family engagement assessment and problem … · to understand individual and family issues. ......

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FAMILY ENGAGEMENT,

ASSESSMENT &

PROBLEM SOLVING

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OBJECTIVES:

As a result of this training, you will be prepared to:

� Recognize the importance of attitudes and beliefs while applying specific techniques in engaging families.

� Define “family” as a system, and assessment as both a process and product.

� Utilize selected family assessment tools.

� Critique a family assessment.

� Implement the fundamental aspects of Motivational Interviewing.

� Employ a problem solving approach.2

IMPORTANCE OF ENGAGING FAMILIES

�Child welfare serves “dual clients.”

� Child needs safety/security (primary!)

� Parent needs to change/care for child.

�With effective engagement, workers and clients become partners who collaborate.

�Without effective engagement, workers and clients become adversaries who avoid, argue, and antagonize.

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CEI2

Child Welfare Training Institute Office of Workforce Development and Training MDHHS 04.16.15

CEI2 Early contacts can set a positive – or negative – tone for the working relationship between the family and child welfare professional, and can even have a profound effect on the relationship between the family and other workers that family may work with in other areas of the continuum.Isanhart, Courtney (DHS), 01/16/2014


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GROUP DISCUSSION

�Take 5 minutes to read Sample Family

Assessment Document: The Parker

Family in your Reference Books

� Which of the people mentioned in the

scenario do you – as a person – like the most?

Why?

� Which of the people mentioned do you – as a

person – like least? Why?

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ENGAGING FAMILIES IS A PROCESS

�Engagement is both an initial and ongoing process.

�Engagement requires a one-to-one working relationship with each person, and the family as a whole.

�Working relationships require two components of trust.

� Integrity

� Competence

�Working relationships are goal-directed, time-limited, honest, realistic, and safe. 5

THE STRENGTH BASED PERSPECTIVE

�Seeks clients’ understanding of facts.

�Believes in clients’ competence.

�Makes an effort to determine what clients want.

�Focuses on client and environmental strengths.

�Discovers clients’ uniqueness.

�Works collaboratively with clients and other professionals.

�Uses understandable language.

�Avoids blame.

�Obtains agreement from clients.6

CEI3


CEI3 If your thoughts about your clients center primarily on what you feel they have done “wrong,” you are more likely to take a punitive approach in all of your interactions with them, which is going to have a negative effect on your engagement with your clients and the quality of your collaboration with them.Isanhart, Courtney (DHS), 01/16/2014


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STEPS FOR ENGAGING FAMILIES IN

EARLY CONTACTS

�Make a positive first impression:

� Be on time, respectful, and interested in clients.

� Introduce yourself and explain your work:

� Who, what, when, where.

�“Normalize” reactions to involvement in the child welfare system:

� Guilt, shame, blame, fear/anxiety.

� People usually do the best they can. 7

ROLE-PLAY OF FAMILY ENGAGEMENT

SCENARIO

Players:

�One (family) “client” and one “worker.”

�Rest are “consultants.”

Discussion after role-play:

� What part of this role-play was easiest for your group?

� What challenges did your group face during this role-play?

� What suggestions do any of you have for dealing with these challenges?

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FAMILY ASSESSMENT

�Family assessment is facilitated by family

engagement and forms the foundation for

family intervention.

� Introduction to family assessment.

� Selected family assessment tools.

� Introduction to problem solving.

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PROCESS & PRODUCT

Assessment is both a process and a product through which information is gathered, analyzed, and synthesized to provide a concise picture of the client system and its needs and strengths. Assessment serves as the basis for goals, intervention, and evaluation.

(Hepworth, Rooney, Rooney, Strom-Gottfried, & Larsen, 2010)

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MYD3

PERSONAL PROFESSIONAL

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BELIEFS, PREFERENCES & FACTS(THOMLINSON, 2007)

�Beliefs are assumptions (“truths”):

� Personal beliefs.

� Family (client) beliefs.

� Professional beliefs.

� Practice setting beliefs.

� Legal requirements.

�Preferences are subjective opinions (“shoulds”).

�Facts are statements that can verified or disconfirmed. 12


MYD3 Tie into continuum of care by reminding trainees that these aspects of assessment apply whether you are a CPS investigator or foster care worker assessing a birth family, a licensing worker assessing a foster family, or an adoption worker assessing a potential adoptive family.Davenport, Michele (DHS), 01/29/2014


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SMALL GROUP DISCUSSION

Discuss your reactions to the following statements:

� Parents should forfeit rights if they mistreat their children.

� The bond between children and their parents lasts forever.

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PURPOSES OF FAMILY ASSESSMENT

�To understand individual and family issues.

