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Administrative Supports for Comprehensive Family Assessment
It is clear that comprehensive family assessment is not practiced consistently in the field. Jurisdictions vary in their capacity and commitment to comprehensive family assessment, but the bottom line is that the Child and Family Services Reviews indicate a general need for improvement in this area to enhance the responsiveness of interventions to the needs of the family.
The key areas where administrative supports are needed for comprehensive family assessment to move forward are:
- Direction and support in policies
- Availability, adequacy, and accessibility of services
- Training and preparing staff
- Clinical supervision and mentoring
- Coordination of services provided through other agencies
- Systems of accountability and evaluation—including forms for documenting information, time lines, and responsibilities, as well as quality assurance procedures to determine if assessment practices are being implemented and whether they are affecting outcomes.
Direction and Support in Policies
Policies refer to a wide range of written directions or standards that inform practice. They include statutes, state plans submitted to the federal government as well as to state legislatures, policy manuals for the public child welfare system and its staff, practice standards, and procedures for case practice.
The level of articulation of practice necessarily varies depending on the particular document in question; child welfare policy manuals, for instance, are more specific and concrete than state statutes. What is necessary, however, is to assure congruence among different policies as well as to support the more specific with the more general framework.
Common policy areas that should be examined in light of providing support for comprehensive family assessment include:
- Distinguishing between assessments—safety, risk, and comprehensive family assessment, requiring all of them as needed, and clarifying their initial and ongoing mutual relationships to case practice;
- Incorporating the workload implications of completing comprehensive family assessments into staffing needs and time frames for assessments to be completed;
- Clarifying expectations related to the process of comprehensive family assessment, such as the involvement of fathers and other relevant family members, as well as community providers who know the child, youth, and family;
- Clarifying the nature of child protective services as being more than the “investigation of allegations,” more comprehensive than “incident-focused”—yet still focused on safety, permanency, and child well-being;
- Fortifying practices that involve mental health, substance abuse, domestic violence, and public health by federal, state, and local policies that facilitate collaborations across programs;
- Including language that supports family engagement and involvement, individualized assessments, and ongoing assessment and re-assessments; and
- Providing a framework for comprehensive assessment that clearly helps staff with the process of gathering and using assessment information, including information on protective factors in service plans.
Availability, Adequacy, and Accessibility of Services
For frontline staff to do comprehensive assessments in ways envisioned in these guidelines, it is essential that the child welfare agency ensure that the array and accessibility of services are enhanced in the following ways:
- The agency's purchase of service system needs to assure that they are able to buy what families need.
- Services need to be available where families live or transportation supports need to be built into purchase of service contracts to assure families can access needed services.
- Services must be adequate to the demand. Services may be available, but if they entail lengthy waiting lists, they are responsive neither to the needs of families nor the time frames required under ASFA guidelines.
- Services must be provided in a culturally sensitive manner and available in a language the family can understand.
- Assessment information on individual cases can be aggregated for planning purposes to identify gaps in services availability.
- Aggregating assessment information with regard to needed services by geographic areas of the State may help the State to identify gaps in its service array and to plan for needed resource development.
Training and Preparing Staff
Caseworkers are often not prepared by age, education, and experience to delve into the circumstances of individual families, to engage families in a change process, to get a full picture of the underlying issues and resources, to reach appropriate conclusions about the meaning of the information gathered, and to use this information in service planning and ongoing decision-making.
This understandably challenging reality needs to be recognized and addressed in the formal training curricula for child welfare staff as well as in the less-formal patterns of clinical supervision and mentoring.
Areas that warrant examination in the existing process of training and preparation of staff include:
- Incorporating materials on the nature and distinguishing features of safety, risk, and comprehensive assessments and how they are used;
- Understanding the types of abuse and neglect and associated family dynamics;
- Understanding and incorporating family-centered values and beliefs into case practice.
- Training on engagement, building a helping relationship, and interviewing family members including children and non-custodial parents;
- Training on the benefits and process for family team meetings;
- Training on the process of conducting and using comprehensive family assessment—staff need to be trained in how to do accurate and complete assessments and how to use the information appropriately;
- Defining and structuring caseworker roles in light of the more comprehensive work of going beyond presenting problems and examination of allegations;
- Specifying when re-assessments are needed, how to gather information on case progress, when to revise service plans;
- Making judgments using comprehensive assessment information; understanding and utilizing “stages of change” to guide decisions;
- Learning how to help families use protective factors to leverage necessary changes;
- Helping staff identify what has to change to achieve the outcomes of safety, permanency, and child well-being; building service plans based on comprehensive assessments, and ensuring that the assessments do not simply generate laundry lists of unrelated needs, but are focused on the outcomes;
- Guiding staff in the use of specialized assessments—initial screening, when to involve specialized assessments, and how to focus and use results in service planning; and
- Helping staff to identify and use resources in the community and to develop facilitation skills and strategies.
Clinical Supervision and Mentoring
Clinical supervision is vital to reinforce what is covered in formal training as well as to provide guidance to caseworkers in gathering assessment information, using it to develop service plans, as well as interpreting ongoing assessment information at key decision points.
