Rating the quality of the family environment in different cultures

Objective: To examine the extent to which clinicians from different culture s agree when rating the quality of a child's family environment and the eff ect of country, language, and training factors on these ratings. Method: Ei ghty-seven health professionals from Malaysia, Spain, Australia, Indonesia, the United States, Denmark, and Singapore rated 7 case vignettes using the Global Family Environment Scale. Half (54%) were psychiatrists. One quarte r (26%) performed the ratings after attending a training session, the rest (n = 64, 74%) after reading a training manual. Results: Overall, interrater agreement (intraclass r) was 0.84 (95% confidence interval: 0.68-0.96). Th ere were no significant differences in agreement according to country, lang uage, training, or professional group, although there were country differen ces in the ratings given to 2 vignettes. The majority of raters found the d escription of the anchor points (86%), training manual (95%), and case vign ettes (97%) clear. Conclusions: Clinicians from different cultures seem to be able to make global ratings of the quality of the family environment tha t are reliable and consistent when using case vignettes. This can be achiev ed with little training. Global ratings of the quality of the family enviro nment may be a useful tool in mental health research and clinical work.