�To identify individual and family strengths.

�To set goals.

�To select interventions/resources.

�To report to court or other decision makers.

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CEI6

SOURCES OF ASSESSMENT DATA

� Interviews/observations:

� Child.

� Parents/caregivers (birth, foster, adoptive, kinship).

� Siblings.

� Extended family.

�Existing documentation.

�Assessment tools.

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CEI6 How can we tie bullets 3 and 4 in to be relevant to adoption workers?Isanhart, Courtney (DHS), 01/16/2014


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ECOLOGICAL FAMILY ASSESSMENT

�Views individuals and families as interactive elements of larger systems:

� Individuals develop through interpersonal relationships.

� Families are systems at once affected by and affecting their environments.

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FAMILY AS CONTEXT

Individuals interact within family systems.

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FAMILY IN CONTEXT:

THE FAMILY INTERACTS WITH LARGER

SYSTEMS

Federal Policy

Court/DHS

Community

Family

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WHAT IS A FAMILY?

Individually write a brief answer to the following questions:

� As a CW worker, how will you define “family”?

� What are the primary functions families (should) fulfill?

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DEFINITIONS OF FAMILY

�Legal – the family is defined by legal rights, contracts, marriage, adoption.

�Biological – the family is defined by genetics, heredity, and “blood.”

�Relational – the family is defined by the emotional connections valued by members.

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FUNCTIONS OF FAMILY

� Bonding, attachment, emotional connection (belonging).

� Behavioral control.

� Cognitive development.

� Moral development.

� Contribution, achievement, value.

� Self-regulation, autonomy, launching (individuation).

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CEI8


CEI8 When we are asking the group to respond to them, what are we asking? Are we asking if they agree that those are all functions of family?Isanhart, Courtney (DHS), 01/16/2014


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MATRIX OF IDENTITY

In all cultures, the family imprints its members with selfhood. Human experience of identity has two separate elements: a sense of belonging and a sense of being separate. The laboratory in which these elements are mixed and dispensed is the family, the matrix of identity.

Minuchin, S. (1974). Families and family therapy. Cambridge, MA:

Harvard. 22

MYD5 CEI20

FAMILY ASSESSMENT TOOLS

�Genogram.

�Eco-Map.

�Social Support Network Map.

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CEI9

FAMILY ASSESSMENT INTERVIEW

A family assessment interview is a professional conversation that is:

• Purposeful: To engage a family, explain services, obtain information.

• Focused: Attention is centered on the purpose, and effort is invested to stay on track.

• Clear: Communication is pertinent, meaningful, and understandable.

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CEI10


MYD5 changed the word labortory to experiencesDavenport, Michele (DHS), 01/30/2014

CEI20 Changed "experiences" back to "laboratory," as this is a direct quote from the book, not a paraphrase.Isanhart, Courtney (DHS), 04/02/2014

Slide 23

CEI9 Again, tie into the continuum -- these are valuable assessment tools regardless of what type of assessment you are conducting, or what type of family you are assessing (birth, foster, adoptive, kinship, etc.).Isanhart, Courtney (DHS), 01/16/2014

Slide 24

CEI10 Also share that the assessment process can be uncomfortable for the family, as they may feel that they are being asked to “air their dirty laundry” and talk about things they may rather not discuss. As professionals, we need to keep that in mind, and address uncomfortable personal topics with professionalism and sensitivity.Isanhart, Courtney (DHS), 01/16/2014


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INTERVIEWING FAMILIES

� Use basic interviewing skills:

� Attending, focusing, obtaining content and observing process, questioning, expressing empathy.

� Seek out, invite, and engage all relevant family members.

� Involve all family members who are present.

� Thank all family members who participate.

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CEI11

CIRCULAR QUESTIONS

Are open-ended inquiries that:

�Seek family members’ perceptions of other family members.

�Explore interaction pattern.

�Outline similarities and differences between family members.

� Identify individual and collective strengths.

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EXAMPLES OF CIRCULAR QUESTIONS

�Who bugs you more, Mom or Dad?

�When your brother criticizes you, how do you think that makes your mom feel?

�How did your brother react when you were adopted and he wasn’t?

�When you accepted responsibility for your grandson, how did your partner respond?

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CEI11 Should we also note that there are certain topics (like DV) where we should absolutely ensure that we discuss them with individuals separately to ensure that family members feel safe answering honestly?Isanhart, Courtney (DHS), 01/16/2014


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EXERCISE: FORMING CIRCULAR QUESTIONS

� Using the Parker Family Scenario in your Reference Books, brainstorm circular questions to use with this family.

