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 Childrens 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.

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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

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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

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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., childs 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

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FAF Components

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

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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

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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 someones history)
• G. Caregiver History - 8 items
• H. Personal Characteristics - 12 items

19
Child Behavior Observation Checklist

• Child Specific Categories - optional items not
  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

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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

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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

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FAF Overview

• Walk through FAF
• Factors, items
• Definitions
• Scoring
• Caregivers
• Notes

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How Do I Use the FAF?

• Meaning of Scores
• FAF Scoring
• FAF as Initial Assessment
• FAF at Termination of Services

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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 caregivers
  well-being. Intervention required.
• 5. Situation is endangering to childrens health,
  safety, and well-being. May call for removal of
  child intervention and monitoring required.

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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

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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

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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

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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

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Exercise 1 Section A

• Divide into groups of two
• Look at drawing
• Make list of strengths and concerns observed
• Complete FAF section A
• Debrief

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Exercise 2 Sections B, C, DE

• 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

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• LUNCH

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Exercise 3 Sections BC

• Role Play Sections BC Supports to Caregivers
• Volunteer parent and home visitor
• Review Sections BC items as group
• Begin role play
• Rotate home visitor role as needed
• Discuss FAF item scores as a group

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Goal Setting

• What is a goal?
• the end toward which an effort is directed -
  Websters 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?

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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
  familys
• Timeframe for achievement

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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.

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Sample Goals/Objectives

• Concern Cleanliness/orderliness inside home
  (dirty dishes, trash overflowing, soiled diapers
  on floor)
• Goal Parents will increase childrens 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

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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

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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

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Mini-Exercise

• Is it a goal or objective quiz

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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

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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

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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 AB, 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

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Final Comments

• Questions and Answers
• Next Steps
• Participant satisfaction/feedback surveys