assessment of parenting capacity: a workshop - iasa allerton assessment … · 1 assessment of...
TRANSCRIPT
1
Assessment of
Parenting Capacity
Mark Allerton www.lawlink.nsw.gov.au/ccc
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The Big Picture
• Why are you here? Why do you need to know about this?
• Clinical, ethical and professional problems
• What can/can’t mental health professionals offer?
3
The NSW Children’s Court Clinic
• Set up by NSW Children &Young Persons (Care and Protection) Act 1998
• Conducts independent assessments for courts, mostly of children, and of parenting capacity
• Both internal and contracted Authorised Clinicians (child psychologists, social workers and psychiatrists) conduct assessments, and are expert witnesses in court.
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Ages of Children Referred…
1044
749
658
583545
508 488440 417 424 401
300261 238
13775
25 19 7
0
200
400
600
800
1000
1200
0 ye
ars
1 ye
ars
2 ye
ars
3 ye
ars
4 ye
ars
5 ye
ars
6 ye
ars
7 ye
ars
8 ye
ars
9 ye
ars
10 yea
rs
11 yea
rs
12 yea
rs
13 yea
rs
14 yea
rs
15 yea
rs
16 yea
rs
17 yea
rs
18 yea
rs
Age of children
Nu
mb
er
of
ch
ild
ren
5
Children per Order …
2037
928
531
211117
39 24 4 10
500
1000
1500
2000
2500
1 ch
ild
2 ch
ildre
n
3 ch
ildre
n
4 ch
ildre
n
5 ch
ildre
n
6 ch
ildre
n
7 ch
ildre
n
8 ch
ildre
n
9 ch
ildre
n
No. of children
No
. o
f A
pp
licati
on
s (
To
tal:
3892)
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Questions we attempt to answer (See the clinic website for more details*)
1.Parenting capacity/responsibility
2.Parent/caregiver–child relationships
3.Children and young persons’ individual
characteristics, needs and wishes
4.Suggestions for steps to achieve desired
outcomes
-But we need an agreed case summary, and to know
what specific problems the court needs to resolve.
* www.lawlink.nsw.gov.au/ccc
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Abusive Parents and their Children
• Risks of parents’ drug and alcohol abuse
• Abusive parents (Denver Group)
• The abused child’s perspective (Martin)
• Children in abusive and neglectful
families (Crittenden)
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Risk and Protective Factors in
Vulnerable Families Fonagy (1998)
(i) Biological factors
(ii) Family and social factors
(iii) Quality of parenting
(iv) Quality of attachment status
(v) The influence of non-maternal care
Caregiver relationships are primary:
practical parental empathy/ responsive caregiving
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Areas Affected by Child Abuse and Neglect
Physical development
Emotional development
Behavioural development
Social development
Cognitive and cultural development
Development not even, sequential or
harmonious
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What Children Need, and the Impact of
Child Abuse and Neglect
Area A Child Needs Problems…
Physical Physical care and safety Physical, nutrition, growth,
dental, coordination
Emotional Empathic Attention and
Attachment Relationship
Attachment disorders, FTT,
emotional and behaviour
Behavioural Emotional and behavioural
self-regulation
Attention, impulsivity,
aggression
Social Role models Social, language
Cognitive
and Cultural
Cultural Education Attention, play, problem-
solving, education, culture
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Clinic Data: Child Problems
School-Aged Children
0
2
4
6
8
10
12
14
16
18
20
Infants (5-7y) Primary (8-11) High (12-18) Total
Percen
t
Disability
Mental Illness
Violent Behaviour
School Non-Att
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Parents’ Resources
• Responsive caregiving and
protection
• Reflective Function
• Bonding
• Emotional availability
• Strategic behaviour management
• Ability to transmit the community’s
cultural and social values.
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Child Needs
Nor
mal
Vulne
rable
Chro
nic
Need
Parent Resources
Ap
pro
pri
ate
Vu
lne
rab
le
Ch
ron
ic
Pro
ble
m
Physical Care
and Safety
Responsive Caregiving and
Protection
Empathic
attention
Reflective Function
Attachment
Relationship
Bonding
Emotional Availability Emotional and
behavioural
self-regulation
Strategic Behaviour
Management
Role model
To learn
Ability to transmit
community values
Assessment of Parenting Capacity
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Child Needs Assessment
Physical Care
and Safety
•Welfare and medical/ development history,
•Developmental assessment,
•Observation of behaviour,
•Predictable developmental crises
Empathic
attention
• Observation, attachment assessment
Attachment
relationship
• Relationship history, attachment assessment
Emotional and
behavioural self-
regulation
•Behaviour problems and emotional symptoms,
•Family observation, social interactions, school
reports
Role model •Behaviour, peer socialisation, adaptive
behaviours
Cultural
education
•Education, peer socialisation, recreation, cultural
and spiritual development
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Assessment of Parents’ ResourcesResponsive
Caregiving and
Protection
•History, observation of parentcraft (e.g., PSI long form)
•Cognitive/language abilities
•Adaptive behaviour (e.g., ABAS)
•Risk Predictors (e.g., CAPI, SAARA)
Reflective
Function
•Clinical interview, AAI, partner interviews, attachment
assessment
Bonding •Relationship history, attachment assessment, PCRI
Emotional
Availability
•Mental health, interview about the child, observation of
interaction (e.g., MSE, DASS, PAI, PSI, CAPI, SASSI-3,
STAXI-2)
Strategic
Behaviour
Management
•Observation of interaction: management of behaviour,
behaviour problems
Community
values
•Social, educational and work history,
•Extended family network, socialisation, community links,
•Capacity to foster cultural/moral/spiritual development
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An Ordinary Assessment Model
• Reason for the referral
• Obtain a history of the family
• Parent and child:
– Cognitive aspects/Adaptive behaviours
– Emotional/Personality/Psychiatric aspects
– Social Interaction
• Specific tests of family functioning
• Formulation (formulation tool)
• Recommendations
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Specific Risks and Challenges
• Intellectual disability
• Drug/alcohol problems
• Personality disorders
• Maternal health
• Mental health
• Domestic violence
• Cross-cultural, ecological factors
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Clinic Data: Parent Problems
Parents of children assessed by the CCC
11
29
65
45
0
10
20
30
40
50
60
70
80
90
100
Disability Mental Illness AoD Abuse Violent Behaviour
Parent Factors (%)
Perc
ent
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Difficult decisions
• Is the child in imminent danger?
• How inadequate or damaging is the family?
• Concrete evidence of a child’s vulnerability?
• How likely are supportive interventions to
change things?
• How adequate are the alternatives?
• Placement factors
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The big question:Will the child benefit from restoration?
Think: What is in the child’s best interests?
•Yes?
Immediate (unconditional)? or
Conditional? – treatment, placement, contact: but can the child wait?
•No?
What environment will be safe, nurturing, stable and secure for this child?
Contact visits
Future prospects
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The End
– Thanks