methods have been developed for research contexts and have not been specifically applied to clinical practice. Therefore, many instruments do not provide either the instructions or clinically relevant norms and comparisons necessary for use in practice settings. These factors may explain the recent survey finding that most family practitioners do not necessarily view formal family assessment as an important part of clinical practice (Boughner et al., 1994). To overcome some of these problems, this article reviews the current status of family assessment, key family processes and constructs, and family assessment methods that have been consistently reported in the literature on family relationships and their impact on individual and family functioning. This review will hopefully encourage family clinicians to use more formal family assessment methods and facilitate the implementation of research on family process into practice settings. There are several reasons for clinicians to use formal, standardized methods for assessing families (Boughner et al., 1994; Floyd et al., 1989; Miller et al., 1994). Evaluations conducted prior to therapy or counseling 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. Assessment also insures that a broad range of routine information is collected to make certain that important areas are not overlooked. …