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Comprehensive Family Assessment Process
A comprehensive family assessment is a “process,” not the completion of a “tool.” This does not mean that tools are superfluous; they are helpful in documenting needs or in stimulating the conversation about assessment issues. It does mean, however, that the engagement of family members in a discussion that is individualized to their situation is vital. Simply completing a form will not capture all that is needed for comprehensive assessment.
The initial comprehensive assessment can build on the information obtained in previous assessments of safety and risk. All safety issues, progress on the safety plan, and areas of risk and strengths that have already been identified are explored as to their current impact on needs. The process includes assessing the family's understanding of the safety and risk factors facing their children, examining what they have done already to address the concerns, what they consider to be the barriers to progress, and their most pressing needs in relation to the safety and risk factors. This information is then incorporated into the comprehensive family assessment and plans for services.
Important information often arises from the first meeting with the child, youth, and family and should be documented in the comprehensive family assessment. All information obtained during the assessment process is used to develop the service plan.
Key parts of the process involve reviewing existing information, meeting with the family, interviewing children and youth as appropriate, meeting with the staff of other agencies, obtaining specialized assessments, identifying the family needs and circumstances contributing to the need for child welfare intervention, making judgments and decisions about services, documenting information and decision-making with the family, doing ongoing assessments of progress and needs, and disseminating information to the family and other providers to initiate and update the service plan.
Review Existing Information
Review all relevant documentation that has emerged through:
- The initial review of records and summary of any past experience in the child welfare system or other related service systems;
- What was learned from the reporter and collateral contacts;
- Initial contacts with the family;
- Safety assessments, including safety plans, and risk assessments;
- Observations of the home, interactions between adults in the home, parent/child interactions, affect of child or youth (for example, confident, fearful); and
- Any specialized evaluations done as part of the initial assessment or in the recent past related to factors impacting children, youth, or adults in the home.
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VIGNETTE 1: The Archuleta Family
The vignette illustrates guidelines for a comprehensive family assessment (CFA) at two points in child welfare services:
First Comprehensive Family Assessment — Preparation for Conducting the CFA A. Review of existing information:
B. Identify and document risks, strengths/protective factors, and possible needs to guide the comprehensive family assessment:
C. Map out a plan for gathering assessment information:
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Meet with the Family
Family meetings with the parents and/or caretakers if the children are not living with their parents should occur as soon as possible after the child welfare agency has decided to open the case. Parents or caretakers should be invited to bring other supportive people to the meeting if they like. Siblings who are old enough to participate in such a meeting and have something useful to contribute should also be included. These other people, including former or current service providers, might help identify needs, protective factors, or be resources for commitment to the ensuing service plan. These meetings not only provide a fuller picture of the family situation and networks, but also help staff to understand who can be involved in the change process as they develop the service plan. Judgments should be made with the family as to who can safely be included, especially in situations involving domestic violence. Trained, objective facilitators can be very helpful in the family meetings.
A general understanding of who is in the family, where they reside, and how the connections work is useful information. Gathering this information from the family also provides a way to get the parent to engage in the discussion. Exploring their broader connections to faith communities, tribal, cultural, or ethnic bonds, or neighbors helps focus families on the resources that not only define them, but also could help address their current needs. Genograms, ecomaps, and ethnographic interviewing are useful tools to do this.
These family meetings should explore not only the current situation, but also the broader context of issues that affect the safety, permanency, and well-being of the children. Exploring how parenting issues have generally been addressed over time, as well as the family's level of understanding of the current safety and risk factors are important. Ask about and listen to the parents' perceptions of why they are now involved with child welfare, what they might fear, and what they can expect to gain from services. Exploring their commitment to change helps the caseworker recognize their readiness for change and the need to mobilize additional supports to the parents for their participation in the service plan.
Parents/caretakers should be asked to identify their needs relevant to the protection of their children. If they are or have been involved in services from other agencies, that involvement should be explored to identify services offered and provided and determine which services have been helpful to them in addressing parenting issues or related needs.
The caseworker should address any current pressing need that the family identifies relevant to the agency's intervention with the family, such as a rent payment to avoid eviction.
Interview Children
In most cases, it may be helpful to interview children separately from their parents. If children are living at home, seeking parental permission for these meetings and possible participants in the meetings whenever appropriate is wise. A trusted adult, possibly a teacher or minister, could be with the child. Not only would they provide support but also could use their ongoing relationship to help the child understand the process and purpose of the assessment. For older children, particularly, it is important to get each child's perspective on the issues. Whenever appropriate, children should be interviewed separately as well as together.
When children are interviewed, it is necessary to put them at ease by initially exploring “safe” areas of their lives—possibly school, religious, recreational activities.
