© Copyright ISBN 0 11 322426 5 ADULT WELLBEING 1a

Name of Child:

Completed by:

Relationship to child:

Date:

Adult

Wellbeing

THE SCALE

9. I’m awake before I need to get up

For 2 hours For about 1 hour For less than Not at all. I

or more 1 hour sleep until it is

time to get up

10. I feel tense or ‘wound up’

Yes, definitely Yes, sometimes No, not much No, not at all

11. I feel like harming myself

Yes, definitely Yes, sometimes No, not much No, not at all

12. I’ve kept up my old interests

Yes, Yes, No, No,

most of them some of them not many of them none of them

13. I am patient with other people

All the time Most of the time Some of the time Hardly ever

14. I get scared or panicky for no very good reason

Yes, definitely Yes, sometimes No, not much No, not at all

15. I get angry with myself or call myself names

Yes, definitely Yes, sometimes Not often No, not at all

16. People upset me so that I feel like slamming doors or banging about

Yes, often Yes, sometimes Only occasionally Not at all

17. I can go out on my own without feeling anxious

Yes, always Yes, sometimes No, not often No, I never can

18. Lately I have been getting annoyed with myself

Very much so Rather a lot Not much Not at all

ADULT WELLBEING SCALE

This form has been designed so that you can show how you have been feeling in

the past few days.

Read each item in turn and UNDERLINE the response which shows best how you

are feeling or have been feeling in the last few days.

Please complete all of the questionnaire.

1. I feel cheerful

Yes, definitely Yes, sometimes No, not much No, not at all

2. I can sit down and relax quite easily

Yes, definitely Yes, sometimes No, not much No, not at all

3. My appetite is

Very poor Fairly poor Quite good Very good

4. I lose my temper and shout and snap at others

Yes, definitely Yes, sometimes No, not much No, not at all

5. I can laugh and feel amused

Yes, definitely Yes, sometimes No, not much No, not at all

6. I feel I might lose control and hit or hurt someone

Sometimes Occasionally Rarely Never

7. I have an uncomfortable feeling like butterflies in the stomach

Yes, definitely Yes, sometimes Not very often Not at all

8. The though of hurting myself occurs to me

Sometimes Not very often Hardly ever Not at all

ADULT WELLBEING 1b

Scoring

19. The sheet accompanying the questionnaire indicates the method of scoring

the 4 subscales.

20. Use of cut-off scores gives indicators of significant care needs with respect

to depression, anxiety, and inwardly and outwardly directed irritability.

21. Inward irritability can point to the possibility of self-harm. Outward

irritability raises the possibility of angry actions towards the child(ren).

22. As with any screening instrument, interpretation must be in the context of

other information. Some respondents will underreport distress, others

exaggerate it. A high or low score on any scale does not guarantee that a

significant level of need is present.

23. Most value is obtained by using the scale as a springboard for discussion.

Reference

Snaith RP, Constantopoulos AA, Jardine MY & McGuffin P (1978) A clinical scale for

the self-assessment of irritability. British Journal of Psychiatry. 132: 163–71.

Adult

Wellbeing

GUIDANCE ON

USING THE SCALE

11. Where social workers were new to the family situation they said they learnt

things they did not know. ‘It helped me to be aware of the carers’ needs’,

and ‘highlighted stresses’. It helped focus on ‘parents’ needs and feelings’.

12. Even when parents were known to the workers it gave topics an airing and

clarified areas to work on; it ‘released tension’.

13. Progress can also be registered. It was ‘useful to measure when things were

calmer’.

14. Used flexibly it can provide openings to discuss many areas including

feelings about relationships with partners and children.

Administration

15. It is vital that the respondent understands why they are being asked to

complete the scale. Some will be concerned that revealing mental health

needs will prejudice their chances of continuing to care for their child. For

example, it can be explained that many carers of children experience

considerable stress, and it is important to understand this if they are to be

given appropriate support.

