§3 ch3: Family-Centered Services Family Assessment and Written Service Agreement Development
3.2 Completion of the Family-Centered Services Assessment Process
- The entire FCS assessment process will be completed within thirty (30) days from the date the case is assigned to the completion of the Written Service Agreement. This will include, at minimum, the completion of the NCFAS G+R (intake fields), Genogram (CD-14-G), Culturagram (CD-14F), Safety Assessment (CD-17) and Risk Assessment, if not completed with a hotline and Written Service Agreement (CD-14B). The assessment should be updated when necessary throughout the treatment plan process.
3.2.1 Tools for Completing an FCS Family Assessment
The NCFAS G+R and attachments are comprised of the following tools:
- NCFAS G+R (intake, interim, and closure fields)
- CD-17 – Safety Assessment
- CD-18 – Safety Plan (if required)
- Risk Assessment or CS–16E – Re-assessment
- CD-14B – Written Service Agreement
- CD-14C – Formal/Informal Provider Contact Sheet
- CD-14D – Termination of Services/Aftercare Plan
- CD-14F – Culturagram
- CD14G – Genogram
- CD-14H – Ecomap (optional tool)
3.2.2 Identifying Formal/Informal Provider History
A review of formal/informal providers and supports can be very useful in assessing the family’s current situation and identifying resources for the treatment plan development.
The Formal/Informal Provider Contact Sheet (CD-14C) should be a running document that can be attached to the front of the case file. It can be used as a reference when a family has multiple open cases. The worker should be documenting resources available to the family or providers involved with the family currently or in the past. This is a running list of informal providers the family has identified such as relatives or neighbors; or training, counseling or rehabilitation history the family has attempted or completed.
3.2.3 Case Identifying Information and Household Members
The Children's Service Worker shall document household member information on the Family-Centered Services Information screen in FACES.
3.2.4 Identifying Children with American Indian Heritage
The worker will identify American Indian Heritage for children listed on the report, including the specific tribe. This information is documented by the family using the Indian Ancestry Questionnaire, CD-116, within 24 hours of case opening. The Children's Service Worker then uses the Indian Child Welfare Act Checklist, CD-123, to collect and document findings as required by the Indian Child Welfare Act, ICWA. The CD-116 and CD-123 should be maintained in the child's section of the case record. Any initial American Indian heritage obtained should be documented in the opening summary. Follow up information should be documented in the monthly summaries.
3.2.5 History with the Agency
Prior to making contact with the family the worker should document in the narrative a brief description of prior reports of abuse/neglect, as well as a summary of concerns identified in unsubstantiated reports. Due to expungement criteria for unsubstantiated reports, incident numbers will NOT be listed. Workers should use such phrases as “Concerns have been identified in the past that include.”, rather than stating “These concerns were from prior reports” in their documentation.
3.2.6 Reason for CD Involvement
To help track the case history, the Children's Service Worker shall identify its origin, i.e. whether from a CA/N investigation, initial Family Assessment, self-referral, court order, etc. This should not be a definition of the problem, but rather how the Division became involved with the family. The worker should document the findings in the case opening summary.
Other agencies and community systems which were involved with the family immediately prior to, or during, the referral process should also be listed.
Enter additional information provided by the reporter or other collateral. A brief description of prior reports of child abuse/neglect should also be given, including a summary of concerns identified in unsubstantiated reports. Due to expungement criteria for unsubstantiated reports and reports substantiated prior to August 28, 1999, the incident numbers will not be listed here. Phrases such as “Concerns have been confirmed in the past that include…”, rather than stating these concerns were from prior reports.
3.2.7 Family’s Perception of CD Involvement
The Children’s Service Worker shall allow all family members to state their opinions about the presenting (and underlying) problems. Encouraging this ventilation of opinions signals respect of the family and the importance of their cooperation. The Children’s Service Worker should key into who is being blamed for the family discord and how the family perceives its relationship to outside systems. The worker will document in the narrative the family’s perception/relationship toward CD involvement. (Example: family was hostile/cooperative or family considers CD an asset/intrusive/indifferent…etc.)
3.2.8 Assessment of Safety
Assessment of child safety is always a primary concern of the division and whether the workers are formally or informally assessing the child’s safety, assessment continues throughout the life of the case. Workers should always be alert to changes in the family circumstances or household composition that pose a threat to the safety of the child. If changes in circumstances cause concern for the safety of a child formal safety assessment using the CD-17 should be completed.
The CD-17 results in a safety decision of “safe” or “unsafe”. If the safety decision is “unsafe” a Safety Plan (CD-18) is required.
A safety plan is a written, mutually agreed upon, arrangement between the worker and the family that establishes how threats of danger to child safety will be managed.