Clinical supervision assumes the supervisor focuses on guiding staff in making judgments and decisions on cases.
The patterns of supervision, the actual roles supervisors play, and the focus on guiding and supporting caseworker decisions vary within and across jurisdictions.
There are particular areas of practice that are known to be problematic for frontline staff. It would be useful to examine how each of these is or could be supported through supervision:
- Incorporating information from intake, safety, and risk assessments into comprehensive family assessments;
- Engaging families, children, and youth;
- Working with other agencies;
- Obtaining parental permission and authorizing releases of information;
- Making decisions about specialized assessments;
- Conducting re-assessments at particular points in the case process;
- Making judgments based on comprehensive family assessment as to what has to change to achieve outcomes;
- Using assessment information, including protective factors, in service planning; and
- Evaluating family progress.
It is often helpful to have clinically strong caseworkers operate as case consultants to less-experienced staff to augment clinical supervision.
Caseworkers need transfer of learning opportunities through observation, mentoring, evaluation, and feedback regarding the incorporation of training content into practice, and other ways to cement the understanding and incorporation of principles and practices associated with comprehensive family assessment.
Coordination of Services Provided Through Other Agencies
Comprehensive family assessment assumes that information will both be gathered from and shared with other agencies that have been involved with the family or that will be part of the services outlined in the service plan. When working with other agencies, caseworkers will need support from their supervisor and agency to assure that issues related to parental consent and confidentiality are sufficiently addressed.
This cross-program focus is difficult to achieve when collaboration is not the norm. As indicated above, policies have to be in place to support cross-agency collaborations; this cannot happen solely through efforts of front-line staff and supervisors.
Jurisdictions vary in the degree that child welfare staff operate as case managers more than direct service providers, but in every case, the child welfare agency has the ultimate responsibility to decide who will be served, what the overall focus of intervention needs to be, and whether the child, youth, and family are getting the services they need and are making the changes necessary to achieve the outcomes of safety, permanency, and child well-being.
In fact, most child welfare agencies recognize the need to collaborate with other agencies in the community. The needs of children and families require their involvement. Therefore, the issues of cross-agency collaboration are vital to address.
In relation to comprehensive family assessment, some mutual administrative support mechanisms that may enhance collaboration should be explored. These include:
- Policies and processes of information sharing, including obtaining releases of information;
- Confidentiality protection arrangements;
- Purchase of service contract provisions/memoranda of understanding that support sharing and utilizing information vital to understanding needs and evaluating progress of families' toward goals;
- Reporting obligations from agencies related to changes in clients or progress on outcomes when services are provided to child welfare clients—reporting has to meet the informational needs of child welfare;
- Participation in family meetings, case conferences, and other forums where needs assessment information is being developed for service planning decision-making;
- Preparation of child welfare staff in obtaining and using information from other agencies—the purposes of every referral for specialized evaluations and/or services should be clear to everyone involved;
- Identification of the process of assuring that other agencies involved with families have and utilize comprehensive family assessment information in service/treatment plans across agencies; and
- Cross-training opportunities as well as opportunities for jobshadowing and other mechanisms that promote better understanding across systems.
Accountability and Evaluation
In each jurisdiction, the child welfare administration has to guarantee that the following is done for all open cases:
- The comprehensive family assessment takes place;
- The process in the guidelines is followed;
- The results are utilized in service plans;
- Services address needs;
- Evaluations of case progress are directly tied to the specific changes needed in each case to contribute to the outcomes; and
- The entire process of assessment, service planning, service delivery, reviews of progress, key case decisions, and outcomes is documented in the paper or electronic case folder.
In addition, the jurisdiction's quality assurance programs need to monitor key issues such as family engagement and involvement, individualization of assessment and service planning, and the comprehensive focus on needs that stand in the way of longer-term achievement and the sustaining of safety, permanency, and well-being of children.
Some necessary administrative supports related to accountability and evaluation are:
- The documentation of the process of comprehensive family assessment—frameworks and forms completion;
- The development of procedures for regular case record reviews to examine whether and how comprehensive family assessment information is gathered and utilized for service planning;
- The development of resource allocation decisions in relation to time needed for assessment;
- The determination of how information is shared and utilized by other agencies and coordinated by child welfare;
- The process for sampling case records to determine the relationship between needs identified and services utilized and the responsiveness to established time lines; and
- The capacity to measure outcomes in relation to the quality and comprehensiveness of the needs assessment and whether the interventions had an impact on the needs identified in the assessment.
A process must be in place for continual quality improvement that involves using accountability and evaluation information for course corrections in policies, training, clinical supervision, and collaborations across systems as well as case practice.
There needs to be a continuous feedback loop to assure practice fidelity and to support supervisory capacity to help staff implement the content, process, utilization, and documentation of comprehensive family assessment.
Incorporation of peer reviews, coaching, and mentoring have all been found useful in the process of continual quality improvement. Focusing staff on the distinctive purposes and methods of utilizing comprehensive assessments is essential.