� Write out three of your questions and identify which family member(s) to whom you might pose that question.

� Switch papers with another group.

� Select the best example(s) from that group to read to the large group.

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GENOGRAM

Bett

y

55

2

9

Tina

46

Ali

22

Louey

60

Arme

32

“Buzz

”

51

Stan

41

279

35 2

76

Ami

3

Andy

5

m 2010, div 2012

Anxious

Overwhelmed

“All alone”

K Teacher reported “neglected”

(falls asleep, dirty/torn clothes,

“hungry”, “keeps to himself”)

Beautiful, selfish

“Cute”, “Sweet”,

Scared

“Angry”, hard worker

D. 2002

“Strong”,

“Tough lady”

m 1974

m 1985

div

1990

Alcohol, “mean drunk”

“Ladies man”,

drinker

Devoted dad, sober 11

years

m 2005

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CEI13

PLACEMENT GENOGRAMSMCMILLAN, J.C., & GROZE, V. (1994). USING GENOGRAMS IN CHILD WELFARE

PRACTICE. CHILD WELFARE, 73, 307-318.

�Genograms can be adapted to depict birth, foster, adoptive, and kinship families.

�Start with the birth family genogram and add foster family and/or adoptive family genograms to represent the child’s placement history.

�Kinship family genograms may require additions to the birth family genogram.

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CEI13 What do we mean by a "fused" relationship? Is this like enmeshed? Codependent?Isanhart, Courtney (DHS), 01/16/2014


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ECOMAP

Indicate connections where they exist. Use for intense, for moderate, for tenuous, and / / / / / for stressful. Signify direction of flow of energy/resources with directional arrows. Fill in empty circles or add circles as needed to represent areas of life.

Bani6

Miki36

Juli32

Rok40

DHS Moneywoes

Extended Family

Work

Friends

Prison

Alcohol

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SOCIAL SUPPORT NETWORK MAP

Neighbors

Friends

Work

School

Clubs

Religious

OrganizationsExtended Family

Other

Other

Richards,

Jagger,

Clapton

Melonie,

Isis, Judyth

God is Great

Church

(DHS worker)

Cammie

Momma Leonie

Auntie Trina

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DOCUMENTING FAMILY ASSESSMENT

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A GOOD FAMILY ASSESSMENT DOCUMENT:

� States/describes the reason/objective of the assessment.

� Includes information about individuals, relationships, and family within its environment.

� Accurately reports facts/observations.

� Clearly identifies interpretations.

� Integrates facts/observations and interpretations to describe individual and family functioning, strengths, and needs.

� Informs goals, interventions, and recommendations.34

CEI15

EXERCISE: CRITIQUING A FAMILY

ASSESSMENT DOCUMENT

�Read the sample family assessment document.

�Apply the checklist for family assessment documents.

�Discuss your responses with your group and work toward consensus.

�Select the most significant weakness and the most significant strength of this document to report to the large group.

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MOTIVATIONAL INTERVIEWING (MI)

�Motivational Interviewing is a collaborative conversation designed to strengthen a person’s own motivation for and commitment to change.

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CEI15 Could we change the first bullet to "States/describes the reason/objective of the assessment"? This would help tie in for adoption workers.

Similarly, could we change the last bullet to "Informs goals, interventions, and/or recommendations"?Isanhart, Courtney (DHS), 01/16/2014


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BASICS OF MOTIVATIONAL INTERVIEWING

http://www.motivationalinterview.org/quick_links/about_mi.html

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10 ESSENTIAL CHARACTERISTICS OF MI

1. It is a conversation about change – usually behavioral change.

2. Has a specific purpose – to evoke and strengthen the person’s motivation to change.

3. It is collaborative – a person-centered partnership.

4. It is designed to honor the fact that people make their own choices.

5. It evokes the person’s own motivation to change.

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10 CHARACTERISTICS (CONT.)

6. Uses specific communication skills –

OARS:

� Open-ended questions

� Affirmations

� Reflections

� Summaries

7. Goal oriented – resolves ambivalence in

the direction of change.

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8. Makes use of change talk – DARN-CAT:

Preparing:

� Desire – I want to change.

� Ability – I can change.

� Reason – It’s important to change.

� Need – I should change.

Implementing:

� Commit – I will make changes.

� Activation – I am ready, willing, and prepared to change.

� Taking steps – I am taking specific action to change.

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9. Responds to change talk in specific ways:

� Elaboration – ask for more details – “In what way?” “Tell me more…,” “What does that look like?”

� Affirmation – statements that recognize strengths.

� Reflection – reflective responses express empathy.

� Summary – recap of what has happened in the conversation.

