FAST Description

Brief description   Psychometric properties   Treament planning and evaluation
History of the FAST   Cross-cultural research    
Test application   Clinical discriminant validity    

Brief description
  The Family System Test (FAST) is a new approach for the quantitative and qualitative analysis of relational structures. This clinically-derived figure placement technique was designed to evaluate cohesion and hierarchy in the family and its subsystems in a variety of situations. Cohesion is represented by the distance between figures on the board. Hierarchy is represented by the elevation of figures with blocks. The FAST is a versatile clinical and research tool which can be used in individual and family settings with respondents as young as six years.

The FAST is very economical compared with other instruments which provide similar information. Another significant advantage of the FAST lies in its ability to trigger a process of reflection on family relations among respondents, thus facilitating diagnosis and therapy. A first evaluation is possible right after completion of the representations. For example, it is possible to determine structural characteristics such as clarity of generational boundaries without any prior calculations. A review of the follow-up interviews and the spontaneous comments of the family members permits ad hoc individual and family-oriented systemic hypotheses (see concept of the FAST).

History of the FAST
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The first pilot studies with the FAST were conducted in the early 1980's by the test author at the Outpatient Clinic of the Department of Child and Adolescent Psychiatry at the University of Zürich. These showed that parents and children were highly stimulated to reflect upon the relationships in their families, a fact that contributed to the planning of therapeutic interventions. Financial support from the Swiss National Research Foundation and the Stanford Center for the Study of Families, Children and Youth enabled the test author to conduct validation studies with healthy families at the Department of Psychology at the Stanford University, California from 1985 to 1988. The following research with the FAST in Switzerland focused again on interpersonal constructs of distressed family members. The studies were devoted to conceptualize empirically-based interventions for families with a mentally disturbed offspring. The attempted goal was to develop the FAST as an instrument that is flexible to accomodate the requirements of systemic treatment strategies and at the same time allows to meet high clinical standards.

The FAST manual, originally published in Germany 1993, has recently been translated into major European languages as well as Japanese, and clinicans and researchers from various fields are now using this tool (see FAST publications).

Test application
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A large number of different social situations can be studied by means of the FAST. Depending on the issue on the hand, the standard test procedure can be modified to include different phases of current conflicts as well as past and anticipated events. Furthermore, the figures need not to be limited to the persons living in the same household as the respondent. In fact, if children of divorced or separated families are allowed a free selection of figures, they can provide interesting information regarding their identification with absent family members. For example, children of divorced parents often represent the absent parent when the relationship is not stressful. Sometimes, however, respondents include even deceased family members in their set of important figures.

Psychometric properties
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Psychometric properties of the FAST were established using individual and joint representations of middle-class families from the San Francisco Bay Area. Results for individual representations include the following four aspects:
  • Independence of cohesion and hierarchiy dimensions
  • Relationships between family and subsystems representations
  • Test-retest reliability
  • Convergent and discriminant validity as assessed by FACES III and FES as external criteria
Results for FAST representations by multiple members of the same family are based on comparisons of:
  • Individual representations of fathers, mothers and children
  • Family members’ individual and their joint representations
  • Observed patterns of family interaction and portrayed interpersonal structure.
Cross-cultural research
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Using clinical and nonclinical samples FAST representations by respondents from the following countries have been compared:

Switzerland vs. USA Switzerland vs. China Italy vs. England
Switzerland vs. Japan Germany vs. Russia Germany vs. Brazil
Clinical discriminant validity
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Clinical discriminant validity of the FAST was established by comparing interpersonal constructs of members of well-functioning families with those of parents and children of distressed families from the Zurich City Area. Convergent with structural family therapy, it has been documented that families with a mentally disturbed child represented their family structures more often as being disengaged and with unclear generational boundaries. Comparisons of FAST representations from members of the same family revealed that clinical respondents (i.e. child psychiatric patient, their parents and siblings), contrary to nonclinical ones, agreed on the evaluation of their current relationships. Thus, child and adolescent psychiatry can obtain reliable and useful information on overall family functioning on the basis of individual FAST portrayals of a single family member.

Treatment planning and evaluation
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Using the FAST a model for the participative planning and evaluation of interventions with families of disturbed children has been developed at the University of Zurich, Department of Child and Adolescent Psychiatry. It is based on the family members’ individual and joint FAST representations (see case example). The results of numerous therapy evaluation studies indicated that parents and children represented improved family structures and reported less problems after completion of individual or family treatment. The outcome of the FAST correlated with family as well as patient development as derived from various clinical measures.