Using family functioning as an evaluation criteria for parents, carers and families

‘In truth a family is what you make it. It is made strong, not by number of heads counted at the dinner table, but by the rituals you help family members create, by the memories you share, by the commitment of time, caring, and love you show to one another, and by the hopes for the future you have as individuals and as a unit’ (Kennedy & Spencer King, 1994). This well-known quote summarises effectively what constitutes a fully-functioning family.

Programs and interventions dealing with family functioning might focus on improving family relationships and the overall functioning of the family.

Family functioning - the concept

The families COPMI works with are at greater risk of multiple psychosocial problems (eg poverty, housing, family disruption, marital conflict, reduction in social and leisure activities, out-of-home care, exposure to family violence) and are highly vulnerable to experiencing emotional or behavioural difficulties as a result. Recent evidence has shown that family-focused interventions in COPMI families are effective, see sustained improvement over time in parent illness-related behaviours, and result in a reduction of internalising symptoms in children (Beardslee, Wright, Gladstone & Forbes, 2008).

It is critical to measure family functioning so that caregivers can provide informed support, tailor interventions, and measure outcomes for both the individual and the entire family.

This section explores five of the major theoretical models of family functioning and their assessment tools. It is important to understand each theoretical orientation so that you can make an informed decision about the most applicable assessment tool for the context in which it will be used.

Theoretical background and definition of key concepts

The five major theoretical models of family functioning are:  

1. Stress and Coping Theory

The Stress and Coping Theory is a field that has been growing since the 1960s.

Stress is defined clearly by Folkman (1984) as ‘the relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and as endangering his or her well being’. Stress and Coping Theory is based on the notion that the person and the environment are in a dynamic, mutually reciprocal and bidirectional relationship (Folkman et al., 1986).

Coping is referred to as the ‘thoughts and acts people use to manage (reduce, minimize, master or tolerate) the demands of stressful transactions’ (Folkman et al., 1987).

From a family functioning perspective, Stress and Coping Theory emphasises family vulnerability and regenerative power (McCubbin, 1979; Moos, 2002). ‘Vulnerability’ refers to how susceptible the family is to experiencing stress and ‘regenerative power’ is the family’s ability to respond to stress. The family is viewed as a ‘reactor to stress’ and a ‘manager of resources within the family unit with which to combat and control change within the family system’ (McCubbin, 1979).

Family functioning is viewed as the family’s ability to:

  • adapt to stress
  • reduce the family and its members’ overall vulnerability and susceptibility to stress.

In this framework, the functioning of the individual is inextricably related to the life-context factors under which the individual resides ( Moos, 1992). 

2. Beavers System Model

The Beavers System Model was developed over a 25-year period from clinical observations of both dysfunctional and healthy families in treatment and research settings. The Beavers System Model integrates Family Systems Theory and Developmental Theory to understand family health or pathology (Franklin, Cody & Jordan, 2004). Families are classified by this model under two dimensions:

  1. family competence
  2. family style (Beavers & Hampson, 2000).

Families are rated on these two dimensions by the structure and flexibility they display in areas such as power, parental coalitions, family mythology, goal-directed behaviour, negotiation, autonomy and family affect (Anderson & Gavazzi, 1990).

Family competence refers to the structure of the family, available information, and adaptive flexibility of the system. The more open the family system is to receiving energy from the outside world to assist in maintaining its structure and flexibility, the more the family can negotiate, function and deal effectively with stressful situations (Beavers & Hampson, 2000).

Family style refers to the stylistic quality of family interaction and examines where families gain most of their satisfaction, whether it be from within the family (centripetal) or from the outside world (centrifugal). This dimension is thought to have a curvilinear relationship with family health (ie optimal families fall in the middle of the continuum, experiencing satisfaction from both within the family and the outside world). Family dysfunction is associated with both ends of the continuum – centripetal and centrifugal (Beavers & Hampson, 2000). 

3. Circumplex Model of Family Functioning

The Olson Circumplex Model of Family Functioning was also derived from Systems Theory over a period of 25 years of clinical and research work with families and marital couples. The model has developed over time from having two to three underlying dimensions, from which the authors (Anderson & Gavazzi, 1990; Craddock, 2001; Franklin et al., 2004) built their typologies:

  1. Cohesion
  2. Flexibility
  3. Communication

Cohesion is defined by Olson and Gorall (2006) as ‘the emotional bonding that family members have toward one another’ and is comprised of the concepts ’emotional bonding, family boundaries, coalitions, time, space, friends, decision making, interests and recreation’ (Fristad, 1989).

