Comprehensive family assessment as a prerequisite of individualized planning, monitoring and evaluation of family-visitation program in Croatia Professor Marina Ajduković, Ph.D, psychologist Professor Antonia Žižak, Ph.D, special educator University of Zagreb and UNICEF Croatia

Background Deinstitutionalization of public care for children is among the most important priorities in Croatia in the area of social care for children. Among the total of children in alternative care due to insufficient parental care 54,5% are placed in foster families and 46,5% live in children homes. Goal: 80% of children in alternative care placed in foster families.

Paths of deinstitutionalization of the out-of-home care for children Efficient early Deinstitutionalization Good quality fostering in interventions families Work with parents while child is in out-of-home care

Early interventions in families The Family Law provides two measures for the protection of the rights and well-being of the child: (1) Warning the parents about shortcomings in their care for and upbringing of a child and helping them to remedy the shortcomings through counseling and parent training (2) Monitoring and supervision of parental care through home visitation in cases when shortcomings in care for the child are multiple and frequent or when the parents need particular care in the upbringing of the child. The centre for social work determine the monitoring/supervision program for the child and the parents, and appoints the person who will carry out this program (family supervisor).

Monitoring/supervision of parental care through home visitation Overview Number of cases of monitoring/supervision of parental care in the period of last five years was between and Family supervisors (N=81) reported that greatest obstacles in implementation of monitoring/supervision program were: lack of cooperation by parents and their poor motivation for change (23) resistance to the measure (21) lack of insight into own problems and behaviors (13) breech of agreements (11).

Monitoring/supervision of parental care through home visitation Obstacles Standardized procedures and instruments are not used for needs assessment Monitoring/supervision programs are typically too general, not individualized nor developed based on the good assessment; they are directed primarily to risks and failures without review of parents' strengths Programs are made without participation and cooperation of the parents The change is/was needed

Project cooperating institutions Ministry of Health and Social Welfare Department of Social Work, Faculty of Law UNICEF Croatia – project implementing agency

Framework of project values Every child has the right that his/her family gets high quality, focused, multidimensional and timely assistance, in order to avoid placement in alternative care. If the child has to be placed in alternative care for her/his best interests, to provide adequate assistance for strengthening parental capacities and to provide adequate circumstances for return of the child into the family.

Project goals Develop criteria for assessing and monitoring competencies and potential for change of parents whose children are at risk to be taken out of the family and for parents whose children are already placed in alternative care. Advance the concept (contents) and implementation (methods) of monitoring/supervision of parental care. Expand the range of early interventions for families under risk for placing children into alternative care, such as day care for children, group work with parents, one-time workshops with parents, modeling of parental behaviors, etc.

Project dimensions Action project – direct work with families and children under risk for placement in public care and families where the children have already been taken out of families. Developmental project – development of a model of more effective work in the area of early and/or targeted interventions with families with children at risk. Community project – working towards development of a local community as a context for social interventions with families at risk, including development of a local team of professionals

Project implementation The project was carried out in four centres for social work during 12 months through: First three-day educational seminar followed by: Practical assignments related to the content of the training Two supervision sessions Second two-day educational seminar followed by: Practical assignments related to the content of the training Three supervision sessions Third two-day educational seminar followed by: Practical assignments related to the content of the training Three supervision sessions One-day consultation with the project team External evaluation

New professional concepts Concept of early interventions for family at risk for child/children separation Comprehensive family assessment Family empowerment and collaborative approach

Expected outcomes Guidelines for comprehensive family assessment, including child risk assessment Development of a set of assessment tools Guidelines for planning and carrying out family-visitation program based on: Comprehensive family assessment Development of individualized program of change Criteria for monitoring and evaluation Skilled professionals providing better quality services for families in need

Comprehensive family assessment (1) Comprehensive family assessment (CFA) is the process of identifying, gathering, and assessing the importance of information to understand the significant factors affecting the child's safety, permanency planning, and well-being, the parental protective capacities, and family availability to assure the safety and well-being of their children. The purpose of CFA is to develop a service plan or a strategy for intervention that addresses the major factors affecting a child's well-being, safety, and permanency over time.

Comprehensive family assessment (2) Begins with the first contact with a family and continues until the "case" is closed Must be completed in partnership with families, children and youth and in collaboration with other community partners; the staff must be trained to engage family in that work Must identify individual and family strengths and protective factors Is a process and has to be updated whenever major changes in family circumstances occur and at the points of key decision- making on a case.

Areas of assessment - Parents Background and history of the parents or caregivers including history of abuse and neglect Problems in accessing basic necessities such as employment, housing, income, child care … Ability to recognize problems and accept responsibility, motivation for change Patterns of social interactions, including the characteristics of social support networks Parenting practices (understanding of child development and/or emotional needs of children, methods of disciplining and supervising children) Behaviors/conditions associated with domestic violence, mental illness, physical health, disabilities, alcohol and drug abuse.

Areas of assessment – Children Information relevant for assessment of child safety and well- being. Depending on specific context information can be related to: Health Intellectual and cognitive functioning Academic achievements Emotional and social functioning Attachment patterns Vulnerability/ability to communicate and protect themselves Developmental needs.

List of assessment tools 16 assessment tools identified as a part of CFA guidelines Three of them are locally developed and other were translated international instruments The assessment tools cover broader spectrum - from assessment for family stress, parental stress, risk for child abuse, family strengths, level of meeting child's needs, attachment patterns family embeddedness in community, etc. Important!!! When using instruments the risk of "social technology" should be avoided.

Internal evaluation (1) The project had positive effects on increase of professional competency of participants, their understanding of family in crisis improved, and they started to involve parents as collaborative partners more often. Most important changes in their practice: Use of comprehensive family assessment Collaborative work with parents as active participants in all phases: from needs assessment to evaluation of each activity Development of plans according jointly defined priorities Use of concrete short term action plans

Internal evaluation (2) 95,2 % of the trainees were very satisfied with having participated in the project and suggest dissemination of the project outcomes to the whole professional community.