Safety interventions utilized in a safety plan may be seen on a continuum from least intrusive (such as in-home interventions that utilize the family’s own resources) to most intrusive (such as out-of-home placement). Workers will utilize the least intrusive interventions that will assure the child is safe.
3.2.9 Description of Family System
The comprehensive assessment includes family-centered services tools for engaging and diagramming families, such as the genogram and the culturagram. The purpose of the culturagram is to help staff recognize the cultural differences between families. Culture is the thoughts, ideas, behavior patterns, customs, values, skills, language, and religion a person holds. The purpose of the genogram is to gain information regarding the structure and history of the family/household.
By using the various methods of diagramming, the Children’s Service Worker and family may learn something about the relationships within the family, the location of the family’s boundaries, and the variety and quality of the family’s connections to outside systems. In addition to assessment, the use of these diagramming methods may be useful as:
- Helpful additions to the case recording, since they give a clear quick view of the family; and
- Tools for organizing information to assist in the case planning and preparation for services.
Engagement and relationship building is of central importance in gathering meaningful information from families, children, and youth regarding their needs and strengths and essential for achieving safety, permanence and well-being for children. Staff are to encourage and work with parents to be cooperative and engaging of the non-resident or non-custodial parent as appropriate in preserving the best interest and safety of their child/ren. Involving a non-custodial or non-resident parent may be beneficial as:
- A child’s identity is strongly influenced by his or her family. Encouraging the engagement of a non-custodial or non-resident parent may introduce a child to members of his or her family previously unknown or uninvolved
- A non-custodial or non-resident parent may provide valuable family history or health information
- Essential family information will be gathered should the need for future alternative care placement arise
- The non-custodial or non-resident parent may have relatives who are willing to be involved in a supportive role to the family as part of the FCS case and
- Children may benefit from their parent’s social security benefits or inheritance.
Children’s Division staff have the responsibility to preserve confidentiality in these voluntary cases; however, for successful treatment services, families are to be encouraged to engage the non-custodial or non-resident parent as appropriate in preserving the best interest and safety of their child/ren. The client with the open FCS case should be reminded that any biological parent of child/ren involved in the FCS treatment case has the right to access the case record, provided they only receive information regarding the child.
3.2.10 Study of the Presenting Problem (Optional Techniques)
It is often useful for the Children’s Service Worker to study the family’s presenting problem. The presenting problem is usually the behavior that brought the family to the attention of the Division.
Timelines - Used to identify "critical events" experienced by the family. By plotting these events on a linear line, this method can help determine the onset of the presenting problem, what was going on before and after the onset.
Ecomap – Is completed to map the family system and its relationships with individuals and systems outside the family. Family systems may include recreation; faith/cultural; social/community; court system, housing; healthcare; employment; school/education; extended family; friends or other sources for family support not named. The ecomap will include important nurturing or conflictual connections between the family and environment. It also demonstrates the flow of resources, as well as resources the family needs that are conflictual or non-existent.
"Sequences of behavior" - This technique allows the Children’s Service Worker and family to see how the presenting problem is embedded in sequences of family behaviors. It can help gain insight into how these repetitious sequences serve an underlying purpose for the family and assist the worker and the family in identifying appropriate points of intervention to interrupt dysfunctional patterns.
3.2.11 Assessment of Risk
The SDM risk assessment tools are only used for families in which there are children in the home.
By completing the risk assessment, the worker obtains an objective appraisal of the likelihood a family will maltreat their children in the next 18 to 24 months. The difference between risk levels is substantial. High risk families have significantly higher rates of subsequent referral and substantiation than low risk families, and are more often involved in serious abuse or neglect incidents.
When risk is clearly defined and objectively quantified the agency can ensure that resources are targeted to higher risk families in order to enhance the caregiver’s capacity to protect their children from threats of danger and to lessen the families need for outside intervention.
3.2.12 Collateral and Other Information
The Children’s Service Worker should include other pertinent information about the family, including information obtained from relevant collateral sources and other professionals involved with the family. Collateral contacts may include therapists, school personnel, childcare personnel, parent aides, home health professionals…etc.
It may be necessary to check with these sources to verify information that is provided by the family. Information obtained from collaterals may contradict the family’s account of the presenting problems. Inconsistencies may not be intentional lies by the family but merely their understanding or version of reality and should be viewed as such. This comparison may provide insight into the accuracy of the family’s perceptions that are listed previously.
In addition to the providing the worker and the family with differing perspectives on the strengths and needs of the family, collateral sources also assist the worker in meeting minimum contact standards as well alerting the worker to changes in the family dynamics that may give the worker cause for concern.
Use Authorization for Release of Medical/Health Information (SS-6) when necessary.
3.2.13 Assessment of Family Functioning
The NCFAS G+R is designed to assist staff in conducting a thorough and comprehensive assessment of family's history, structure and functioning, identifying protective capacities and child vulnerabilities. A comprehensive assessment should be completed on each open family case.
