Family System  Therapy involves understanding and addressing the complexities of family interactions and relationships. To effectively diagnose and plan treatment, we use in our practice various assessment tools that provide insights into family dynamics, patterns, and individual roles within the system.

Assessment tools in  Family  System Therapy provide crucial insights into family dynamics, helping us  to tailor interventions effectively. By using a combination of these tools, we can comprehensively understand and address the complexities of family relationships and support positive change.

Here’s a comprehensive overview of key assessment tools we use in systemic family therapy and systemic intervention in our practice:

1. Genograms

A genogram is a graphical representation of a family tree that includes detailed information on relationships, major life events, and patterns of behavior across generations.

It maps out not just biological connections but also emotional bonds and significant interactions.

A genogram helps us to identify together recurrent patterns, such as illnesses, conflicts, and alliances, intergenerational influences on current family issues.With the help of the genogram we visualize family structures and dynamics. They help us in exploring how historical factors and family traditions influence present problems.

2. Family Sculpting

Family sculpting is an experiential technique where family members position themselves or others in physical space to represent their roles, relationships, and emotional distances within the family. It provides a visual and tangible way to explore family dynamics.With the help of the family sculpting, we get insight into perceptions of closeness, hierarchies, and alliances in the family and we may establish together possibilities for desired shifting positions and changes.A family sculpting exercise open up possibilities to facilitate shared thoughts, feelings and  name roles that may not be easily verbalized.

How does it work in practice? Family members arrange themselves or use objects to symbolize their relationships. Therapists observe and discuss the arrangement to gain insights into family functioning and individual perspectives.

3. ECOMAP

An ecomap is a diagram that maps out the family’s connections to external systems and resources, such as schools, workplaces, and community services.The usefulness of the ecomaps is that it highlights the quality and impact of these external relationships on the family. With the help of the ECOMAP we can assess the family’s social support network and external influences as well stressors and resources outside the family that affect its functioning.

How does it work?

Under the guidance of the therapist families draw an ecomap with the therapist, marking positive and negative influences. In the assessment stage the ECOMAP helps you  understanding how external factors contribute to or alleviate family issues.

4. Family Life Cycle Assessment

Through the Family Life Cycle Assessment we examine together the stages and transitions your  family goes through over time, from formation to dissolution .This tool seems to be very efficent and  encourage  each family member to self-reflect on how these stages affect individual and family development.The FLCA supports the participant to the exercise to understand how life cycle stages (e.g., marriage, parenthood, aging) influence family dynamics and to anticipate and address challenges associated with developmental transitions.

How does it works?

Under the guidance of the therapist, the participants get the chance to explore together the family’s current life cycle stage and the significant past transitions. This helps in understanding present issues in the context of developmental changes.

5. The Tree of Life is a therapeutic tool commonly used in System Therapy and other trauma-informed practices, particularly in narrative therapy.It was developed by Ncazelo Ncube-Mlilo and David Denborough to help individuals, families, and communities deal with trauma, identity issues, and complex life experiences.

  • The method draws from the metaphor of a tree to represent different aspects of a person’s life and identity. It is often used with people who have experienced displacement, migration, or other major life transitions, which makes it particularly useful in contexts like family systems therapy.
  • In family settings, each member can create their own Tree of Life, and the therapist can help explore how their trees interconnect to form a family or systemic “forest.” This can be particularly powerful in illustrating how family members are individually strong yet connected to one another through shared experiences, histories, and hopes.

In the context of System Therapy, this method allows individuals and families to:

  • Externalize Problems: By using a metaphor (the tree), the problem becomes something external to the person, which can then be discussed and addressed without the individual feeling overwhelmed by it.
  • Create Connection and Belonging: The Tree of Life helps people reconnect with their roots and understand their place within larger systems—family, community, or cultural contexts. It can also reveal relational dynamics and sources of support within these systems.
  • Build a Narrative of Strength and Resilience: By identifying their strengths (trunk), supportive relationships (leaves), and future hopes (branches), people can develop a more empowering narrative that focuses on their ability to overcome adversity.
  • Facilitate Healing from Trauma: This approach helps individuals and families reflect on trauma in a safe and structured way. It creates a space for acknowledging difficult experiences (storms) while still celebrating resilience and hopes( branches)

In the context of System Therapy, this method allows individuals and families to:

  • Externalize Problems: By using a metaphor (the tree), the problem becomes something external to the person, which can then be discussed and addressed without the individual feeling overwhelmed by it.
  • Create Connection and Belonging: The Tree of Life helps people reconnect with their roots and understand their place within larger systems—family, community, or cultural contexts. It can also reveal relational dynamics and sources of support within these systems.
  • Build a Narrative of Strength and Resilience: By identifying their strengths (trunk), supportive relationships (leaves), and future hopes (branches), people can develop a more empowering narrative that focuses on their ability to overcome adversity.
  • Facilitate Healing from Trauma: This approach helps individuals and families reflect on trauma in a safe and structured way. It creates a space for acknowledging difficult experiences (storms) while still celebrating resilience and hopes( branches)