The main purpose of meeting with the child is to gain an understanding of their perception of what is happening, how the current situation might or might not fit within their general experience of being parented, and what they need to feel safe. It would be very useful to know if there are adults in the child's life that they trust or go to for guidance and support.
These meetings might also identify some immediate needs that the caseworker could take care of for the child even as she/he is developing the service plan. An example might be arranging for the child to meet with a counselor.
Meet with Staff of Other Agencies
Meet with staff of other agencies or service providers with whom the parents or children are currently or recently involved. When working with a Native-American family, the tribal child welfare staff should be informed as soon as possible by the caseworker or identified tribal liaison. Family service providers and other possible advocates for the family might attend the family meeting while others may just meet with the caseworker based on schedules as well as their role with the family.
The purpose of these meetings is to gain a better understanding of the needs related to safety, permanency, and child well-being, determine effective ways of engaging the family in changing behaviors, and identify what has been the impact of services provided.
Given the cross-program focus addressed in the principles, these conversations have to take place within a context of professional commitment to confidentiality as well as a shared understanding of the areas of common concern in working with families.
Obtain Specialized Assessments
As information is being gathered in the process of a comprehensive family assessment, it may be useful to go beyond the assessment capabilities of the child welfare worker for specialized assessments. These specialized assessments could be for developmental issues that seem to have an impact on the child, mental health evaluations of the child, youth, and/or parents, evaluations related to the use of drugs, evaluations of the cognitive abilities of children and youth that are affecting their education, or possibly specialized evaluations of various handicapping conditions that affect parenting that could make parents eligible for support.
When the caseworker recognizes the need for specialized assessments, s/he should focus the attention of the specialist on the specific areas of concern and have some sense of what effect the specialized assessment findings have on child welfare decision-making. The recommendations arising out of these specialized assessments should be incorporated into the service plan.
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VIGNETTE 2: The Archuleta Family — Assess the Needs of the Family A. Meet with the parents:
B. Meet with children:
C. Review records and talk with providers as needed:
D. Conduct a family meeting:
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Make Judgments and Decisions: Link Comprehensive Family Assessment to the Development of a Service Plan
Collecting and organizing comprehensive assessment information is not an end in itself; it must be used in focused ways to address the family's identified needs in the service plan. The worker should ensure that the family members have an accurate understanding of why their situation was reported to child welfare, what has to change, and what outcomes are being pursued. Family members should be intricately involved in the process of moving from assessment to the development of the service plan. They should help guide the process of determining what interventions could best address their situation, within the context of a shared commitment to making necessary changes. This process should be transparent—the worker should share the tools and information being used to build the service plan with the family to help them understand how the information they provided contributed to the process.
The purpose of comprehensive family assessment is to provide the information needed to address the individual needs of all family members in the agency's service plan(s) and through its interventions with the family. This can only be done when sufficient information is gathered to identify and understand the various problems and circumstances that have resulted in the need for child welfare service planning. The plan is completed only after analyzing all material the worker has collected with supervisory oversight and guidance and with the family's involvement. The service plan identifies interventions and actions to address the family's needs and to facilitate the changes necessary to achieve sustainable safety, permanency, and well-being for each child.
The service plan must also use assessment of protective factors as points of leverage for the necessary changes, not simply a list of characteristics of the family. By engaging the family to provide what they see as their strengths and by validating their contributions by including the strengths in the service planning process, the caseworker helps the family view the service plan as a realistic and achievable. Delineating the family's strengths and how they can contribute to the child's safety and well-being can reinforce the family's motivation to change.
This process of going from information to judgments is critical. The caseworker is called upon to judge which needs must be addressed initially in order to reduce risk and address safety concerns. The worker must also judge which services will most effectively address the family's needs. Additionally, judgments are required to determine how to use the family's strengths as a part of the service planning process to better individualize the service plan. There is no ready “prescription” for how these judgments are made; each jurisdiction must train its staff to make these essential judgments and assure that sufficient supervisory guidance is available to support staff in this process.
In constructing the service plans through these judgments, the child welfare caseworker is in an excellent position to coordinate and involve other service providers, specialized resources, and the family's resources and motivation to change. This, in turn, helps assure that safety, permanency, and child well-being are the focus of the interventions and the changing behaviors.
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VIGNETTE 3: The Archuleta Family — Analysis of Information and Identification of Needs A. Analyze the information:
B. Link results of assessment to the development of a service plan:
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Document Information
At the completion of the initial process of comprehensive family assessment, as well as when the information is updated, clear and full documentation has to be included in the case file. The service plan should be clear as to what services will be provided, how they will be accessed, and the specific responsibilities of the family members and the worker along with other service providers.
