The Family Assessment Form

1. The Family Assessment Form Agency/Program Name Date

2. Agenda • Welcome and Introductions • FAF Overview • Assessment Exercises • Service Planning Exercises • Training Evaluation

3. Introduction • Name • What is most rewarding to you about your job?

4. Objectives • To understand purpose of the FAF • To become familiar with FAF structure • To practice using the FAF

5. A Brief History • Developed between 1986-1990 at Children’s Bureau of Southern California, a non-profit agency providing child abuse treatment and prevention services. • Created by a team of staff: home visitors, supervisor, developmental psychologist, and research consultants. • Developed as a home based instrument for use in family support/family preservation services and used by programs across the country • Used in several program evaluation studies and a major controlled research study in Los Angeles County. • Distributed by Child Welfare League of America beginning in 1997. • Software developed between 2000-2004.

6. Mini-Exercise • Divide into two groups. • Group One: Make a list of your greatest challenges in working with families and in home visiting. • Group Two: What kinds of information do you get from families to decide how you can help them?

7. FAF Purpose • Thorough Family Assessments • Focused Goals and Service Plans • Consistent and Efficient Documentation • Staff Orientation and Training • Program Evaluation

8. Thorough Family Assessment • Focus on family strengths • need structured way to emphasize strengths • Challenge of home visitation • multiple distractions and crises can interfere with understanding core issues • worker not in control of environment • family problems can be overwhelming • Importance of the Big Picture • need to understand family dynamics, short and long-term needs, stresses, etc. • good assessments take time; time well spent

9. Focused Goals and Service Plans • Goals and service plans need to be family driven and linked to assessment • Cannot address everything; need to be thoughtfully selective in engaging family in goal setting • Service plan needs to be realistic and unique to the family situation • Assessment informs HOW you work with a family as well as what you work on • unique family strengths and characteristics

10. Documentation • Consistency of documentation across workers, program sites, etc. • Short-hand method for home visitor • Easy to review by others (i.e. supervisor, back-up home visitor) • FAF takes a “snapshot” of the family • FAF takes the place of a written, narrative assessment

11. Staff Orientation and Training • FAF helps clarify expectations and scope of work for new staff • Points to areas of individual or team training needs • Helps structure individual supervision and case presentations • FAF is a tool to teach assessment and service planning • FAF provides objective language for report writing

12. Program Evaluation • Provides immediate feedback to worker and family on individual family change • Aggregate data can be used to report on program outcomes

13. Philosophical Approach • Practice First • first and foremost a practice tool that has to work for the home visitor • not designed to structure family sessions, rather to document differently what is learned about the family • need a disciplined way to “see” strengths in families with complex problems

14. Philosophical Approach • Ecological/Systems Theory • Problems are not within individuals rather in the “fit” between parts of the system • FAF addresses physical environment, social support, caregiver child interactions, caregiver functioning and child behavior • Intervention might be targeted at a “misfit” in the system • i.e., child’s school problem may be related to parent/teacher communication • Change in one part of the system will change another part • i.e., improved parenting skills will improve child development

15. FAF Components • Case Log/Intake • Family Functioning Factors • Child Behavior Observation Checklist • Service Plan • Contacts • Closing Summary

16. Case Log/Intake • Case Name/Contact Information • Case Number • Worker Assigned • Family Composition and Demographics • History of Child Welfare System Involvement • Assessment Dates

17. Family Functioning Factors • Six Outcome Measures of Family Functioning - 39 items total • A. Living Conditions - 6 items • B. Financial Conditions - 5 items • C. Supports to Caregivers - 6 items • D. Caregiver/Child Interactions - 12 items • E. Developmental Stimulation - 4 items • F. Caregiver Interactions - 6 items

18. Personal Characteristics/History • Two Adult Assessment Factors – optional items, not used as outcome measures because not expected to change or could get worse (i.e., learn more about someone’s history) • G. Caregiver History - 8 items • H. Personal Characteristics - 12 items

19. Child Behavior Observation Checklist • Child Specific Categories - optional itemsnot used for outcome measurement • I. Acting Out Behaviors - 7 items • J. Inner Directed Behaviors - 9 items • K. School Behaviors - 4 items • L. Health and Development - 7 items • M. Temperament - 4 items

20. Service Plan • Components • FAF items indicating strengths • FAF items of concern • Goals related to areas of concern • Tasks for addressing each goal • Frequency and duration of contact

21. Contacts • Date of Contact • Who Involved • Goal Addressed • What Interventions • Referrals • Progress/Homework Notes

22. Closing Summary • Result (i.e., completed, dropped, lost, child placed, etc.) • Outcome on Individual Family Goals • Outcome of Referrals • Summary Progress Notes • Case Statistics

23. BREAK

24. FAF Overview • Walk through FAF • Factors, items • Definitions • Scoring • Caregivers • Notes

25. How Do I Use the FAF? • Meaning of Scores • FAF Scoring • FAF as Initial Assessment • FAF at Termination of Services

26. Meaning of Scores • 1. Above average. Positive influences/traits that have a strengthening effect on the family and/or child. • 2. Generally Adequate. Minor problems within normal limits; not necessarily nonexistent, but do not create problems for caregivers or children. Treatment or intervention not necessary, but may be desired by caregivers to improve parenting. • 3. Problems of a moderate nature. Negative impact on the welfare of children or put the family at risk. Counseling, intervention, or parent education are indicated. • 4. Problems of a major nature. Significant negative influence on children or caregiver’s well-being. Intervention required. • 5. Situation is endangering to children’s health, safety, and well-being. May call for removal of child; intervention and monitoring required.

