3.3.1  Definition and Policy Requirement

Written Service Agreement is the written working agreement between the family and the Children’s Service Worker.  It documents what each party agrees is required to address the family's service needs.  The service needs are identified during the family assessment process.

The entire family assessment and case planning process will be completed within 30 days.  This includes from the time the case is assigned or the due date for the family assessment re-assessment until the family signs the completed Written Service Agreement.

3.3.2  Purpose of the Written Service Agreement

• To provide overall structure and direction to the casework process;
• To document the family's willingness to participate in treatment services and the Division's willingness to assist by providing services;
• To provide an instrument to evaluate case progress and accountability of participants; and,
• To document the required reasonable efforts on behalf of the Division to prevent the out-of-home placement of children.

3.3.3  Components of Written Service Agreement

It is essential that the plan of the family be specific about:

• What the family and Children’s Service Worker hope to accomplish during the treatment process (Treatment Goals);
• How the family and Children’s Service Worker intend to accomplish the defined goals (Tasks); and
• When the tasks will be performed and completed (Time Limitations).

The main components of the Written Service Agreement are identified as:

Treatment goals which identify what the family is to accomplish in the time-limited treatment process; and,

Tasks which the family members and the agency will do to help the family reach the treatment goals.

3.3.4  Written Service Agreement Development

The language in the plan shall be clear and understandable to the family.  The plan must be written in simple, behaviorally specific, descriptive terms.

Below are five (5) steps that are important in developing an effective Written Service Agreement with the family:

1. The Children’s Service Worker shall actively involve the family in the planning process.  As in the family assessment process, the Written Service Agreement is developed with the family, not for them.  Family involvement serves to:
   • Facilitate the development of a therapeutic alliance between the family and Children’s Service Worker.  It provides evidence that the feelings and concerns of the family have been heard and considered;
   • Promote the investment of the family in the treatment process.  People who are involved are more likely to change;
   • Empower parents to take the necessary actions to change dysfunctional behavior patterns; and
   • Help ensure that the Children’s Service Worker and family are working toward the same goals.

   Initially, the family and Children’s Service Worker may have differing perspectives on the reasons for the Division's intervention.  The Children’s Service Worker's active efforts to involve family members in the assessment and planning process are essential in overcoming these obstacles.

2. The Children’s Service Worker and family shall select reasonable and achievable goals and tasks that address identified risk factors.  Important points to consider when selecting goals and tasks are:
• Measurable and time-limited.  Behaviors which can be measured by frequency within certain time frames will enable the Children’s Service Worker and family to evaluate progress;
• Goals and tasks should be behaviorally stated so that the family and Children’s Service Worker know when change has occurred;
• Goals and tasks should be phrased in a positive manner.  They should specify what change needs to take place, not what should be stopped;
• Goals and tasks should be phrased in a clear and understandable language;
• Tasks should be very specific.  The family members should know exactly what has to be done within the specified time frame; and
• Initial tasks should be meaningful to the person or family.  They should be achievable in a two (2) to four (4) week period.  These tasks should be viewed as a need and a priority by the family member(s).
3. The Children’s Service Worker shall address the relevant needs and risk factors identified in the assessment.  The family's strengths and resources are to be considered when determining the tasks needed to achieve treatment goals.  The Children’s Service Worker should:
• Consider the environmental and other influences upon the family.  Start where the family members are and help them select goals which can realistically be achieved in the time frame; and
• Recognize and reinforce family efforts.  Acknowledge their achievements.
4. The Children’s Service Worker shall be able to document what all participants in the plan will do and when.  Therefore, the plan should:
• Describe what family members, the Children’s Service Worker, and any other service provider, will do; and
• Identify time frames for accomplishing each task and the overall treatment goals.  Treatment plans must not exceed 90 days.
5. The participants (the Children’s Service Worker, family, and service providers) shall decide how they will determine achievements and goal attainment.  The Children’s Service Worker should:
• Specify when the plan will be reviewed.  This review will include the Children’s Service Worker and the family members.  It will evaluate case progress and the need for plan revision; and
• Confer regularly with any service provider.  Agree on a method of ongoing communication to evaluate the effectiveness of the services of the provider to the family.  (Marsha Salus, 1988)

3.3.5  Treatment Goals

Treatment goals are statements of what the Children’s Service Worker and family intend to accomplish during the treatment process.  Establishing sound treatment goals requires the Children’s Service Worker and family to have a common understanding of what needs to be accomplished to improve family functioning.  These goals must relate to the reasons for family dysfunction identified in the family assessment.  They will identify what the family will be doing differently when change occurs.

Usually the family assessment will indicate several critical areas, or underlying problems, for casework intervention.  Focusing upon the underlying problems requires the Children’s Service Worker and family to establish desired outcomes that will improve family functioning.  The desired outcome(s) of the casework intervention is stated in the treatment goal.  The treatment goals are written on the Written Service Agreement and serve as a "roadmap" for the Division's intervention with the family.

