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Introduction
Families are at the heart of children's worlds. Yet children's families sometimes fail to care for and protect them. When child welfare agencies receive a report concerning alleged child abuse and neglect, an investigation to determine the facts of what has happened is necessary. However, when agency staff members determine that a child is in need of protective services, they must quickly move beyond investigating facts to develop an understanding of what has occurred, including why it has occurred and what will be required to restore the family's functioning and prevent the recurrence of abuse or neglect. If a family's functioning can be restored, the family can safely remain at the heart of the child's world.
In order to develop an understanding of the whole situation, many questions must be answered. The process of finding the answers to these questions and to understanding the family is comprehensive family assessment. Questions for assessment include:
- What is the exact nature of the abuse and/or neglect?
- For how long has the abuse and/or neglect occurred, and what has been the impact on the child's functioning and development?
- How do the parents and the children view their current situation?
- What in the parents' past and current experiences contributes to the family's needs and problems?
- In what ways have the parents adequately provided for their children and what are their strengths?
- What previous efforts have been made by the parents to meet the child or youth's needs and resolve the family's problems?
- What kinship resources are available, including resources of the tribe or clan to which the family belongs?
- What specific services are needed by the child and the child's parents to resolve the problems that are requiring protective services?
- What considerations impact on the decision to select a specific permanency plan?
Comprehensive family assessment is recommended when it is determined that the child welfare agency is responsible for serving the family. Such assessment goes beyond the investigation to permit the identification and provision of services that are specifically targeted to address the family's needs and problems and insure the child's safety, well-being, and permanency.
These guidelines address the components of comprehensive family assessment, show the linkages to service planning and service provision, and illustrate how child welfare agencies can support their use. As states and agencies use these guidelines, they will be updated using the knowledge and experience gained from the implementation of comprehensive assessment. These guidelines are provided as an initial framework to facilitate efforts to move the child welfare community towards comprehensive assessment as a best practice. Additional technical assistance is being developed to support the implementation of these guidelines.
This document:
- Defines and describes the comprehensive family assessment (CFA) process in child welfare;
- Articulates the assumptions of quality practice that support the comprehensive family assessment;
- Identifies the key points in the casework process when comprehensive family assessment and re-assessment are needed;
- Suggests how the comprehensive family assessment can be used to develop service plans and inform recommendations to the Dependency Court regarding the need for care, custody, and control of the child;
- Provides a case example that illustrates the process of comprehensive family assessment; and
- Identifies organizational and administrative supports necessary for effective comprehensive family assessment.
Assumptions Central to these Guidelines
A number of assumptions are central to the Comprehensive Family Assessment Guidelines presented in this document:
- If the child welfare agency is responsible for serving the family, a comprehensive family assessment is usually the best means to obtain information to guide decisions on service planning.
- Comprehensive family assessment
- begins with the first contact with a family and continues until the case is closed;
- must be completed in partnership with families and in collaboration with other community partners;
- is a process, not the completion of a tool. Simply completing a form will not capture all that is needed for comprehensive assessment.
- Collecting and organizing comprehensive family assessment information is not an end in itself; the information and the resulting understanding of the child and family's situation must be used in focused ways in the service plan. Thus, the purpose of comprehensive family assessment is to develop a service plan or a strategy for intervention with the family over a period of time, increasing the likelihood of matching services to family members' real needs and addressing the key issues within the limited timeframes prescribed by law.
- Engagement and building relationships are of central importance in gathering meaningful information from families, children, and youth regarding their needs and strengths.
- Services secure the link between existing needs and desired outcomes. For services to be relevant and effective, workers must systematically and continuously gather information and evaluate the needs of children and parents/caregivers as well as the ability of family members to use their strengths to address their problems.
- A regular process of communication must exist between child welfare and other service providers, contractual or otherwise, on the changing conditions within the family.
- Assessments must be updated as family circumstances change, as families make progress or face setbacks, as a parent's readiness to change evolves, and as new information provides new insight into existing needs.
- Clear and full documentation must be included in the case file at the completion of the initial process of the comprehensive family assessment as well as when the information is updated.
- Organizational and administrative supports are necessary for an effective comprehensive family assessment, including resource allocation in relation to staff time needed for assessment.
- Formal training, clinical supervision, and mentoring are required to support caseworkers in completing comprehensive assessments in a culturally sensitive manner, because caseworkers are often not prepared by age, education, and experience to delve into an individual family's circumstances, engage families in a change process, get a full picture of the underlying issues and resources, reach appropriate conclusions about the meaning of the information gathered, and use this information in service planning and ongoing decision-making.
- Jurisdictions vary in the degree to which the child welfare staff members operate as case managers more than direct service providers. But in every case, the child welfare agency has the ultimate legal responsibility to decide who will be served, what the overall focus of intervention needs to be, and whether the whole family is getting the services they need and making the changes necessary to achieve the outcomes of safety, permanency, and child well-being.