This is important for case management, for use in service planning and monitoring progress, to provide vital information if the court is involved or becomes involved, to share with other service providers as necessary, and to provide continuity of implementation in case the caseworker assigned to the case changes.
The requirements for documentation vary across jurisdictions. How much of the information on comprehensive family assessment is documented also varies. It is essential to document sufficient information regarding the assessment process and outcome to support case management, case coordination with other service providers, and court requirements. Some of this information may also be incorporated into some jurisdictions' automated information systems, supporting decisions on service planning and service provision.
Documentation of comprehensive family assessment information, like all child welfare documentation, should be written legibly in jargon-free language so that families can understand what is written. Additionally, they should be available in the family's language if English is not their primary language.
Documentation incorporates what is known from the assessment of the safety concerns, risks, strengths/protective factors, and needs; and it is framed in a way that suggests what expectations, services, and interventions would help meet the family's needs. Each child should be mentioned individually in documentation. Although the family's signature is needed on the service plan, the signature alone is not sufficient documentation of the family's involvement in the process.
Documentation should incorporate aspects of compliance with the Indian Child Welfare Act (ICWA) where appropriate. Documentation should also articulate what has to happen for the case to be closed.
Conduct Ongoing Assessment of Progress and Needs
Risk, safety, strengths/protective factors, and needs are all periodically reviewed as a part of ongoing assessment of progress
Ongoing work with the family is not static, since changes in the circumstances and the family composition alter a child's risk and safety. Therefore comprehensive assessment must be completed periodically to inform case planning. Reassessment of safety and risk informs these subsequent reassessments of the family. Progress reviews are based in part on talking with and observing the family, talking with other key case participants (extended family, providers), and review of progress reports from service providers.
For periodic assessment of progress to occur, service providers must provide timely, specific reports on progress that address the following:
- Identified child welfare-related issues;
- Compliance with requirements (for example, attendance and participation); and
- Outcome-related progress (for example, parents have negative urine analysis; Carmen demonstrates acquisition of job readiness skills; parents demonstrate age-appropriate expectations of children; Angela makes progress in language skills).
Strategies that can facilitate discussion about progress include using scaling questions (for example, comparing levels of concern from one time to another), timelines, “temperature” gauge charts (measuring progress to a goal), and other behaviorally oriented graphics.
Complete periodic reassessment of needs based on progress and new events or information
- Needs change as families make progress or face setbacks. For example, the parents may require in-patient or intensive outpatient drug treatment. If successful in this first phase of drug treatment, they may no longer need intensive treatment but instead, less intensive outpatient follow-up. If relapse occurs, they may need treatment that is more intensive. Later, if job training is successful, the parent may need on-the-job coaching and support.
- Needs change as the parent's stage of readiness to change evolves. A parent who is in the pre-contemplative stage (sees no problem) needs to become aware of the impact of the child welfare issues. A parent who is aware of the issue and is determined to make a change needs support in creating a practical plan for change.
- Sometimes new information provides new insight into existing needs. For example, a parent may reveal a history of child trauma or show signs of depression related to this, thus indicating a need to cope with the effects of these experiences.
- Sometimes family circumstances change, such as a parent moving back into the home or a grandparent moving out, etc. Such changes affect family dynamics and interactions and may trigger the need for counseling or other interventions.
Use a variety of forums and times to assess progress and reassess needs
- The forums used initially (such as individual and group interviews with family members, family meetings, intra and inter-agency meetings, progress report reviews, or discussions with providers) are the same means of reassessing needs.
- All contacts with family members and people in their support system provide opportunities to gather information about a family's progress and needs. These activities should not be left only to formal meetings; sometimes meaningful information is more readily shared at less-formal times and when it seems most relevant. For instance, a father may talk with a service provider or a caseworker about progress or setbacks in understanding his child's developmental needs when an important event occurs, such as a birthday party, but may not remember or feel comfortable talking about it later in a formal meeting.
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VIGNETTE 4: The Archuleta Family — Ongoing Assessment of Progress and Needs Ongoing review of progress The ongoing review can be done in the context of a follow-up family team meeting with family members and service providers as well as extended family or parent support people who have been involved in the case. The following information was obtained about progress and needs over a four-month period after the initial comprehensive family assessment was completed:
Re-assessment of needs over this four-month period indicates the following:
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Disseminate Information to the Family and Other Providers and Update the Service Plan
As information on circumstances and needs is gathered from different sources, the caseworker should meet with the family to help them understand how their specific needs are informing the development of the service plan.
