Copyright child and family training 2010 1 Analysis and Planning in Social Work Assessments Stephen...

Copyright child and family training 2010 1

Analysis and Planning in Social Work Assessments

Stephen Pizzey


Authors

Bentovim, A. Cox, A, Bingley Miller, L. and Pizzey, S. (2009)

Safeguarding Children Living with Trauma and Family Violence: A Guide to Evidence-Based Assessment, Analysis and Planning Interventions.

London: Jessica Kingsley.


Inquiries and Guidance

Perhaps the most difficult part of assessment is the interpretation of the information collected and the weighting of the various factors…..the reports demonstrate that not only are situations constantly evolving and changing, but that new information becomes available reinforcing the need for continuing reassessment. (DHSS 1982)

Social workers should seek a broadly based assessment of the child. An outline of the child’s social development together with information about important relationships is vital information. (Cleveland Report 1987)

What patterns of interaction were operating within the family and between the family and the professionals during the assessment? (Department of Health 1988)

Understanding what is happening to a vulnerable child within the context of his or her family and the local community cannot be achieved as a single event. It must necessarily be a process of gathering information from a variety of sources and making sense of it with the family and, very often, with several professionals concerned with the child’s welfare. (Department of Health et al 2000)


Serious Case Reviews

Information and evidence should be collected, and systematic observation assessed within the context of an ecological framework based on a clearly understood developmental and psychosocial theories including the relationship and developmental histories and processes that have shaped parents, families and children. (Brandon et al 2008)

A dynamic ecological explanatory [not a static understanding and assessment of children and their families] view of parent-child interaction which takes account of environmental and cultural factors and the links with workers and services should allow practitioners to spot warning signs of maltreatment at an earlier stage, based on less information. (Brandon et al 2009)


Principles underpinning the Assessment Framework

Assessments:

are child centred; are rooted in child development; are ecological in their approach which means the child must be

understood within the context of their family and this includes the:

• role of economic disadvantage• role of friendship groups• impact of supportive families on parenting capacity; and • the main areas which need to be taken account of include:

– child’s developmental needs.– parents or care giver’s capacity to respond appropriately.– wider family and environmental factors;


CHILD

Safeguarding &

promoting welfare

Assessment FrameworkA conceptual map of relevant data (information) to be collected

Health

Education

Identity

Family & SocialRelationships

Social Presentation

Emotional &Behavioural Development

Selfcare Skills

CH

ILD

’S D

EV

ELO

PM

EN

TAL

NE

ED

S

PAR

ENTIN

G C

APA

CITY

FAMILY & ENVIRONMENTAL FACTORS

Basic Care

Emotional Warmth

Stimulation

Guidance & Boundaries

Ensuring Safety

Stability

Wider Fam

ily

Housing

Em

ployment

Income

Family’s S

ocial

Integration

Family H

istory

& Functioning

Com

munity

Resources


Working with the Assessment Framework

The Assessment Framework provides a map for assessing the needs of children

The Child’s Developmental Needs Domain of the Assessment triangle maps Strengths and Impairment in Development

The Parenting Capacity Domain is concerned with Attributability.

Where there is no observable or measurable impairment, the Parenting Capacity and Family and Environmental Factors Domains are relevant to the Likelihood of Impairment.

Note that the nature of any impairments is also relevant to attributability e.g. Autism is genetic, Cerebral Palsy is congenital in most instances.


The Assessment Process(Bentovim et al 2009)

Stage 1: Consider the referral and aims of the assessment

Stage 2: Gather information from available sources including assessment tools

Stage 3: Categorise information and organise it using the Assessment Framework

Stage 4: Analyse the processes influencing the child’s health and development

Stage 5: Predict the likely outlook for the child

Stage 6: Plan interventions

Stage 7: Identify Outcomes and Measures that would indicate whether interventions are successful


Stage 2: Gather information from available sources

Good assessments use multiple sources of information. An assessment should not rely on one source of information.