Other assessment and intervention tools used in Family and Couples Therapy 

6. Dyadic Adjustment Scale (DAS) Is a self-report questionnaire that measures the quality and satisfaction of relationships between partners and it evaluates areas such as consensus, satisfaction, affection, and cohesion. Partners complete the DAS individually and based on their results the herapists use the results to discuss relationship strengths and areas for improvement.The purpose of such scale is to assess the health and functioning of couple relationships within the family and to identify specific areas of conflict or dissatisfaction that may impact family dynamics.

7. McMaster Family Assessment Device (FAD). The FAD is a questionnaire that assesses family functioning across multiple dimensions, including communication, problem-solving, roles, affective involvement, and behavior control. The device provides a comprehensive overview of how the family operates as a unit.How it works? Family members fill out the FAD independently. Results are used to facilitate discussions on how each member perceives the family’s functioning and to set therapeutic goals.The purpose of FAD is to identify strengths and weaknesses in family functioning and based on that  guide treatment planning by highlighting areas needing attention.

8. The Worries Questionnaire (W.Q) by Rober & Van Tricht (2015)  is an assessment tool administrated by the therapist  before the first  therapeutic session. The WQ offers the therapist a glimpse of the different worries that live in the family, as filtered by every family member perception.The questionnaire of concerns helps the therapist initiate first circular questions to the participants and open the premises to a shared space of communication and mutual attunment.

9. Dialogical Feedback Questionnaire (DFQ)  by Rober & van Tricht (2015) is an instrument of evaluation of the therapeutic sessions and it works as a feedback tool for the therapist. The clients are requested to give their input on the quality of the session, their  benefits and challenges, with the purpose of adjustment  and improvement for reaching the therapeutic goals.The instrument can be used by the end of each session as well by the final evaluation.

10.SOFTA SCALE s a self-assessment tool which consists of a set of 16 questions administrated to each participant to the therapy, which measures primarily the therapeutic alliance as  principal subject of family therapy. The questions are subordinated to four sub-dimensions:1. Safety within the Therapeutic System 2. Shared Sense of Purpose within the Family 3. Engagement in Therapeutic Process and 4.Emotional Connection with the Therapist. This instrument is extremely benefiting to the therapist since it shows the impact of the sessions on every participant to the sessions, the level of commitment, participations and the attunement on the axis client-therapeutic, giving valid indication about the therapeutic alliance as well regarding to the  members participations to the process and their bond.

References

  1. Carter, B., & McGoldrick, M. (1999). The expanded family life cycle: Individual, family, and social perspectives (3rd ed.). Allyn & Bacon.
  2. Epstein, N. B., Baldwin, L. M., & Bishop, D. S. (1983). The McMaster Family Assessment Device. Journal of Marital and Family Therapy, 9(2), 171-180. https://doi.org/10.1111/j.1752-0606.1983.tb01497.x
  3. Friedlander, M. L., Escudero, V., & Heatherington, L. (2006). Therapeutic alliances in couple and family therapy: An empirically informed guide to practice. American Psychological Association. https://doi.org/10.1037/11429-000
  4. Hartman, A. (1995). Diagrammatic assessment of family relationships. Families in Society: The Journal of Contemporary Social Services, 76(2), 111-122. https://doi.org/10.1177/104438949507600207
  5. McGoldrick, M., Gerson, R., & Petry, S. (2008). Genograms: Assessment and intervention (3rd ed.). Norton & Company.
  6. Ncube, N. (2006). The Tree of Life Project: Using narrative ideas in work with vulnerable children in Southern Africa. International Journal of Narrative Therapy and Community Work, 2006(1), 3-16.
  7. Rober, P., & Van Tricht, K. (2015). The Worries Questionnaire: A method to assess the content of family members’ concerns in family therapy. Journal of Family Therapy, 37(4), 418-435. https://doi.org/10.1111/1467-6427.12073
  8. Rober, P., & Van Tricht, K. (2015). The Dialogical Feedback Questionnaire: Assessing the therapeutic alliance in family therapy. Journal of Family Therapy, 37(4), 436-457. https://doi.org/10.1111/1467-6427.12074
  9. Satir, V., Banmen, J., Gerber, J., & Gomori, M. (1991). The Satir Model: Family therapy and beyond. Science and Behavior Books.
  10. Spanier, G. B. (1976). Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family, 38(1), 15-28. https://doi.org/10.2307/350547