Flexibility is ‘the quality and expression of leadership and organisation, role relationships and relationship rules and negotiations’.

Communication is ‘the positive communication skills utilised in the couple or family system’. Communication is postulated to facilitate alterations within the core dimensions of cohesion and flexibility (Anderson & Gavazzi, 1990).

Cohesion and flexibility are thought to fall on a curvilinear continuum, from disengaged to enmeshed for cohesion and rigid to chaotic for flexibility. Optimal functioning – having balanced levels of cohesion and flexibility – is expected to fall in the middle of each continuum and dysfunction at the end of each continuum (Craddock, 2001).

4. McMaster Model of Family Functioning (MMFF)

The MMFF, based on a systems approach, views the family as an open system made up of a complex interplay between subsystems (individual, marital, dyad) that relate to external systems (eg extended family, schools, religion, work). This model does not reduce the family to any single dimension of the family but rather takes a whole-system approach by evaluating family structure, organisation and transactional patterns (Barney & Max, 2005; Epstein, Bishop & Levin, 1978; Franklin et al., 2004). Family health or dysfunction is attributed to the ongoing complex interplay between the individual, relationships and family system (Akister & Stevenson-Hinde, 1991).

The MMFF attempts to integrate Systems Theory, drawing on concepts of communication theory, learning theory and the transaction approach to inform therapeutic intervention. (Epstein et al., 1978).

Five key underpinning components guide family work using the MMFF:

  1. Parts of the family are related to each other.
  2. One part of the family cannot be understood in isolation from the rest of the system.
  3. Family functioning is more than just the sum of the parts.
  4. A family’s structure and organisation are important in determining the behaviour of family members.
  5. Transactional patterns of the family system are involved in shaping the behaviour of family members (Epstein et al., 1978).

The MMFF is based on the assumption that family functioning is related to the accomplishment of essential functions and tasks that assist family members in their social, psychological and biological development and maintenance (Akister & Stevenson-Hinde, 1991; Epstein et al., 1978). These tasks are grouped into three areas:

  1. Basic tasks
  2. evelopmental tasks
  3. Hazardous tasks (Epstein et al., 1978)

The MMFF identifies six core areas that impact on a family’s ability to meet these functions and tasks:

  1. Problem solving
  2. Communication
  3. Roles
  4. Affective responsiveness
  5. Affective involvement
  6. Behavioural control

5. Process Model of Family Functioning

The Process Model of Family Functioning (The Process Model), like the MMFF, was developed from Systems Theory and explores family functioning in the context of the ability of the family and its members to accomplish a variety of tasks.

The Process Model identifies seven basic constructs to evaluate how successful a family is at meeting basic, developmental and crisis tasks that are central objectives to family life:

  1. Task accomplishment
  2. Role performance
  3. Communication
  4. Affective expression
  5. Involvement
  6. Control
  7. Values and norms

The Process Model diverges from the MMFF in its emphasis on the larger social system and family history (norms and values) and its focus on integrating intra-psychic, interpersonal and family systems (Skinner, Steinhauer & Sitarenios, 2000).

The Process Model considers the family system whilst acknowledging that a variety of factors can influence this process (Steinhauer & Tisdall, 1984). This model stresses that it is not a model of family therapy but rather a model for understanding families.

Measures of family functioning

When deciding which methodology will be most appropriate to gather information regarding family functioning, clinicians and researchers alike need to:

  • be clear about their specific clinical or research questions
  • decide what components of the family are important to assess
  • take into account the resources of the organisation (Alderfer et al., 2008).

Typically, methods that assess family functioning – other than self-report questionnaires – are time consuming, costly, and require extensive training and expertise to administer (Barney & Max, 2005). Such methods are more comprehensive than a self-report questionnaire but not always feasible or clinically indicated due to time, costs or resourcing. The self-report questionnaire has the advantage of being relatively quick and cost effective, and can:

  • gather information about the attitudes of individuals within the family about how their family functions
  • identify differences in attitudes between family members
  • target specific aspects of family functioning relevant to the clinical or research question (Bloom, 1985).

Self-report questionnaires can be particularly useful during the screening process to identify high and low-risk families (Park et al., 2008). 

Family Environment Scale (FES)

The FES has three forms – real, ideal and expected – that can be completed by family members 12 years and older. A pictorial version of the FES was developed for children between five and 11 years.