10. Non-confrontational – avoids arguments.41

FOUR FUNDAMENTAL PROCESSES IN MI

� Engaging – listen and employ OARs.

� Guiding – agenda setting, find a focus, inform, and advise.

� Evoking – selective eliciting, responding, and summaries.

� Planning – negotiating a change plan and consolidating commitment.

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PRACTICING STRATEGIES THAT LEAD TO

CHANGE TALK

Read the handout about Molly and the Walters

family, and come up with any many questions

as possible in your assigned categories which

would evoke change talk.

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MI SUMMARY

�MI is a specific interviewing technique that:

� Builds on strengths.

� Works to build collaborative conversations designed to:

� Strengthen a person’s own motivation for and commitment to change.

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CHILD WELFARE PROBLEM SOLVING

� It’s Not about the Nail

http://www.examiner.com/video/it-s-not-about-the-nail

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TARGET LEVELS FOR PROBLEM SOLVING

Individual

Family

Community

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BUILDING A RELATIONSHIP

�The problem-solving process should take place while building and in the context of a professional relationship.

�Research has identified three qualities that are critical for a helpful and positive relationship.

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A PROFESSIONAL RELATIONSHIP

Research has identified three key qualities:

� The worker needs to be warm/caring.

� The worker needs to be genuine.

� The worker needs to be empathic.

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OVERVIEW OF THE PROBLEM-SOLVING

PROCESS

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CEI16

PROBLEM IDENTIFICATION

�Begin with the person or persons with the problem.

�The problem is at least partially identified in the initial referral to CPS, or the goals for foster care or adoption.

� In addition to the identified problem, explore other circumstances and issues to be considered as potential problems.

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CASE EXAMPLE

You are the Children’s Protective Services

worker who made an initial home visit based

on a referral that a teenage mother was

neglecting her two-year-old son due to

unsanitary conditions. At the home visit, you

noticed that the apartment was messy, the

child had a deep and persistent cough, and

the mother had bruises on her face. She

showed you an eviction notice and court

summons. Both mother and son appeared thin

and pale. 51

MYD4


CEI16 Share that, after the worker begins working with a fmaily, they may determine that the problem identified on the referral is the effect of another problem, and fixing that bigger problem might improve not only the previous identified issues, but other issues as well.Isanhart, Courtney (DHS), 01/16/2014

Slide 51

MYD4 remove the word indeed from the "indeed messy" statement.remove the word fesh from the "fresh bruises" statement.change the word looked to appearedDavenport, Michele (DHS), 01/29/2014


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PARTIALIZE & FOCUS

� Most often, a child welfare professional is faced with more than one problem – in addition to the referral or to the challenges associated with reunification or adoption, other issues are observed, discovered, or disclosed.

� There is the need to partialize—break a big problem down into pieces to be prioritized.

� There is the need to focus—begin with one problem.

Discussion Question: In the case example, where should the worker start?

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WHERE TO BEGIN

Where do you need to start problem solving? The messy house is the basis for the referral, but it might not be the priority:

� Prioritize what is most urgent – the child’s and mother’s health and the eviction notice?

� Prioritize what is quickest and easiest to improve?

� Need to partialize and focus but work on multiple problems simultaneously?

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ASSESSMENT

� The prioritization of problems tells the worker what to focus on for gaining more information.

� Gaining more information may also shape the way that a worker prioritizes the problems.

� Identify the problem(s) and gain information and arrive at an understanding of what is going on, why, and what needs to happen.

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CASE EXAMPLE (CONT.)

You inquire about the child’s health and learned that the cough had been constant for some time and was accompanied by a high fever.

When you began asking the mother about her health, she indicated that she had not eaten much food for days. When you asked about the bruises on her face, she whispered one word: “boyfriend.”

She asked you to read the eviction notice. A court date was soon. The mother had no telephone or car. She had not responded to earlier notices.

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SOMETHING TO CONSIDER

� In some cases, there is a physical illness or mental disorder that is discovered or identified as part of the assessment.

� A child welfare professional should be able to recognize the signs of mental illness, but a diagnosis should come from a physician/psychiatrist.

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The mother seemed to be oriented to recognize that she was facing a number of challenges. She could explain her situation and relate to you. She seemed depressed and anxious, and this seemed appropriate under the circumstances!

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PLANNING

Once the problem is identified:

� A big problem is broken into pieces or multiple problems are prioritized.

� An assessment has begun.

� A plan(s) for addressing the problems is formulated.

Two questions to ask:

� What are the options to meet the prioritized needs?

� Who will take responsibility for the plan’s features?

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What plans should be formulated and put into place to address:

� The child’s health.