Judgements must be based on an integration of data from:

varied methods of assessment different assessors different occasions different locations varied (groups of ) respondents


Stage 2: Gather information from available sources

Developed with funding from the Department of Health (when responsible for Children's Social Care) and referenced in Working Together 2010:

Home Inventory – assessing parenting and the quality of the home environment provided for the child

Family Pack of Questionnaires and Scales - child, adolescent and adult well being, parenting daily hassles, joint family activities and assessment of family and environmental factors i.e. recent life events, home conditions and alcohol use

Family Assessment – maps current identified problems and concerns; assesses family relationships and functioning, parenting and the impact of family history

In My Shoes – a computer-assisted interview for communicating with children and vulnerable adults

Developed in collaboration with Royal Holloway, University of London Attachment Style Interview – assessment of adults’ ability to make &

maintain relationships, attitudes towards & use of support & their attachment style

Others e.g. CECA – a retrospective measure of childhood and adolescent experience

that provides descriptions of children’s experience of abuse


Using the Assessment Framework categorise the available information regarding each child

Check:

Is the information in the correct domain and dimension?

What is not yet known which it is important to know?

Stage 3: Categorise information and organise it using

the Assessment Framework


CHILD

Safeguarding &

promoting welfare

Assessment FrameworkA conceptual map of relevant data (information) to be collected

Health

Education

Identity

Family & SocialRelationships

Social Presentation

Emotional &Behavioural Development

Selfcare Skills

CH

ILD

’S D

EV

ELO

PM

EN

TAL

NE

ED

S

PAR

ENTIN

G C

APA

CITY

FAMILY & ENVIRONMENTAL FACTORS

Basic Care

Emotional Warmth

Stimulation

Guidance & Boundaries

Ensuring Safety

Stability

Wider Fam

ily

Housing

Em

ployment

Income

Family’s S

ocial

Integration

Family H

istory

& Functioning

Com

munity

Resources


Met child’s developmental needs

What needs of the child are being met - and how?

Unmet child’s developmental needs

What needs of the child are not being met - and why?

Stage 4: Analysing Met and Unmet Needs


Stage 4: Principles underlying analysis

Remember

What is central is whether there is impairment or likelihood of impairment of the CHILD’S DEVELOPMENT.

Difficulties/impairments in Parenting or broader Family and Environment may or may not be producing impairments in the child’s development.


Stage 4: Principles underlying analysis

(Angold et al 1995)

In analysing the categorised information consideration should be given to:

• Processes – the pattern of influences

&

• Impact – the weight/effect of factors/processes


Stage 4: Principles underlying analysis - Processes

Distinguish:

• What has brought things about (past)

• What keeps things going (present)

• What’s likely to happen in the future


Stage 4: Principles underlying analysis - Processes

Linear or circular processes:


Stage 4: Principles underlying analysis - Impact

• Severity of difficulty: the weight of a negative factor or process

or

• Magnitude of strength: the weight of a positive factor or process

IMPACT


Stage 4: Principles underlying analysis – Impact

Severity of Difficulties & Magnitude of Strengths

When considering severity/strengths of factors and processes, explore:

• Intrusiveness (depth): the more a factor intrudes upon others the greater the concern/ benefit.

• Pervasiveness (breadth): the greater the number aspects of child development, people, situations etc on which the factor impacts, the greater the concern/benefit.

• Modifiability (change): to what extent do other actions or experiences alter a factor/process.

• Frequency (how often): the more frequent a factor/process, the greater its impact.

• Duration (length): the longer duration of a factor/process, the greater the weight.

• Unusualness: the more unusual a factor/process the greater likelihood of it being severe.


Stage 4: Principles underlying analysis - summary

• the more dimensions of domains that show

difficulty;

• the more frequently those difficulties are

manifest;

• the longer the difficulties have existed;

• the less the difficulties are modifiable;

then the greater the severity of the problem

In general:


What are the consequences for each child if each particular need continues to be:

met in the short term

met in the long term or

unmet in the short term and

unmet in the long term

Stage 5: Predicting Outlook for the Child


• What are the options for interventions which might:

(a) help support strengths &/or (b) help meet the unmet needs?

• Towards which met/unmet need is each intervention targeted?

• What resources are available?

• Which of those available is the family most likely to cooperate with?

• Which intervention is likely to produce the most immediate benefit and

which might take time?

• What should be the sequence of interventions and why?

• What is the likelihood of achieving sufficient change within the child’s

timeframe?