The FES is one of the most widely used environment measures in clinical and family research, being identified in over 1400 published research studies (Chipuer & Villegas, 2001; Wise & King, 2008).

Structure of the measure

The FES, developed by Moos and Moos, is a 90-item self-report dichotomous scale that examines whole-of-family functioning and is compatible with Stress and Coping Theory, and social and ecological systems theory (Franklin, et al., 2004).

The FES measures ten major dimensions of family functioning that fall under three higher-order factors:

  1. Relationship dimensions: Cohesion, Expressiveness and Conflict
    Personal growth dimensions: Independence, Achievement Orientation, Intellectual-Cultural Orientation, Active-Recreational Orientation, and Moral-Religious Emphasis
    System maintenance dimensions: Organisation and Control.

Construct validity

The construct validity of the FES is relatively complicated to assess compared to other measures of family functioning, given that it is conceptually distinct from similar measures and has ten subscales (Sanford, Bingham & Zucker, 1999).

Cohesion has been positively correlated with Social Support Appraisals, the Locke-Wallace Marital Adjustment Scale, the Spanier Dyadic Adjustment Scale, and the Parental Bonding Instrument (Moos & Moos, 2002). The FES cohesion was highly correlated with the Family Assessment Device (FAD) and the Family Adaptability and Cohesion Evaluation Scales (FACES) II and III, and the FES control subscale was highly correlated with the FAD measures of control (Moos, 1990). The authors also claim that they built content validity into the FES in their original development of the scale. They conceptually derived the subscales and higher-order factors by preparing items that fitted the defined constructs and selecting items conceptually related to a dimension (Moos, 1990; Oliver et al., 1988).

Reliability

The authors of the FES report moderate to substantial internal consistencies ranging from Cronbach’s alpha = .61 to alpha = .78 (Moos & Moos, 2002). Five of the ten subscales were above the alpha = .70 standard that is required to be classified as a well-established instrument (Alderfer et al., 2008).

The intercorrelations between the ten subscales ranged from .53 to .45, indicating that the subscales measure distinct characteristics of family environment and have good consistency (Franklin et al., 2004).

Test-retest reliabilities are impressive at two-month, three-month, 12-month and 24-36 month intervals ranging from .52 to .91 (Alderfer et al., 2008; Franklin et al., 2004). Test-retest reliabilities have also been calculated for 10-year intervals and range from .38 (conflict) to .77 (moral-religious emphasis). These coefficients reflect overall stability in family climate over time and also reflect changes that occur in the family (Moos & Moos, 2002).

Evaluation and/or research that has used this measure

Other researchers have found lower internal consistencies than the authors of the instrument. Alderfer et al. (2008) reported as low as alpha = .42 (control) and alpha = .44 (independence) and the FES has been criticised for having lower internal consistencies (Roosa & Beals, 1990). Moos (1990) argues that internal consistency is affected by item homogeneity, sample diversity and variability in the data, and that when the FES was developed the aim was to create an instrument that measured a broad item content rather than a narrow construct.

For more information see:

Moos, R. (1990). Conceptual and empirical approaches to developing family based assessment procedures: resolving the case of the Family Environment Scale. Family Process, 29, 199-208.

Roosa, M. & Beals, J. (1990). Measurement issues in family assessment: the case of the family environment scale. Family Process, 29, 191-8.

Availability of the scale

The copyrighted scale and forms may be purchased online or in paper copy by mail from Mind Garden

Beavers Self Report Family Inventory (SFI)

The SFI is associated with the Beavers System Model and is designed for family members 11 years of age or older.

Structure of the measure

The SFI is a 36-item self-report instrument that may be completed by family members 11 years of age or older. Respondents answer using a 5-point Likert scale ranging from ‘Yes: fits our family well’ through to ‘No: does not fit our family’. The SFI assesses five domains:

  1. Health/competence
  2. Conflict
  3. Cohesion
  4. Leadership
  5. Emotional expressiveness (Beavers & Hampson, 2000)

Construct validity

Validity was measured by correlating the SFI with the observational scales of the Beavers System Model. The results indicate a high degree of convergence of family constructs across the two methods at .62 or above (Beavers & Hampson, 2000; Hampson, Hulgus & Beavers, 1991). The authors claim that this indicates that the SFI is roughly equivalent to observations (Franklin et al., 2004).

Reliability

The authors of the instrument report high internal consistencies reliability with Cronbach alphas between .84 and .93 and test-retest reliabilities of .85 or better (Beavers & Hampson, 2000; Franklin et al., 2004).