16. The scale is best filled out by the carer themselves in the presence of the

worker, but it can be administered verbally.

17. It takes about 10 minutes to complete.

18. Discussion is essential. Usually this will be when the questionnaire has

been completed, so the respondent has an opportunity to consider their

own needs uninterrupted. However, there will be times when an important

clue to how the caregiver feels may be best picked up immediately. One

example occurred during piloting, when a respondent expressed distaste for

questions about self-harm.

ADULT WELLBEING SCALE

Background

1. Parent/Caregiver mental health is a fundamental component of

assessment.

2. There is evidence that some people respond more openly to a questionnaire

than a face to face interview, when reporting on their mental health.

3. A questionnaire gives caregivers the opportunity to express themselves

without having to face another person, however sympathetic that person

may be.

4. A questionnaire is no substitute for a good relationship, but it can contribute

to the development of a rapport if discussed sensitively.

5. During piloting the use of the questionnaire was found to convey the social

worker’s concern for the parent’s wellbeing. This can be particularly

valuable where the parent feels their needs are not being considered.

The Scale

6. The scale is the Irritability, Depression, Anxiety (IDA) Scale developed by

Snaith et al (1978).

7. This scale allows respondents four possible responses to each item.

8. Four aspects of wellbeing are covered: Depression, Anxiety and Inwardly

and Outwardly directed Irritability.

Use

9. In principle the questionnaire can be used with any adult, who is in contact

with the child whose development and context are being assessed. In

practice this will usually be the main caregiver(s).

10. In piloting, social workers reported that use of the scale raised issues on

more than half the occasions that it was used. Probable depression was

found amongst almost half the caregivers, and significant anxiety in a third.

ADULT WELLBEING 2b

Adult

Wellbeing

SCORING

THE SCALE

SCORING THE ADULT WELLBEING SCALE

1. Depression – Questions 1,3,5,9 and 12 look at depression. The possible

response scores that are shown below run from the left to the right – i.e. for

question 1 ‘I feel cheerful’, the scores would be looked at from ‘yes,

definitely’ (0), ‘yes, sometimes’ (1), ‘no, not at all’ (3), A score of 4–6 is

borderline in this scale and a score above this may indicate a problem

QU1 QU3 QU5 QU9 QU12

0,1,2,3 3,2,1,0 0,1,2,3 3,2,1,0, 0,1,2,3,

2. Anxiety – Questions 2,7,10,14 and 17 look at anxiety. A score of 6–8 is

borderline, above this level may indicate a problem in this area.

QU2 QU7 QU10 QU14 QU17

0,1,2,3 3,2,1,0 3,2,1,0 3,2,1,0, 0,1,2,3,

3. Outward directed irritability – Questions 4,6,13 and 16 look at outward

directed irritability. A score of 5–7 is borderline for this scale, and a score

above this may indicate a problem in this area.

QU4 QU6 QU13 QU16

3,2,1,0 3,2,1,0 0,1,2,3 3,2,1,0,

4. Inward directed irritability – Questions 8,11,15 and 18 look at inward

directed irritability. A score of 4–6 is borderline, a higher score may indicate

a problem.

QU8 QU11 QU15 QU18

3,2,1,0 3,2,1,0 3,2,1,0 3,2,1,0,

Use of cut-off scores gives indicators of significant care needs with respect to

depression, anxiety, and inwardly and outwardly directed irritability. Inward

irritability can point to the possibility of self-harm. Outward irritability raises the

possibility of angry actions towards the child(ren).

As with any screening instrument, interpretation must be in the context of other

information. Some respondents will underreport distress, others exaggerate. A

high or low score on any scale does not guarantee that significant level of need is

present.

Most value is obtained by using the scale as a springboard for discussion.

Document available

http://www.dh.gov.uk/en/Policyandguidance/Healthandsocialcaretopics/ChildrenServices/index.htm