Identifying families at risk: exploring the potential of the McMaster Family Assessment Device

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Abstract

The Family Assessment Device (FAD) was given to a community sample of intact families with young children. Responses by mothers and fathers were analysed with a view to providing ways of indicating which families might benefit from preventive intervention.

Mother/father agreement was significant on five of the seven scales, with a failure to reach significance on Affective Involvement and General Functioning. The highest correlation between mothers and fathers was on the Roles scale (r = 0.53). However, mothers' means for Roles were significantly higher than fathers', indicating that mothers were less satisfied with family functioning in this area.

In addition to a family mean score greater than a cut-off value as an indicator of unhealthy functioning, present results suggest including those families whose respondents strongly disagree (indicated by scores lying on either side of the cut-off and a difference of more than two standard deviations). With this double criterion, Roles and Affective Involvement were the dimensions most frequently scored as unhealthy. Seventeen per cent of the families scored in the unhealthy range on four or more of the seven dimensions.

This paper considers how to decide where family intervention might be helpful and raises the question of whether screening families might be more widely undertaken, for example by health visitors, to identify those families who are at risk of family dysfunction.

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