Achievement of the goals should reduce risk of future child maltreatment and improve family functioning.  When a risk assessment indicates that risk is reduced and/or eliminated case closure is considered.

Goals may reflect both direct and indirect interventions:

• Direct interventions address the presenting problem directly.  In a more permanent way than a safety plan, the address the behaviors that create  immediate safety issues.  Indirect interventions address the behaviors and circumstances that may be contributing to the presenting problem.
• Indirect interventions can be identified through using the technique of sequencing behaviors and by determining the function of the presenting problem (symptom).

3.3.6  Family Involvement in Goal  Development

The following steps may be helpful in setting behaviorally specific goals and tasks with the family:

1. As the family responds to the questions in the preceding section, the problem is defined more explicitly. The goals that will tell the Children’s Service Worker and family that the problem has been (or how it will be) resolved are discovered;
2. Develop the goal to meet the following criteria.  It should:
• Describe what the family will be doing differently when change occurs;
• Use the client's definition of the problem, whenever possible;
• Be achievable;
• Phrased positively, such as "Mrs. J. will..," rather than "Mrs. Jones will not.…"  If people are asked to give up a behavior, an alternative behavior that meets the underlying need should be identified; and
• Identify increments of change, whenever possible, so the Children’s Service Worker and family can monitor progress.

NOTE:  Using increments may not be appropriate with goals that directly address physical and sexual abuse, and other immediate safety issues.

3. Brainstorm with the family about what action, steps, or tasks, will be necessary to achieve the goal(s); and
4. Assist the family in the provider selection process to meet the treatment    goals.

3.3.7  Writing Goals

The specified goals should be:

• Clearly phrased in a manner that is concise and understandable by the family;
• Written in behaviorally specific terms and identify what the family will be doing differently when change occurs.  Goals should not be defined as services.  For instance, rather than having a goal identified as "Mrs. Jones will attend parenting classes," the goal should focus on what needs to be achieved by her attendance at parenting classes;
• Measurable and time-limited.  Behaviors which can be measured by frequency within certain time frames will enable the Children’s Service Worker and family to evaluate progress;
• Realistically obtainable and recognize minimally acceptable expectations and standards; and
• Mutually agreed upon by the Children’s Service Worker and family.  The skills of the Children’s Service Worker must be utilized to set goals with the family and not for them.

3.3.8  Identifying Increments of Change

When possible, goals should identify increments of change to allow the family and the Children’s Service Worker to see that change is beginning to occur.

NOTE:  Using increments may not be possible with goals that directly address physical and sexual abuse, and other immediate safety issues.

For example, an 18-month old child is left alone several times throughout the week.  We cannot establish a direct goal to eliminate the lack of supervision incrementally (i.e., the child is left alone only one day per week).  A toddler cannot be left alone for any amount of time; change must occur rapidly to ensure the child's safety.  The necessary change to ensure the child's safety will be a direct goal that addresses the presenting problem and will be behaviorally specific.  Indirect goals, to address contributing and underlying factors, may be used in conjunction with the direct goal.  Indirect goals may be written incrementally and will also be behaviorally specific.

The timeframes for the goals may vary.  The time frames may be written into the goal itself, or specified in the time limit section of the CD-14B.  Also, more than one CD-14B may be used in a treatment period to allow for goals of differing time frames.

Short-term goals will be more easily and quickly obtainable.  They provide the family some measure of success within a brief period of time.  Long-term goals will require a longer period of time.  Generally, they are more difficult and will require more consistent effort on the part of the family.  Subsequent treatment periods which build upon previous successes, may be required for accomplishment of long-term goals.  Accomplishing long-term goals should result in the achievement by the family of a minimal level of functioning.

3.3.9  Prioritizing Goals

A large number of goals on the Written Service Agreement will overwhelm the family.  Generally, there should be no more than two (2) goals written on the Written Service Agreement at any one time.   This allows the family to focus upon one or two critical issues, build upon success and move on.  Because of this, it is important for the Children’s Service Worker to fully explain the rationale for limiting the number of goals on the treatment plan.  Questions to ask the family in order to help them process and prioritize goals are:

• If this need is not attended to, what will happen?
• Does this need impact safety?
• How much and how often does this need bother you?
• Is there a time limit to this need?

It is important also that the Children’s Service Worker clearly identify goals and issues that cannot, or should not, be pursued at the present time.  He/She should explain that there may be other identified treatment goals if it appears that more than one treatment period will be necessary.  Furthermore, more than one CD-14B may be used within a treatment period to cover all the goals that need to be addressed.  Identifying the most critical treatment goals with the family, then planning the order in which each goal will be addressed, should help the family work through the treatment plan.

