the family assessment form insert agency/program name date of training
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The Family Assessment Form
Insert Agency/Program NameDate of Training
Objectives
To understand purpose and theory underpinning development of the FAF
To become familiar with FAF structure
To practice using the FAF
A Brief History
Developed between 1986-1990 at Children’s 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.
Used in several program evaluation studies and a major controlled research study in Los Angeles County.
Research/Evaluation Findings
Highlights FAF is valid and reliable measure of family
functioning; good inter-rater reliability within 1/2 point Families served by Children’s Bureau changed most in
areas of caregiver/child interactions and least in caregiver/caregiver interactions
Families most likely NOT to change exhibited common characteristics
Serious problems in caregiver’s own historiesSerious problems in current functioning (i.e. substance abuse,
mental illness, domestic violence, etc.)Serious problems in multiple family functioning factors
FAF Development Goals
Thorough Family AssessmentsFocused Goals and Service PlansOrientation for New StaffIdentification of Training NeedsConsistent and Efficient
DocumentationProgram Evaluation
Thorough Family Assessment
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
Focus on family strengths need structured way to emphasize strengths
Focused Goals and Service Plans
Goals and service plans need to be linked to assessment
Cannot address everything; need to be thoughtfully selective 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 impact of personal characteristics and/or history
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
Documentation
Consistency of documentation across workers, program sites, etc.
Short-hand method for home visitor casework documentation
Easy to review by others (i.e. supervisor, back-up home visitor)
FAF takes a “snapshot” of the familyFAF takes the place of a written, narrative
assessment
Program Evaluation
Provides immediate feedback to worker on individual family change
Valid, reliable measure of family functioning in six key areas
Aggregate data can be used to report on program outcomes
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
Philosophical Approach
Ecological/Systems Theory Problems are not within individuals rather in the “fit”
between parts of the systemFAF 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., child’s 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
Philosophical Approach
Emphasize Family Strengths need a disciplined way to “see”
strengths in families with complex problems
FAF rating scale “forces” identification of strengths
FAF Overview
Family Functioning FactorsPersonal Characteristics and HistoryChild Behavior/Observation ChecklistService PlanContactsClosing Summary
Family Functioning Factors
Six Outcome Measures of Family Functioning - 38 items total
A. Living Conditions - 6 items B. Financial Conditions - 5 items C. Supports to Caregivers - 5 items D. Caregiver/Child Interactions - 12 items E. Developmental Stimulation - 4 items F. Caregiver Interactions - 6 items
Personal Characteristics/History
Two Adult Assessment Factors - not used as outcome measures because not expected to change or could get worse (i.e., learn more about someone’s history)
G. Caregiver History - 8 items F. Personal Characteristics - 12 items
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
Service Plan
Components
FAF items indicating strengths
FAF items of concern
Goals related to areas of concern
Methods for addressing each goal
Frequency and duration of contact
Contacts
Components Who, what, when, where Intervention Lists
Teaching and DemonstratingCounseling/Issues AddressedCase Management/AdvocacyConcrete/Practical
Progress/Homework/Follow-up Tasks Referrals
Closing Summary
Case Result (i.e., completed, dropped, lost, child placed, etc.)
Outcome on Individual Family Goals
Outcome of Referrals
Summary Progress Notes
FAF Process
Meaning of Scores
FAF Ratings
FAF as Initial Assessment
FAF at Termination of Services
Meaning of Scores - found on Help Menu
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 caregiver’s well-being. Intervention required.
5. Situation is endangering to children’s health, safety, and well-being. May call for removal of child; intervention and monitoring required.
FAF Ratings
Each item is rated on a 1-5 scale option to rate 1.5, 2.5, etc.
Each item has an operational definition, based on the overall meaning of scores, to guide rating 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
rating decisions as needed
FAF as Initial Assessment
FAF serves as only form of assessment documentation rule of thumb is to complete within 3-4 visits
including service plan rate items following each visit with a family review FAF areas not assessed yet in
preparation for subsequent visits Do not change ratings following this
established “baseline” period
FAF at Termination
Re-rate 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 rating should take about 1/2 hour
Programs may wish to re-rate FAF at additional intervals (i.e., annually)
Key Points for Using FAF
FAF is a framework for approaching assessment NOT a structured interview or questionnaire
FAF is a psychosocial assessment documented differently
Obtain FAF data by asking and observing
Key Points for Using FAF
Use the operational definitions and overall meaning of scores to determine ratings this is key to maintaining inter-rater reliability
Brief narrative comments are essential helps explain scores and uniqueness of each
familyRemember to tie goals directly to assessed
areas of concern
Exercise # 1
Practice Rating Living and Financial Conditions Factors Think of a home you know well. It could
be your own, the one you grew up in, or a clients. Get a good picture of it in your head.
With a blank FAF and pencil, rate sections A and B.
Debrief as a group
Exercise #2
Mock Interview Divide into small groups no larger than 5 Each group gets a Script and blank FAF Group members take turns reading the two
parts in the Script - worker and mother Stop, discuss and rate the FAF as indicated
on the Script Continue working through Script Debrief as a large group
Goal Setting
What is a goal? “the end toward which an effort is
directed” - Webster’s New Collegiate Dictionary
a future state of being what will the family situation look like
when you have finished your work together
what will be different?
Goal Setting
What factors contribute to goal setting? Input from the family Presenting problem by referral source FAF assessment Other?
Art is in blending these together into meaningful goals that the client is willing to work towards
Goal Setting Guidelines
Specific and ClearMeasurable and ObservableAccomplishments - state positively
To practice active listening skills vs. to reduce level of arguing
Use active voice Parents will clean the house once a week
Realistic based on resources - yours and the family’s
Timeframe for achievement
Sample Goals
Problem: Cleanliness/orderliness inside home (dirty dishes, trash overflowing, soiled diapers on floor)
Goal: Parents to demonstrate understanding of hygiene for children’s health and safety by maintaining a clean home (i.e., doing dishes daily, taking out trash weekly, etc.)
Method: Teach parents about connection between health and hygiene using videos and handouts; help develop cleaning schedule; provide start-up cleaning products
Sample Goals
Problem: Appropriateness of discipline (only use corporal punishment with shoes and belt)
Goal: Parents to verbalize and implement timeout technique correctly
Method: Teach and demonstrate time-out; provide timer; coach and support parents in explaining new rules and consequences with children
Sample Goals
Problem: Bonding style to children (parent pushes baby away and believes he is crying intentionally to anger parent)
Goal: Parent to respond positively to child’s cry for comfort; parent to verbalize understanding of child development and reasons for crying behaviors
Methods: Provide and review child development information; explore parent’s feelings; demonstrate how to comfort baby; develop options for parent so child’s needs are met
Service Planning Exercise
Divide into small groups no larger than 5Each group member gets a sample
completed FAF with ratings and commentsEach group gets a flip chart size piece of
paper and markersEach group gets assigned sections of the
FAF to work on (i.e., group 1 gets section A, group 2 gets section B, etc.)
Service Planning Exercise
Ask each group to: list on the flip chart paper the strengths
identified in their assigned section list on the flip chart paper the concerns
identified in their assigned section develop at least one well stated goal
addressing one of the concerns identify what methods the group might use to
address this goal
Service Planning Exercise
Debrief Exercise Have each group present their thinking
related to their section Engage group in constructively
critiquing the goals and methods Reinforce how to use the family
strengths to address the concerns
Final Comments
Reinforce important messages
Questions and Answers
Plan for Next Steps in Implementation of
FAF in your agency
Participant satisfaction/feedback surveys
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