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