This article describes some of the challenges involved in the selection of self‐report outcome measures for use in family and systemic therapeutic services, and potential ways of overcoming them. It highlights factors that may undermine the demonstration of the effectiveness of services related to the characteristics of services, client groups and the measures themselves. Choosing appropriate self‐report outcome measures is particularly difficult for practitioners responding flexibly to the needs of heterogeneous client groups and those working with multiple family members. Measures need to be acceptable to both clients and practitioners, addressing constructs relevant to individual and systemic level change, and incorporating features that enhance sensitivity to client change. Possible solutions are discussed, with the aim of enabling services to make more informed choices when selecting outcome measures for use in the monitoring and evaluation of family and systemic therapy. Practitioner points Develop a logic model to identify possible mechanisms of change and key impacts. For heterogeneous client groups, consider assessing overarching constructs or using idiographic in addition to nomothetic approaches. To enhance the chances of capturing change within a family system, use more than one instrument and ask different family members to complete them. Select measures with appropriate language, structure and length for piloting with clients and practitioners. 选择用于家庭和系统治疗的自我报告式疗效指标 本文描述了在选择用于家庭和系统治疗过程中的自我报告式疗效指标时存在的一些挑战, 以及一些可能的应对方法。文中突出了一些可能影响疗效呈现的因素, 这些因素与治疗过程的特点、来访者类型以及指标本身有关。对于需要灵活回应不同类型的来访者和同时与多个家庭成员开展工作的从业者来说, 选择一种合适的自我报告式疗效指标是尤其困难的。指标需要被来访者和从业者双方接受, 针对个人和系统层面改变的概念, 并且包含某些特征以增强对于来访者变化的敏感度。本文讨论了可能的解决方式, 目的在于帮助家庭治疗服务机构在选择用于监督和评估家庭和系统治疗的疗效指标时做出更加明智的决定。 对实务工作者的启示 开发一套逻辑模型以识别变化的种种可能机制及其关键影响。 对于不同类型的来访者, 考虑评估首要概念, 或者用个案代替通则式研究方法。 为了增加在家庭系统中捕捉到变化的机会, 应使用不止一种测量工具, 并让不同的家庭成员参与完成。 为来访者和从业者参与的初步研究选择语言、结构和长度合适的指标。 关键词：自我报告式疗效指标；家庭和系统治疗；评估；判定变化