Transcript Standard HOME and Q & S - The Michael Sieff Foundation

Analysis and Planning in Social
Work Assessments
Stephen Pizzey
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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.
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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)
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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)
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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;
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Assessment Framework
A conceptual map of relevant data (information) to be collected
Health
Basic Care
Education
Ensuring Safety
Emotional &
Behavioural Development
Emotional Warmth
Identity
CHILD
Stimulation
Family & Social
Relationships
Social Presentation
Selfcare Skills
Safeguarding
&
promoting
welfare
Guidance &
Boundaries
Stability
FAMILY & ENVIRONMENTAL FACTORS
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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.
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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
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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
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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
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Stage 3: Categorise information and organise it using
the Assessment Framework
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?
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Assessment Framework
A conceptual map of relevant data (information) to be collected
Health
Basic Care
Education
Ensuring Safety
Emotional &
Behavioural Development
Emotional Warmth
Identity
CHILD
Stimulation
Family & Social
Relationships
Social Presentation
Selfcare Skills
Safeguarding
&
promoting
welfare
Guidance &
Boundaries
Stability
FAMILY & ENVIRONMENTAL FACTORS
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Stage 4: Analysing Met and Unmet Needs
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?
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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.
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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
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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
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Stage 4: Principles underlying analysis - Processes
Linear or circular processes:
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Stage 4: Principles underlying analysis - Impact
IMPACT
• Severity of difficulty: the weight of a
negative factor or process
or
• Magnitude of strength: the weight of a
positive factor or process
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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
•
Pervasiveness (breadth): the greater the number aspects of child development,
•
Modifiability (change): to what extent do other actions or experiences alter a
•
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
concern/ benefit.
people, situations etc on which the factor impacts, the greater the concern/benefit.
factor/process.
severe.
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Stage 4: Principles underlying analysis - summary
In general:
• 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
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Stage 5: Predicting Outlook for the Child
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
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Stage 6: Planning interventions
•
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?
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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.
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Stage 7: Identify Outcomes and Measures that would indicate
whether interventions are 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
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Stage 7: Identify Outcomes and Measures that would indicate
whether interventions are 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
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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
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Prognosis for Achieving Change
(Bentovim et al 1987)
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
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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
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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
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Prognosis for Achieving Change
(Bentovim et al 1987)
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?
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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
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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
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Safeguarding Analysis:
Process used to make the analysis (2)
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
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Safeguarding Analysis:
Process used to make the analysis (3)
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?
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Safeguarding Analysis:
Process used to make the analysis (4)
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?
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Safeguarding Analysis:
Process used to make the analysis (5)
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?
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Safeguarding Analysis:
Process used to make the analysis (6)
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
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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
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