� The mother’s health and the domestic violence.

� The potential eviction.

� The condition of the house.

� The lack of food.

� The social isolation.

� Other concerns.59

MYD6

IMPLEMENTING A PLAN

When a plan is outlined:

� Steps are identified to meet the needs based on the assessment.

� Timelines need to be established.

� Locating needed resources needs to occur.

� The plan needs to be acted upon by the responsible person.

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CEI17


MYD6 changed the word messy house to the condition of the house. Workers need to utilize words that are objectiveDavenport, Michele (DHS), 01/30/2014

Slide 60

CEI17 Perhaps remind participants that these are some of the things we do after a MiTEAM meeting (to tie it toDHS policy/procedures).Isanhart, Courtney (DHS), 01/17/2014


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EVALUATION OF PROBLEM-SOLVING

ACTIONS

�The child welfare professional will be evaluating the success of the action steps:

� Have conditions improved?

� Are there areas of success and problems getting solved or the difficulties sufficiently reduced and manageable?

� Does the plan need to be revised to address new problems or problems that were not adequately resolved in the original plan?

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CEI18

REASSESSMENT

� If initial problems have been successfully addressed, move on to the next set of problems.

� If you are not the right person to address those problems, make a referral.

� If problems are not improved, there may need to be an expanded assessment:

� New plans that better understand obstacle

� Or even a new problem that should be the focus of attention.

� If enough is improved, close the case.62

EVIDENCE-BASED INTERVENTIONS

�A problem-solving framework provides a strategy for approaching almost all situations.

� Increasingly there is an emphasis on worker actions that have been demonstrated to be helpful to children and families.

�Because these actions are supported by research studies that evaluate their effectiveness, these are called “evidence-based interventions.”

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CEI18 Add a bullet about revising the plan if necessary?Isanhart, Courtney (DHS), 01/17/2014


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EVIDENCE-BASED INTERVENTIONS

�During this pre-service training, a number of activities will be identified as “evidence-based.”

�The goal of learning and using evidence-based interventions is being promoted across the United States by child welfare systems.

�A list of evidence-based interventions can be found at: www.cebc4cw.org this is the website for the California Evidence-Based Clearinghouse for Child Welfare. 64

WRAP UP

�Today we have looked at:

� Family engagement.

� Strengths based assessment.

� Motivational interviewing.

� Problem solving.

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REFERENCES

� Brill, N., & Levine, J. (2005). Working with people: The helping process. Boston: Pearson.

� Hartman, A., & Laird, J. (1983). Family centered social work practice. NY: Free Press.

� Hepworth, D.H., Rooney, R.H., Rooney, G.D., Strom-Gottfried, K., & Larsen, J. (2010). Direct social work practice: Theory and skills. Belmont, CA: Brooks/Cole.

� Hohman, M., Kleinpeter, C., & Loughran, M. (2005). Enhancing motivation, strengths, and skills of parents in the child welfare system. In J. Corcoran, (ed.) Building strengths and skills: A collaborative approach to working with clients. NY: Oxford.

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CEI19


CEI19 Some references are older, but appear to still be relevant despite their age.Isanhart, Courtney (DHS), 01/17/2014


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REFERENCES (CONT.)

Jordan, C., & Franklin, C. (2011). Clinical assessment for social workers: Quantitative and qualitative methods. Chicago: Lyceum

Minuchin, S. (1974). Families and family therapy. Cambridge, MA: Harvard.

McMillan, J.C., & Groze, V. (1994). Using genograms in child welfare practice. Child welfare, 73, 307-318.

Mooradian, J.K., Timm, T.M., Hock, R.M., Jackson, R. (2011). “It’s about us”: Marital adjustment and marital adaptation of couples who adopt children from the child welfare system. Journal of Family Social Work, 14, 262-280.

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REFERENCES (CONT.)

Saleeby, D. (1992). Introduction: Beginnings of a strengths approach to practice. In D. Saleeby (ed.) The strengths perspective in social work practice. White Plains, NY: Longman.

Thomlinson, B. (2007). Family assessment handbook: An introduction and practical guide to family assessment. Belmont, CA: Brooks/Cole.

Tracy, E.M., & Whittaker, J.K. (1990). The social support network map: Assessing social support in clinical social work practice. Families in society, 71, 461-470.

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REFERENCES (CONT.)

Child Welfare Information Gateway https://www.childwelfare.gov/

California Evidence Based Clearinghouse for Child Welfare http://www.cebc4cw.org/

Motivational Interviewinghttp://www.motivationalinterview.org/quick_links/

about_mi.html

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family engagement assessment and problem … · to understand individual and family issues. ......

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