By establishing goals related directly to an underlying problem and selecting the easiest goals first, the Children’s Service Worker and family can help facilitate a successful plan.

3.3.10  Use of the Scaling Technique

Scaling is a useful method to create specificity in goals and identify increments of change.  Numbers, from 1 to 10, are used to describe a person's behavior, the frequency of behavior, or a person's feelings.

On a scale from 1 to 10, with 1 being never and 10 being constant, we ask the person to pick a number to describe how often the behavior occurs now.  Once this is done, you can establish a number they would like to be at by a certain date.  This becomes a marker, or increment of change.  Once this increment is reached, additional increments, or scaling numbers, can be set and reached.

3.3.11  Treatment Tasks

To achieve a treatment goal(s), the Children’s Service Worker and family must identify tasks that, when completed, will achieve the specific goal(s).  Tasks can be specified for the family unit, an individual, Children’s Service Worker, or other provider or resource.

The Children’s Service Worker must take care not to overwhelm the family with tasks.  The number of tasks for the Children’s Service Worker and the family should be roughly the same.  The tasks of the Children’s Service Worker should complement the tasks of the family.  They should encourage family empowerment and enhance the family's ability to solve problems.  To help prevent failure, family tasks should take into account the following:

• The cognitive and social abilities of the family members;
• The family's level of cooperation and motivation;
• The ability and willingness of the family to use community resources; and
• Practical limitations, such as transportation.

3.3.12  Time Limits

Time limits must be included in the plan.  Recognizing that families have a right to be free of unnecessary interference, Division intervention should not be open-ended.

The CD-14B, Written Service Agreement, is used to document the case goals in addition to what the family, Children’s Service Worker, and others will do to accomplish the case goals during the 90 day period. In some instances, it may be beneficial to use more than one CD-14B during this 90 - day period.  A formal evaluation of the case is required by the Children’s Service Worker and supervisor at the end of the treatment period.

Related Subject:  Section 3, Chapter 7.1, Policy Requirements Related to the Evaluation

Time limits are needed to evaluate the success of the specific goals and tasks.  They help the Children’s Service Worker and family to measure progress on an ongoing basis and help prevent the family from being overwhelmed.  Measuring progress in time increments make goal attainment more manageable.  More than one CD-14B may be used in a treatment period to allow for goals of differing time frames.

It is important not to mislead the family when discussing the time limits of the Written Service Agreement with the family.  The Children’s Service Worker should explain that, depending on case progress, more than one CD-14B might be used, or successive treatment periods may be necessary.

The maximum timeframe The Family Assessment process will not only address the reported concern alleged in the hotline report, but will take into account the family’s situation as a whole.  The Children’s Service Worker will carefully review all information available at the time the report is first received before engaging the family in the family assessment process.   The Family Assessment process will not only address the reported concern alleged in the hotline report, but will take into account the family’s situation as a whole.  The Children’s Service Worker will carefully review all information available at the time the report is first received before engaging the family in the family assessment process.   for the development and implementation of a CD-14B, Written Service Agreement, is 90 days from the date the case is assigned to the reassessment date.    Treatment goals that are identified in the plan are expected to be achieved during this period.

If it appears that unresolved treatment issues exist at the end of the treatment period, the Children’s Service Worker and supervisor must decide, based on assessed risk, if the case should remain open.  A re-assessment, CD-14A, CS-16E, and CD-14B is due within 30 days of the expiration of the treatment period.

3.3.13  Family Approval

As the Written Service Agreement is to reflect a cooperative agreement between the Children’s Service Worker and the family, the parent(s) or caretaker(s) should sign the plan.  Other family members should sign the plan, if needed.

The plan will be written on the designated self-carboning page, CD-14B, included in the CD-14, the Family Assessment Packet.  The Children’s Service Worker should make an effort to elicit family participation in the planning process.  This process should be as informal as possible.  The family's approval of the plan should convey their agreement to the goals and requirements of the plan.

Family refusal to sign the plan should not automatically indicate their refusal to participate in treatment services.  If they refuse to sign, yet agree to participate, a copy of the plan shall still be provided to them.

If the family refuses to participate in the planning process, the Children’s Service worker shall consult with his/her supervisor to decide the appropriate action to take.

Related Subject: Section 3, Chapter 2.5, Family Refusal of Services

3.3.14  Questions to Ask Resistant Families in Goal Planning

To identify goals to work on in a Written Service Agreement, the following questions may be particularly useful when the family is resistant and may not be accepting ownership of the behavior:

• Whose idea was it that you receive services?
• What makes the referral source (i.e., Children’s Division (CD) investigator, juvenile court) think we need to meet together?
• What does the referral source think  the reason is that you have this need?
• What does the referral source think will happen as a result of us meeting together?
• What will it take to "convince" the referral source that we do not need to meet together?  (This is a particularly useful question when the family denies having the need.)
• What will be different in your life then?