Alderfer et al. (2008) caution against the use of the leadership subscale as a distinct scale due to its very low internal consistencies (eg alphas = .02-.31).

Evaluation and/or research that has used this measure

The SFI appears to have sound psychometric properties on the surface. However, most of the psychometric properties have been reported in non-peer-reviewed locations (eg commentaries and chapters) and therefore, according to the criteria of Alderfer et al. (2008), qualify as ‘approaching well-established’.

For more information regarding the criticisms of the SFI see: Alderfer, M. A., Fiese, B. H., Gold, J. I., Cutuli, J. J., Holmbeck, G. N. & Goldbeck, L. (2008). Evidence-based assessment in pediatric psychology: family measures. Journal of Pediatric Psychology, 33, 9, 1046-61.

Availability of the scale

Forms are available from the publisher.

Family Adaptability and Cohesion Evaluation Scales IV (FACES IV)

All family members over the age of 12 can complete the FACES IV.

If choosing this tool to assess the efficacy of an intervention, you should take into account that the FACES IV is still in its infancy. Most of the preliminary data uses an earlier version of the FACES IV and indicates mixed support for its reliability and validity.

Structure of the measure

The FACES IV is a 42-item self-report measure of family functioning answered on a five-point Likert scale ranging from ‘strongly disagree’ to ‘strongly agree’. The FACES IV was designed to measure the cohesion and flexibility dimensions outlined in Olson’s Circumplex Model of Marital and Family Systems. The device contains six subscales, with two balanced scales and two unbalanced scales intended to tap low and high cohesion (disengaged and enmeshed) and flexibility (rigid and chaotic) (Olson, Gorall & Tiesel, 2007).

Construct validity

The authors also report the correlations of the FACES IV with the SFI, Family Satisfaction Scale and the Family Assessment Device (FAD) to test the scale’s validity. The correlations ranged from adequate to good and in the directions expected by the authors, given that they were measuring both balanced and unbalanced dimensions. The discriminate validity of the FACES IV, tested by comparing it to the SFI and FAD, had a predictive accuracy of 92% (Olson et al., 2007).

FACES IV also had good convergent validity with the FAD, the Family Relationship Problems subscale of Hudson’s Multi-Problem Screening Inventory (MPSI), and the Family Social Support subscale of Vaux’s Social Support Behaviors Scale (SSB). The discriminate validity of the FACES IV was also assessed in the study; the authors found that the FACES IV was able to accurately classify 84.1% of subjects when the Total Circumplex Score was used.

Reliability

In the validation study (Olson, Gorall & Tiesel, 2007), scale reliabilities were reported to be acceptable for research purposes and applicable for clinical purposes only if combined with other methods of assessment, ranging from alpha = .77 to alpha = .89 (Olson et al., 2007). Test-retest reliabilities were high, ranging from .83 to .96 (Craddock, 2001).

Evaluation and/or research that has used this measure

The FACES IV was categorised as ‘approaching well-established’ and Alderfer et al. (2008) stated that the preliminary psychometric information is promising, but more information is required before it can be rated as ‘well-established’. One concern was that the psychometric information published on the FACES IV was in non-peer-reviewed documents.

Research using the initial version of the FACES IV:

Craddock, A. E. (2001). Family system and family functioning: Circumplex Model and FACES IV. Journal of Family Studies, 7, 1, 29-39.

Franklin, C., Streeter, C. L. & Springer, D. W. (2001). Validity of the FACES IV family assessment measure. Research for Social Work Practice, 11, 5, 576-96.

Availability of the scale

The person ordering FACES IV also receives unlimited rights to duplicate the assessment for their own project. However, this fee provides permission only to the person who orders the assessment. Download the order form from the FACES IV website.

Family Assessment Device (FAD)

The FAD measures overall family functioning and six key areas of family functioning. Family members who are 12 years or older can respond to the FAD questionnaire.

Structure of the measure

The FAD is a 60-item self-report measure of family functioning answered on a four-point Likert scale ranging from ‘strongly agree’ to ‘strongly disagree’ (Akister & Stevenson-Hinde, 1991). The FAD contains seven subscales designed to assess the six dimensions of the McMaster Model of Family Functioning: Problem Solving, Communication, Roles, Affective Responsiveness, Affective Involvement and Behaviour Control, and contains a seventh General Functioning scale.

