Description

The Family Rituals Scale (TFS-11) is a psychometric instrument designed to assess the frequency, continuity, and preservation of family ritual practices. The scale was developed to evaluate family functioning, particularly in families with a member diagnosed with schizophrenia, and examines the extent to which families maintain structured activities that contribute to cohesion, emotional stability, and continuity.

Family rituals include socially, culturally, and religiously defined practices that provide a sense of belonging, support, identity, and organization within family life. The TFS-11 is mainly used in the fields of social psychiatry, family psychology, and clinical assessment of family functioning.

Objective

The main objective of the TFS-11 is to assess whether families maintain meaningful ritual practices and to examine the role of these practices in family cohesion and emotional stability.

The scale aims to:

Evaluate Family Ritual Continuity, by measuring the presence and frequency of established family activities.

Assess Family Functioning, by examining whether family rituals are preserved or disrupted in the context of mental illness.

Identify Families Requiring Support, as reduced participation in family rituals may indicate difficulties in family organization, communication, and emotional connection.

Structure and Content

The TFS-11 was developed by Madianos and Economou (1994). The initial version included 16 items, from which 11 questions were selected based on their highest discriminative ability.

Data are collected through an interview with a family member regarding specific ritual activities that occurred during the previous 12 months.

The assessed activities include:

Family celebrations, such as birthdays and special occasions.

Religious and cultural practices, including Christmas gift exchanges and visits to cemeteries.

Traditional family activities, such as preparing traditional meals.

Social activities, including family outings, excursions, and Sunday meals.

The scale does not include separate subscales and provides a single overall score representing the degree of preservation of family rituals.

Scoring Method

Each of the 11 items is rated on a 4-point scale:

1 = Normally (regular presence of the family ritual)

to

4 = Never (complete absence of the ritual practice).

The total score ranges from:

11 to 44

Higher scores indicate fewer preserved family rituals, reflecting greater disruption or absence of ritual practices.

A cut-off point of:

≥18

has been proposed for classification purposes:

Score <18: Families maintaining ritual practices.

Score ≥18: Families showing reduced or absent maintenance of family rituals.

Data Analysis and Use

The psychometric evaluation of the TFS-11 was based on data from:

71 families with at least one member diagnosed with schizophrenia, including 250 individuals.

67 families from the general population, including 295 individuals.

Statistical analysis demonstrated that the scale can differentiate families with preserved versus disrupted rituals.

Higher scores are associated with greater disruption of family rituals and may indicate increased difficulties in family functioning.

The presence of elevated scores may be useful as an indicator for the need for psychosocial support and family-focused interventions.

Validity

The validity of the TFS-11 was examined using the Family Atmosphere Scale as an external criterion.

For the proposed cut-off score of ≥18, the scale demonstrated:

Sensitivity = 0.73

Specificity = 0.75

These findings indicate satisfactory discriminative ability in distinguishing families with and without preserved ritual practices.

Reliability

The reliability of the TFS-11 was evaluated through internal consistency analysis using Cronbach’s alpha coefficient.

Reported reliability values were:

Total sample: α = 0.89

General population families: α = 0.85

Families with a member experiencing psychosis: α = 0.81

These findings indicate strong internal consistency and support the stability and reliability of the instrument.

Applications

The Family Rituals Scale can be applied in social psychiatry, family assessment, mental health research, and studies examining the relationship between family organization and psychological well-being.

It provides researchers and clinicians with information regarding the preservation of meaningful family practices and their possible role in supporting family resilience and adaptation to mental health difficulties.

References

Madianos, M., & Economou, M. (1994). Schizophrenia and Family Rituals: Measuring Family Rituals among Families of Schizophrenics and “Normals”. European Psychiatry, 9, 46–51.