What is Comprehensive Family Assessment?
Several kinds of assessments are conducted in child welfare, such as assessments of safety, risk and development. All serve distinct purposes and may be used at one or more points in the casework process, but they are not all comprehensive. For the purposes of these guidelines, “comprehensive” means that the assessment incorporates information Comprehensive Family Assessment Guidelines 5 collected through other assessments and addresses the broader needs of the child and family that are affecting a child's safety, permanency, and well-being—the “big picture”—not just a set of symptoms.
Different types of assessments are used in child welfare: assessments of safety, risk assessments, and special assessments of particular needs such as developmental assessments. A comprehensive family assessment incorporates information collected through other assessments— particularly safety and risk assessments.
Those conducting comprehensive family assessment need to consider the family's history and the passage of time—what led to the current problems as well as the likely impact of both the maltreatment and the response on the child and family. Comprehensive means moving beyond the “here and now.”
The purpose of a comprehensive family assessment is to develop a service plan or a strategy for intervention that addresses the major factors affecting a child's well-being, safety, and permanency over time. This plan should aim at helping the family get on the right track for improved functioning.
In short, a comprehensive family assessment involves recognizing patterns of parental behavior over time in the broad context of needs and strengths, rather than focusing only on the incident that brought the family to the attention of the child welfare agency.
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Need for the Guidelines
Gathering valid and useful information is critical for appropriate and adequate intervention with children, youth, and families who enter the child welfare system. If comprehensive family assessment is not undertaken as part of developing the service plan, we often miss the opportunity to develop interventions that contribute to lasting change. Moreover, comprehensive assessment helps us to prioritize what can change through interventions. ASFA (Adoption and Safe Families Act) timelines for intervention make the comprehensive assessment critical as the foundation for developing an effective plan with the family. An early and well-conducted comprehensive assessment increases the likelihood of matching services to the real needs and addressing the key issues within the limited timeframes prescribed by the law.
Most jurisdictions use safety and risks assessments to gather information to guide and structure initial decision-making, predict future harm, and develop service plans. It is not clear, however, how caseworkers gain a full understanding of family strengths, needs, and resources with just these assessments or how this information is incorporated into ongoing service planning and decision-making.
Overall performance on the Child and Family Services Reviews (CFSRs) in both outcome areas and systemic factors is closely connected to the process of comprehensive family assessment and service planning. Findings from the CFSRs indicate that most states are not in “substantial conformity” with the outcomes related to permanency and well-being. These findings are strongly affected by other findings that suggest there is limited understanding of what is keeping the family from achieving these outcomes.
All jurisdictions have some form of assessment, but the role of comprehensive family assessment as distinct from safety and risk assessments needs to be clear. Clarification is also needed as to how these various assessments support and complement one another. Frontline staff members are often confused regarding the various types of assessment, their purposes, and how they function together to promote successful intervention for families. Workers need more complete assessment information to help them focus on what should be done in visits with the family, child, and/or youth. Supervisors need this information to help frontline staff develop and implement meaningful service plans.
Regardless of the type of assessments in place, child welfare agencies need to know how to incorporate assessment findings into service planning and decision-making.
Guidelines for a comprehensive family assessment should describe what it is and how it is to be used, as well as how agencies can support this practice through policy, practice standards, training, clinical supervision, and accountability procedures.
These guidelines provide a framework that can be used by state child welfare agencies and tribal child welfare programs, as well as Children's Bureau Resource Centers, and the HHS regional offices as they work with state agencies on assessment issues. It is anticipated that the guidelines will support technical assistance to states and jurisdictions in conducting and using comprehensive family assessments.
The guidelines do not prescribe, or even recommend, a particular tool or instrument for comprehensive family assessment, although agencies should have a tool or guidelines for conducting assessments. These guidelines are mainly a resource:
- To help child welfare administrators re-examine their policies, data systems and service delivery strategies;
- For program managers and supervisors to assess and augment the ability of staff to conduct and use comprehensive family assessments; and
- To support federal training and technical assistance efforts.
Foundations of Quality Practice
The guidelines were developed based on these foundations of quality practice:
- The central importance of engagement and relationship-building for gathering meaningful information on family, children, and youth;
- The essential involvement of families and youth in identifying their own needs and strengths;
- The need to assess the cultural, ethnic, linguistic, and other individual factors influencing the perception of family and youth needs and the caseworker's willingness to discuss these factors;
- The recognition of the significance of the “stages of change” on the family's and youth's capacity and willingness to identify their needs and in their motivation to change; and
- The benefits of identifying and including extended family and other family support resources as well as other service providers who know the family in the process of assessing needs and strengths.