Construct validity

The FAD has good construct validity, significantly correlating with the corresponding Clinical Rating Scale of the McMaster family assessments, and obtaining correlations with the Family Unit Inventory and the FACES II that were close to a priori predictions based on descriptions of subscales for each of the instruments (Miller et al., 1985).

The FAD and the Family Assessment Measure III were found to be highly correlated (Skinner et al., 2000). This is not unexpected given that the theoretical underpinnings are roughly equivalent for six of the seven dimensions assessed by the model. The authors of the FAD report that, based on the cut-off scores, the FAD has the ability to discriminate between clinical and non-clinical families effectively on six of the seven subscales (Miller et al., 1985).

Reliability

The internal consistencies reported for the FAD range from alpha = .71 to alpha = .92 (Byles et al., 1988). The Roles and Problem Solving subscale have been documented as having much lower internal consistency at alpha = .60 and alpha = .47, respectively (Alderfer et al., 2008). Test re-test reliabilities at a one-week interval have been reported between .66 and .76 for the different subscales (Byles et al., 1988; Miller et al., 1985). The long-term stability of this instrument has not been established.

Evaluation and/or research that has used this measure

According to Alderfer et al. (2008), the FAD and its shorter General Functioning Scale have been categorised as ‘well-established’, although the psychometric properties beyond internal consistencies of the scale are not adequately reported in the literature.

The FAD has a more narrow focus on perceptions of family members in completing essential tasks compared to the broad range of areas of functioning within the family system and the larger external systems assessed by the FES, despite its rating of ‘well-established’.

Availability of the scale

A pdf of the FAD scale is included online 

Family Assessment Measure III (FAM-III)

The FAM III provides quantitative indices of family strengths and weaknesses, assesses the perspective of different family members on the family’s current functioning and takes about 20-30 minutes to administer.

Structure of the measure

The FAM III General Scale is a 50-item self-report measure of family functioning answered on a four-point Likert scale ranging from ‘strongly disagree’ to ‘strongly agree’ (Bloom, 1985; Skinner et al., 2000). The FAM III contains seven subscales that measure the constructs of the Process Model of Family Functioning:

  1. Task accomplishment
  2. Role performance
  3. Communication
  4. Affective expression
  5. Affective involvement
  6. Control
  7. Values and norms

Also included are two subscales that measure response-style bias: social desirability and denial-defensiveness.

Construct validity

The literature indicates that the FAM III has good construct validity and its constructs have been found to correlate significantly with the associated constructs on the FACES, FES, FAD and Family Concept Q Sort. The FAM III has demonstrated good discriminate validity when there is a strong a priori reason to believe the groups differ in terms of family functioning (Skinner et al., 2000).

Reliability

Internal consistencies were found to be excellent at alpha = .94 and test-retest reliabilities ranged from .56 to .66 at a 12-day interval (Franklin et al., 2004; Jacob & Windle, 1999; Skinner et al., 2000). The stability of the tool has not been established for more than 12 days and the test-retest reliabilities at 12 days are only adequate.

Evaluation and/or research that has used this measure

According to Alderfer et al. (2008), the FAM III is categorised as ‘well-established’, though the authors caution against its use as an independent source of information regarding family functioning as it obtains false negatives when used in isolation. That is, highly problematic families obtain normal ratings using the FAM III General Scale (Alderfer et al., 2008; Skinner, et al., 2000).

Availability of the scale

This measure is not freely available in the public domain but may be purchased from MHS Psychological and Assessment Services.

Programs or interventions

Family Talk: this booklet provides tips, helps to answer some of the questions children and young people have, and gives ideas about where families may seek help.

Effective Family Programs

Future Families Inc: Families consciously creating the future. Future Families is a unique, not-for-profit community association commenced in March 2007 by a group of Adelaide (South Australian) mums.

Triple P: Positive Parenting Program. Parenting Program®, backed by over 25 years of clinically proven, worldwide research, has the answers to your parenting questions and needs.

Key readings

Alderfer, M. A., Fiese, B. H., Gold, J. I., Cutuli, J. J., Holmbeck, G. N. & Goldbeck, L. (2008). Evidence-based assessment in pediatric psychology: family measures. Journal of Pediatric Psychology, 33, 9, 1046-61.

Beavers, R. & Hampson, R. B. (2000). The Beavers Systems Model of family functioning. Journal of Family Therapy, 22, 128-43.

