Rehabilitation Psychology 2011. Vol. 56. No. 3. 243-250 © 2011 American Psychological Association 0090-5550/11/$I2.00 DOI: 10.l037/a0024465 Development and Validation of the Caregiver Empowerment Scale: A Resource for Working With Family Caregivers of Persons With Traumatic Brain Injury Charles Edmund Degeneffe San Diego State University Laura Dunlap ACT Medical Group, Raleigh-Durham, North Carolina Fong Chan University of Wisconsin-Madison David Man Hong Kong Polytechnic University Connie Sung University of Wisconsin-Madison Objective: To use multitrait analysis to determine the measurement structure of the Caregiver Empow- erment Scale (CES). Participants: An American sample of 87 adult primary family caregivers of persons with traumatic brain injury (TBI). Resutts: A four-factor structure was identified including factor 1 (Advocacy Self-Efficacy), factor 2 (Community Self-Efficaey), factor 3 (Caregiver Self-Efficacy), and factor 4 (Personal Self-Efficacy). Conctusions: The CES provides clinicians and researchers a means to assess self-perceived coping abilities of family caregivers of persons with TBI. Keywords: traumatic brain injury, family, empowerment, caregiving, social support Families of persons with traumatic brain injury (TBI) are often presented with substantial and extended caregiving responsibili- ties. Families provide an extensive array of both affective as well as instrumental forms of care, such as assistance with emotional well-being and behavioral management (Degeneffe, 2001). In the immediate post-TBI phase, families are propelled into the world of hospitals, rehabilitation centers, and other acute-care settings (Bishop, Degeneffe, & Mast, 2006), and longer term, often find themselves presented with the bulk of caregiving responsibilities. This is often due to the fact that short- and not long-term profes- sional supports are available to persons with TBI (Kolakowsky- Hayner, Miner, & Kreutzer, 2001), and persons with TBI fre- quently experience the loss of friends and other social contacts (Kendall, 2003). The nature of family caregiving can be extensive, including providing support in such areas as daily living skills training, medication management (Eames, Haffey, & Cope, 1990), and This article was published Online First July 25, 2011. Charles Edmund Degeneffe, Department of Administration, Rehabilita- tion, and Postsecondary Education, San Diego State University; Fong Chan and Connie Sung, Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison; Laura Dunlap, ACT Med- ical Group, Raleigh-Durham, North Carolina; David Man, Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China. Correspondence concerning this article should be addressed to Charles Edmund Degeneffe, PhD, CRC, ACSW, Rehabilitation Counseling Pro- gram, Department of Administration, Rehabilitation, and Postsecondary Education, San Diego State University, Interwork Institute, 3590 Camino del Rio North, San Diego, CA 92108. E-mail: cdegenef@mail.sdsu.edu behavior modification (Rosenthal, 1989). Potentially, all members of the family system can assume a caregiving role (Degeneffe, 2001), including those both in and outside the injured family member's residence (e.g., Degeneffe & Burcham, 2008). The assumption of a caregiver role can result in the inability of family members to attend to other life roles (Serio, Kreutzer, & Witol, 1997) and maintain their social networks (Douglas & Spellacy, 1996). Extant research on families of persons with TBI finds they frequently face elevated levels of burden, stress, and depression due to the extensive and chronic nature of TBI care (Chronister & Chan, 2006; Chronister, Chan, Sasson-Gelman, & Chiu, 2010; Degeneffe, 2001). For example, Gan, Campbell, Gemeinhardt, and McFadden (2006) studied family functioning following TBI as experienced by 148 family members of 66 persons with TBI in Toronto, Canada. Gan et al. found that compared to a normative sample on the General Scale of the Family Assessment Measure- Ill (Skinner, Steinhauer, & Santa-Barbara, 1983), participants demonstrated greater levels of distressed family functioning. An overall conclusion of TBI family caregiving research finds they face chronically high distress levels, (Kreutzer, Marwitz, & Ke- pler, 1992), compared to outcomes for other populations such as aging family caregivers of persons with intellectual disabilities, where family caregivers experienced less distress over time (Greenberg, Seltzer, & Greenley, 1993). In response to these findings, recent studies ask families to identify what they need to best adjust and cope with caregiving demands. Based on a comprehensive literature review of common needs endorsed by families of persons with TBI through instru- ments like the Family Needs Questionnaire (Kreutzer & Marwitz, 1989), Bishop and associates (2006) concluded the most common 243