Copyright child and family training Analysis and Planning in Social Work Assessments Stephen Pizzey

Copyright child and family training 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.

Copyright child and family training 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)

Copyright child and family training 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)

Copyright child and family training 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;

Copyright child and family training CHILD Safeguarding & promoting welfare Assessment Framework A conceptual map of relevant data (information) to be collected Health Education Identity Family & Social Relationships Social Presentation Emotional & Behavioural Development Selfcare Skills CHILD’S DEVELOPMENTAL NEEDS PARENTING CAPACITY FAMILY & ENVIRONMENTAL FACTORS Basic Care Emotional Warmth Stimulation Guidance & Boundaries Ensuring Safety Stability Wider Family Housing Employment Income Family’s Social Integration Family History & Functioning Community Resources

Copyright child and family training 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.

Copyright child and family training 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

Copyright child and family training 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

Copyright child and family training 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

Copyright child and family training 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

Copyright child and family training CHILD Safeguarding & promoting welfare Assessment Framework A conceptual map of relevant data (information) to be collected Health Education Identity Family & Social Relationships Social Presentation Emotional & Behavioural Development Selfcare Skills CHILD’S DEVELOPMENTAL NEEDS PARENTING CAPACITY FAMILY & ENVIRONMENTAL FACTORS Basic Care Emotional Warmth Stimulation Guidance & Boundaries Ensuring Safety Stability Wider Family Housing Employment Income Family’s Social Integration Family History & Functioning Community Resources

Copyright child and family training 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

Copyright child and family training 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.

Copyright child and family training 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

Copyright child and family training 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

Copyright child and family training Stage 4: Principles underlying analysis - Processes Linear or circular processes:

Copyright child and family training 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

Copyright child and family training 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.

Copyright child and family training 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:

Copyright child and family training 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

Copyright child and family training 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

Copyright child and family training 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.

Copyright child and family training 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

Copyright child and family training 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

Copyright child and family training 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

Copyright child and family training 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 Prognosis for Achieving Change (Bentovim et al 1987)

Copyright child and family training 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

Copyright child and family training 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

Copyright child and family training 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?

Copyright child and family training 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

Copyright child and family training 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

Copyright child and family training 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 Safeguarding Analysis: Process used to make the analysis (2)

Copyright child and family training 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?

Copyright child and family training 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?

Copyright child and family training 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?

Copyright child and family training 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

Copyright child and family training 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