Since all needs are related to achieving the outcomes of safety, permanency, and child well-being, the family must understand what has to change to achieve the outcomes. Services are provided to secure that link between continuing and newly identified needs and the outcomes. These conversations are part of the process of engaging the family in participating in the services that promote the necessary changes. It would be helpful to include extended family members and people the parents/children view as supportive in this discussion.
Other agencies involved in serving the family, including tribal child welfare programs, also need to understand the comprehensive family assessment. Some of their interventions need to be coordinated with those of the child welfare agency to meet the needs of the family and to utilize existing protective factors to motivate family participation and effective use of service resources. How information is shared depends on each jurisdiction's policies regarding confidentiality protections and release of information.
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VIGNETTE 5: The Archuleta Family — Disseminate Reassessment Findings and Update Plan A. Share information with the family and other providers. As before, work with the parents and their support network to identify services, other interventions, and expectations that link the reassessed needs to a practical plan. This modified plan should build on the strengths/protective factors, ideas, commitments, and resources identified in the assessment. B. Update the plan, incorporating new information. The revised plan for the Archuleta family includes the following goals:
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Reassess Prior to Case Closure
As emphasized throughout this document, comprehensive assessment is a process in which information concerning the needs, problems, circumstances and resources of the family, youth and children must be updated at key points of decision making and whenever major changes in family circumstances occur. Case closure is a significant decision that should reflect the achievement of satisfactory outcomes with regard to the child's or youth's safety, permanence, and well-being.
It is important to acknowledge that achieving permanence for a child through family reunification, adoption, or another permanency plan does not immediately result in case closure. In most instances, achievement of a permanent placement or a change in legal status instead initiates a period of transition for the child and family. Therefore, it is widely recognized that post-permanency services are typically required to support families and children as they work to achieve a new equilibrium.
A period of supervision of the permanent placement, whether it is after reunification or adoptive placement, provides an opportunity to demonstrate that either the risks to child safety that required protective services have been addressed or that the family with whom the child resides can adequately provide for his or her permanence and well-being.
Thus, post-permanency services are provided, case closure becomes a possibility, and the child and family's situation are re-assessed in the new context. Questions similar to those raised in the beginning phase of the case are explored and answered prior to making the final determination to close the case. Additionally, it is appropriate to assess the following issues:
- How have the initial risk factors that led to the agency's involvement with the family been brought under control?
- Are there new risk factors present that affect the child's health and safety?
- How do the child and the parents view their situation and the possibility of case closure?
- If the child has been reunified with his or her parents, in what ways have the parents demonstrated their ability to provide adequately for their child, and what are the parents' strengths?
- What efforts do the parents currently make to meet the child or youth's needs and resolve new problems as they arise?
- What kinship resources continue to be available, including resources of the tribe or clan to which the family belongs?
- What specific community services are needed and utilized by the child or youth and the parents to support their current level of functioning and prevent reoccurrence of those problems that required protective services?
Information is sought prior to reaching the decision to close the case through the same processes followed in the previously ongoing assessment.
For example, in the Archuleta family, should Angela and Pablo be reunified with Carmen, prior to case closure a comprehensive assessment would necessarily examine Carmen's ability to remain drug free, maintain employment, provide adequate housing for herself and the children, maintain the children in their schools and assure that their needs for continued treatment are met. Additionally it would be necessary to identify concrete ways in which the children's father, great aunt, godparents and other family and community resource, including the children's school counselors and Carmen's counselor, continue to support Carmen and the children and will support them in the future.
If a plan for permanency for the children other than reunification has been implemented, prior to case closure an assessment is recommended of the needs, strengths and circumstances of the children's permanent family and the resources needed and available to support permanency when case closure occurs. For example, should Carmen, the children's mother, be unable to resume her children's full-time care and Tiana, the great aunt who has provided out-of-home care, ask to help, several steps must take place. Tiana would need to be assessed by the agency for her ability and willingness to provide a permanent home for the children. Such an assessment should be comprehensive, including exploration of the nature and extent of day-to-day supports, e.g., day care, respite care, transportation of the children to school and appointments, that Tiana will continue to need after case closure. Adoption subsidy assistance should be explored if Tiana adopts the children. An assessment should also identify the children's educational, health, and mental health needs and available ongoing resources to address those needs as well as any current arrangements for contact between the children and each of their parents, any problems in visiting that have emerged, and realistic plans for their continued contact in the future in a manner that provides for the children's protection. Finally, the concrete ways in which the children's parents, godparents and other family and community resources, including the children's school counselors continue to support Tiana and the children, and will support them in the future, must be identified.
A comprehensive assessment requires a continued ongoing commitment to recognizing and identifying current, continuing and emerging issues throughout the life of the case, with the corollary commitment to addressing the issues with appropriate services.