Epstein, N. B., Baldwin, L. M. & Bishop, D. S. (1983). The McMaster Family Assessment Device. Journal of Marital and Family Therapy, 9, 2, 171-80.

Folkman, S., Lazarus, R. S., Gruen, R. J. & DeLongis, A. (1986). Appraisal, coping, health status, and psychological symptoms. Journal of Personality and Social Psychology, 50, 3, 571-9.

Franklin, C., Cody, P. A. & Jordan, C. (2004). Validity and reliability in family assessment. In A. R. Roberts & K. Yeager (Eds.), Evidence-Based Practice Manual: research and outcome measures in health and human services (pp. 436-43). New York: Oxford University Press.

Moos, R. H. & Moos, B. S. (2002). Family Environment Scale Manual: development, applications and research (3rd ed.). CA: Mind Garden, Inc.

Olson, D. H., Gorall, D. M. & Tiesel, J. W. (2007). FACES IV and the Circumplex Model: validation study.

Skinner, H., Steinhauer, P. & Sitarenios, G. (2000). Family assessment measure (FAM) and process model of family functioning. Journal of Family Therapy, 22, 190-210.

Other references

Akister, J. & Stevenson-Hinde, J. (1991). Identifying families at risk: exploring the potential of the McMaster Family Assessment Device. Journal of Family Therapy, 13, 4, 411-21.

Barney, M. C. & Max, J. E. (2005). The McMaster family assessment device and clinical rating scale: questionnaire vs. interview in childhood traumatic brain injury. Brain Injury, 19, 801-9.

Byles, J., Byrne, C., Boyle, M. H. & Offord, D. R. (1988). Ontario Child Health Study: reliability and validity of the General Functioning Subscale of the McMaster Family Assessment Device. Family Process, 27, 1, 97-104.

Chipuer, H. M. & Villegas, T. (2001). Comparing the second-order factor structure of the Family Environment Scale across husbands’ and wives’ perceptions of their family environment. Family Process, 40, 2, 187-99.

Craddock, A. E. (2001). Family system and family functioning: Circumplex Model and FACES IV. Journal of Family Studies, 7, 1, 29-39.

Epstein, N., Bishop D. & Levin, S. (1978). The McMaster Model of Family Functioning. Journal of Marriage and Family Counseling, 4, 19-31.

Franklin, C., Streeter, C. L. & Springer, D. W. (2001). Validity of the FACES IV family assessment measure. Research for Social Work Practice, 11, 5, 576-96.

Fristad, M. A. (1989). A comparison of the McMaster and complex family assessment instruments. Journal of Marital and Family Therapy, 15, 259-69.

Hampson, R. B., Hulgus, Y. F. & Beavers, W. R. (1991). Comparisons of self-report measures of the Beavers Systems Model and Olson’s Circumplex Model. Journal of Family Psychology, 4, 3, March, 326-40.

Jacob. T. & Windle, M. (1999). Family assessment: instrument dimensionality and correspondence across family reporters. Journal of Family Psychology, 13, 339-54.

Kennedy, M. & Spencer King, J. (1994). The single-parent family: living happily in a changing world. New York: Crown.

Park, I. J. K., Garber, J., Ciesla, J. A. & Ellis, B. J. (2008). Convergence among multiple methods of measuring positivity and negativity in the family environment: relation to depression in mothers and their children. Journal of Family Psychology, 22, 123-34.

Moos, R. (1990). Conceptual and empirical approaches to developing family based assessment procedures: resolving the case of the Family Environment Scale. Family Process, 29, 199-208.

Oliver, J. M., Handal, P. J., Enos, D. M. & May, M. J. (1988). Factor structure of the Family Environment Scale: factors based on items and subscales. Educational and Psychological Measurement, 48, 469-77.

Olson, D. H. & Gorall, D. M. (2006). FACES IV and the Circumplex Model.

Roosa, M. & Beals, J. (1990). Measurement issues in family assessment: the case of the family environment scale. Family Process, 29, 191-8.

Sanford, K., Bingham, C. R. & Zucker, R. A. (1999). Validity issues with the Family Environment Scale: psychometric resolution and research application with alcoholic families. Psychological Assessment, 11, 3, September, 315-25.

Steinhauer, P. D. & Tisdall, G. W. (1984). The integrated use of individual and family psychotherapy. Canadian Journal of Psychiatry, 29, 89-97.

Wise, R. A. & King, A. R. (2008). Family environment as a predictor of the quality of college students’ friendships. Journal of Family Issues, 29, 6, 828-48.

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