The NFCAS G+R measures change over a period of time. A key indicator in reunification or case closure is whether or not the family has made the changes necessary to remedy child abuse or neglect. The NCFAS G+R has a readiness for reunification domain which allows staff to quickly determine whether reunification or case closure should occur. The evidence based tool utilizes a six-point scale ranging from clear strength to serious problem and allows staff to calculate an overall domain score. The tool also allows staff to choose whether the item is not applicable or unknown. A comprehensive assessment of the family should be conducted to aid in the development of the case plan.
Workers may draw from the following methods of collection to rate family function items addressed on the NCFAS G+R:
- Direct interview of family members individually and/or together
- Information collected from family members through activities such as drawing genograms and ecomaps
- Personal observation of the family members and their interactions at home or in the community
- Examining written materials such as case records, school reports, etc.
- Collateral contacts with other agencies or individuals involved with the family and
- Referring the family members for an evaluation by a qualified examiner.
The worker may use the NCFAS G+R to compile and organize information that was previously collected, or use it as a reference tool when working directly with the family. The NCFAS G+R provides a systematic and comprehensive way to address significant areas of family functioning that have direct impact on the caregiver's capacity to protect their children from threats of danger which in turn will reduce the probability for future occurrences of child maltreatment.
The NCFAS G+R addresses family functioning under general domains (Environment, Parental Capabilities, Family Interactions, Family Safety, Child Well-Being, Caregiver/Child Ambivalence, Readiness for Reunification, Social/Community Life, Self-Sufficiency, and Family Health). Sub-scales are addressed under each domain.
18.104.22.168 Discrepancies in Family Functioning Ratings
Staff may find that what the worker considers a serious problem in a particular sub-scale may be considered by the family to have no impact or to be a strength. Differing opinions with regards a particular sub-scale can provide an excellent opportunity for discussion and may ultimately lead to the discovery of underlying causes to dysfunctional behavior.
Ratings for sub-scales may also differ from worker to worker or between worker and supervisor. If the case is transferred from one worker to another, the newly assigned worker should conduct an interim assessment within 30 days of case assignment. Again these present excellent discussion points for the worker and the family to engage in a process that will in the long run lead to better goals and family buy in.
3.2.14 Family Strengths and Competencies
No assessment is complete without a thorough evaluation of a family’s strengths, protective capacities, and accomplishments.
Sometimes it is easy to become so problem-oriented that the Children’s Service Worker and family fail to recognize what the family is already doing well. Children’s Service Workers should look for, and acknowledge, the strengths observed within the family members and system. This should be done in an ongoing manner. Often these strengths have been over-looked or hidden. Operating from this perspective inspires hope, reinforces the family’s own problem-solving, and encourages family empowerment. The identified strengths and protective capacities of caregivers provide areas for the Children’s Service Worker and family to build upon in the treatment plan.
One way to help identify family strengths is through relabeling (sometimes called reframing). Relabeling is a process in which a person’s point of view is changed, usually from a negative to a more positive viewpoint.
Relabeling is done by identifying and describing behavior from a different perspective and by recognizing that most things can be seen legitimately in at least two ways. We all experience reality differently; what we say about something reflects our attitudes and feelings about it. By altering the meaning we attribute to a behavior, one can change the person’s perspective and his/her responses to the behavior.
For instance, a father’s hostile or resistive behavior toward the Children’s Service Worker could be relabeled as his protectiveness of his family. By recognizing the protectiveness, the Children’s Service Worker may be more apt to elicit cooperation. A child who is said to be argumentative could be relabeled as independent and a free-thinker. Once the behavior is relabeled, his/her parents may react differently to the child’s behavior.
The Children’s Service Worker is cautioned not to relabel abusive behavior. This could be perceived as acknowledgment that abusive behavior is acceptable and it may minimize the perpetrator’s responsibility for the abuse.
22.214.171.124 Guidelines to Formulate a Relabeling Statement:
- Identify the individual’s behavior that is to be relabeled. This is usually a behavior that, when described, carries a negative connotation
- Relabel the behavior by identifying a way it can be perceived as helping the family. The relabeling statement should contain a "ring of truth" and build upon the idea that most things can be legitimately seen at least two ways
- Inquire into how the individual’s behavior impacts upon other family members and how they usually respond to the behavior
- Tie the relabeling statement of the individual’s behavior to the family system. Once the individual’s behavior is relabeled, consider how the family interactions that surround the identified behavior could now be looked at differently. Relabel the interactions in such a way that the family members could react and interact differently
- Decide if the family will perceive the relabel as helpful, and if they will accept it. The family should be able to feel support and view themselves differently and
- Present the relabeled behavior or action and reframe in a tentative manner (i.e., "I wonder if...", or "Have you considered that...").