27. FAF Scoring • Each item is scored on a 1-5 scale • option to score 1.5, 2.5, etc. • Each item has an operational definition, based on the overall meaning of scores, to guide scoring selection • it is VERY important to follow the definitions • definitions are examples of the kinds of things you might see, hear, etc.; use them as a guide • refer to overall meaning of scores to help with scoring decisions as needed

28. FAF as Initial Assessment • FAF serves as only form of assessment documentation • rule of thumb is to complete within 3-4 visits (6-8hrs) including service plan • score items following each visit with a family based on observations and discussions • in preparation for subsequent visits, review FAF areas not yet assessed • do not change scores following this established “baseline” period

29. FAF at Termination • Re-score FAF at termination of services prior to completing the closing summary • this should not require a special visit with the family as the worker already knows the family well • termination scoring should take about 1/2 hour

30. Key Points for Using FAF • FAF is a framework for approaching assessment NOT a structured interview or questionnaire • FAF documents, in a different way, information you already know about families • Obtain FAF information by observing and asking

31. Key Points for Using FAF • Use the operational definitions and overall meaning of scores to determine scores • this is key to maintaining inter-rater reliability • Brief narrative comments are essential • helps explain scores and uniqueness of each family • Tie family driven goals directly to assessed areas of strength and concern

32. Exercise #1 – Section A • Divide into groups of two • Look at drawing • Make list of strengths and concerns observed • Complete FAF section A • Debrief

33. Exercise #2 – Sections B, C, D&E • Mock Interview • Divide group into small groups of 5-8 • Each participant gets a Script and blank FAF • Participants take turns reading the two parts in the Script - worker and mother • Stop, discuss and rate the FAF as indicated on the Script • Debrief

34. LUNCH

35. Exercise #3 – Sections B&C • Role Play Sections B&C – Supports to Caregivers • Volunteer parent and home visitor • Review Sections B&C items as group • Begin role play • Rotate home visitor role as needed • Discuss FAF item scores as a group

36. Goal Setting • What is a goal? • “the end toward which an effort is directed” - Webster’s New Collegiate Dictionary • a future state of being • what the family situation will look like when you have finished your work together • what will be different? • What are some examples from own life?

37. Goal Setting • What is an Objective? • Step taken by case manager or family to achieve a goal • A specific measurable action • What are some examples?

38. Objective Setting Guidelines • Specific and Clear • Measurable and Observable • Accomplishments - state positively • To practice active listening skills vs. to reduce level of arguing • To increase positive reinforcement vs. to reduce corporal punishment • Realistic based on resources - yours and the family’s • Timeframe for achievement

39. Objective Statements • Objective statement format • WHO will do WHAT, HOW by WHEN • Father will enroll in vocational education program at Austin Community College by Sept 15th.

40. Sample Goals/Objectives • Concern: Cleanliness/orderliness inside home (dirty dishes, trash overflowing, soiled diapers on floor) • Goal: Parents will increase children’s health and safety • Objectives: • Case Manager will teach parents about connection between health and hygiene by showing XYZ videos at next visit • Parents will make sure the dishes are washed on a daily basis and that the trash to taken out each week • Parents will child proof the home for their small children by Sept 15th, using the home safety checklist provided by the Home Educator

41. Sample Goals • Concern:Appropriateness of discipline (only use corporal punishment with shoes and belt) • Goal:Parents will teach their children how to behave using positive forms of discipline • Objectives: • Parents will attend 4 parenting workshops on child behavior management beginning Nov 1 and ending Dec 1, 2006 • Home Educator will coach and support parents in establishing child behavior rules and consequences by Dec 15, 2006

42. Sample Goals • Concern: Bonding style to children (parent pushes baby away and believes he is crying intentionally to anger parent) • Goal: Mother will increase her positive attachment to her new baby • Objectives: • Home Educator will play the Happiest Baby on the Block video, demonstrate and practice calming techniques with Mother during next visit • Mother will identify all the things she likes that are special about her new baby by next home visit

43. Mini-Exercise • Is it a goal or objective quiz

44. Goal Setting • Who contributes to goal setting? • The family • Referral source • Case Manager using FAF assessment • Art is in blending these together into meaningful goals and tasks that the client is willing to work towards

45. Exercise #4: Service Planning • Divide into groups of three • One parent • One home visitor • One observer • Based on Section A drawing exercise, role play working with this family to develop a goal or goals and objectives around home safety and cleanliness • Debrief as group

46. Exercise #5: Service Planning • Divide into groups of five • Each group gets a sample completed FAF with ratings and comments • Assign each group a FAF section (i.e. group 1 gets sections A&B, group 2 gets C, group 3 gets D, etc.) • Each group identifies strengths in their section • Each group identifies concerns in their section • Each group develops at least one goal and objective for their section

47. Final Comments • Questions and Answers • Next Steps • Participant satisfaction/feedback surveys