Outcomes for children are related to the stress experienced by a family’s members. In families with young children, the stress parents experience as they manage daily life can affect their parenting and their children. Services and programs that work with families and parents can use information about parenting stress to understand how parents are doing and if the program is helping. Information about parents' stress can help family service providers to find resources or change activities to better address each family’s needs. Measuring parenting stress helps paint a picture of how the family is doing by looking at the relationships between parents and their children.
The Parenting Stress Index (PSI) is a questionnaire that helps look at stress within a family in about 10 minutes. This allows family services staff to understand how each of their families is coping with their daily lives. This information offers staff the opportunity to suggest additional or different referrals for assistance and help parents to work on the stress in their relationship with their child/ren. Understanding and helping reduce parenting stress leads to more positive parenting, which then leads to improved outcomes for children. The PSI also gives the Children’s Cabinet information on the amount of stress in families being served.
Transcript:
Today we are going to look at the PSI-the parenting stress index short form. We are going to walk through scoring one after it has been completed by a family, and talk about what scores might mean. However, it’s important for you to know that ultimately it is up to you as programs to decide how you will use these scores to understand and support your families.
The PSI short form is administered because we get some of our funding for this program from the Kansas Children’s Cabinet and Trust Fund (KCCTF). KCCTF is required to provide an annual evaluation of the programs they fund, and the PSI short form is used to help with a snapshot of how caregivers are doing twice a year during services. The PSI short form helps the Cabinet understand how the programs it supports help caregivers through their family services.
First, we’re going to take a look at the different sections of the form. The form is split into 3 what we call sub-scales. Each sub-scale is made up of 12 questions. Questions 1-12 measure parental distress, questions 13-24 measure parent-child dysfunctional interactions, and questions 25-36 measure difficult child behaviors. One other piece of scoring that we will look at today is called the defensive responding score. After scoring each sub-scale and the defensive responding score, we will talk about what each of these might indicate about the parent’s or caregiver’s stress level.
Once we have a completed form, the first step in scoring is to look at the defensive responding score. That is going to be the value for questions 1,2,3,7,8,9 and 11. These are all the values that are in that light green color of the form. We're going to calculate those by adding them up and writing that value where it says defensive responding. To interpret that score, we'll come back to it later on.
The next thing we're going to do is score those 3 sub-scales mentioned earlier. We’re going to add the values for the questions in each section (including those included in the defensive responding score) and write the totals in the correct boxes. So, let’s add up these answers to 1-12, then 13-24, then 25-36. Then we’ll add up the total of all of those and write in the box labeled “total stress.”
Once you have the totals, you will want to look at where those totals (also called “raw scores”) are on the table called “Percentile Profile.” This will give you a sense of how elevated the raw scores might be. For example, our family has a “Total Stress” score of 58, which means the caregiver is in the 22 percentile. A percentile indicates how many people have either higher or lower scores on the same thing. In this case, there would be 78% of caregivers measured who would have a higher stress score than 58. It’s up to you and your knowledge of that family to determine whether that is high or low and what maintenance or additional services your program would recommend. All of the sub-scores and “Total Stress” can be matched to a percentile.
Now let’s talk about what these scores might mean. A score may be considered elevated even if it does not reach the shaded portion of the “Percentile Profile” table. The raw scores and percentiles from 86th percentile to 99th percentile are considered clinically high, but you are the best judge of what is happening with your families, so if someone scores below the 86th percentile and you judge that they are experiencing stress that needs attention, you should do what your program recommends. First, let’s look at the subscale about parental distress (1-12). If they score high on this, it might mean that the parent is having trouble adjusting to the stress of parenthood. Questions 13-25 cover parent-child dysfunctional interaction, where a high score could indicate that the parent feels rejected by their child or is disappointed that the child does not respond to them. It suggests that the bond between parent and child was not properly established. For the final subscale called difficult child (25-36), a high score might indicate different things for children of different ages: a child 0-18 months commonly has trouble self-regulating, or an older child may be showing behaviors that the parent is have difficulty managing. The sum of all of these scores will be their total stress score.
Let’s go back to the defensive responding score. This score is going to let us know if parents are responding in a way that indicates too little stress-because as we know parenting is quite frequently at least a little bit stressful. So, if the response to the questions that makes up the defensive responding score is too low (less than 10), that could mean one of three things. One is that they are intentionally giving you low scores because they want to appear that they are doing better than they are. The second is that they're not emotionally invested or do not care enough to be stressed. Third, they could genuinely be handling the stress of parenting exceptionally well. So, if their score is lower than 10 any of these three things may be the cause. You're not going to be able to tell from the paper why they may be scoring low, so you're going to have to rely on the relationship that you've built with that family or caregiver, what you know about the family, and what you continue to observe prior to administering this assessment to understand what might be happening and how to best support them. A low defensive responding score does not mean the assessment failed. It is simply another piece of information to assist you in serving that family.
So, there’s how to score the PSI form and some information about what the scores can mean. As for interpreting it and moving forward with and supporting your families, that's up to you and your program and the services available in your community. This is intended to provide some helpful information around scoring the assessment and what scores might indicate. You know your programs and families best, so this assessment is one more tool that not only helps KCCTF meet its goals but also provides you with valuable information to guide your work with the families you serve.