Stage 6: Planning interventions


Stage 7: Identify Outcomes and Measures that would indicate whether interventions are

successful

The key outcome is the child’s developmental

progress

The aims are to assess :

• Whether the child has progressed and in which

dimensions

• How improvements or deteriorations have come

about.



successful

• Analysis of Pattern and Impact of Processes

leads to hypotheses about Interventions to

promote the child's development

• Interventions may be directed to any

dimension in any domain



successful

To assess outcomes of Intervention need

to measure change over time in:

• The Child's Development

• Factors and Processes thought to influence

the Child's Development

Need baseline and follow-up measures


Prognosis for Achieving Change (Bentovim et al 1987)

Hopeful Prognosis for Change

• Good possibility of change within child’s timeframe

• Reasonable degree of responsibility taken• Reasonable flexibility of relationships• Reasonable balance of family strengths and

difficulties• Potential for individual change with facilities and

resources available• Not too negative an attitude to professionals


Poor Prognosis for Change

• Child subject of serious abuse • Failure to take responsibility• Considerable family difficulties with few

strengths• Severe parental pathology, personality

disorder or level of addiction which implies changes cannot be made in child’s timeframe

• Resources unavailable to intervene given severity of situation

• Negative attitude to professionals



Characteristics where Intervention has been Unsuccessful (1)

(Jones 1991)

• Continuing parental denial of abuse/impairment

• Parents who refuse/don’t cooperate with help

• Severe personality problems• Learning difficulties with accompanying

mental illness• Persistent parental substance/alcohol

misuse• Parental psychosis with delusions involving

child


Characteristics where Intervention has been Unsuccessful (2)

(Jones 1991)

• Severe neglect and/or psychological abuse where parents display pervasive lack of empathy

• Severe sexual abuse involving penetration and of long duration

• Sadistic abuse or that which includes slow premeditated infliction of pain or suffering

• Mixed abuse cases• Specific cases e.g. factitious/self induced

injury, deliberate poisoning, scalding and burns



Doubtful Prognosis for Change

Uncertainty about:• whether change can be achieved or not within the

time frame of the child• the degree of responsibility taken• the potential for collaborative work

and if its not clear: • what further work needs to be carried out to

determine whether rehabilitation can be achieved?


Safeguarding Analysis: A 12-step process

(Bentovim et al 2009)

In assessments where there are continuing safeguarding concerns, need to be able to:

• Assess the profile of harm and risks of re-abuse or likelihood of future harm

• Determine the prospects for successful

intervention

The Safeguarding Assessment and Analysis Framework (SAAF) aims to facilitate this


Safeguarding Analysis: Process used to make the analysis (1)

To make an assessment of the profile of harm, risks of re-abuse /future harm and the prospects for successful intervention, we look in turn at:

• Child’s developmental needs

• Parenting capacity

• Family & individual factors

• Environmental factors


Each domain/area is analysed in turn in terms of:

• The level of difficulty

• Whether parents can acknowledgement of difficulties & motivation to change

• Potential for change




Child’s Developmental Needs:

• The overall levels of harm, past and present, and the impact on child’s health and development and how child’s needs met in the past and currently

• Level of parenting, protection & therapeutic work the child requires, considering level of harm

• Do parents acknowledge and take responsibility for harm? Do the acknowledge the need for protection and therapeutic work for child’s recovery?



Parenting capacity:

• Level of parenting provided

• Do parents acknowledge nature and level of current parenting difficulties? Do they have motivation to change?

• Do parents have potential to respond to child’s needs & develop capacity to help child recover?



Individual & Family Factors:

• The influence of individual and family factors on parenting capacity and in turn the child’s wellbeing

• Do parents acknowledge role of individual & family factors? Do they have motivation to change?

• Is there potential for change in individual & family factors & to respond to intervention & to improve parenting?



Environmental Factors:

• Influence of of environmental factors and their impact on individual and family functioning and parents’ capacity to meet child’s needs

• Do parents acknowledge role of environmental factors? What is the potential to change?

• Nature of family-professional relationships & potential for working together & availability of resources to achieve changes within child’s timeframe


The Assessment Process

Stage 1: Consider the referral and aims of the assessment

Stage 2: Gather information from available sources including assessment tools

Stage 3: Categorise information and organise it using the Assessment Framework

Stage 4: Analyse the processes influencing the child’s health and development

Stage 5: Predict the likely outlook for the child

Stage 6: Plan interventions

Stage 7: Identify Outcomes and Measures that would indicate whether interventions are successful

Stage 8: Safeguarding Analysis where there are continuing safeguarding concerns• Assess the profile of harm and risks of re-abuse or likelihood of future

harm

• Determine the prospects for successful intervention

Copyright child and family training 2010 1 Analysis and Planning in Social Work Assessments Stephen...

Documents

Transcript of Copyright child and family training 2010 1 Analysis and Planning in Social Work Assessments Stephen...