Comprehensive Family Assessments in Complex Child

Welfare CasesKathleen Coulborn Faller, Ph.D., A.C.S.W., D.C.S.W.

Marion Elizabeth Blue Professor of Children and Families School of Social Work

Director, Family Assessment ClinicUniversity of Michigan

Federal Guidelines & Observations

• From the Child Welfare Information Gateway– “Assessment forms the foundation for

effective practice with children and families.”• From the Child and Family Services

Reviews• “agency risk and safety assessments are often not

sufficiently comprehensive to capture underlying family issues that may contribute to maltreatment.”

Too often in child welfare

• Interventions are undertaken without an initial assessment.

• Interventions are “cookie cutter”—counseling, parenting classes, anger management, & substance abuse treatment.

• Interventions place unrealistic burdens on fragile families.

Comprehensive Family Assessments• Comprehensive family assessments should be used

judiciously.– They are costly and time-consuming (2 months minimum).– They are intrusive.– Professionals should weigh the costs and benefits.

• Comprehensive family assessments should be family-focused and child-friendly.

• Ideally comprehensive family assessments should involve a team of professionals from differing disciplines.

• Should assess multiple domains of child and caretaker functioning.

• Should integrate current functioning and past history.

We only know the tip of the Iceberg

Cases for which comprehensive family assessments may be appropriate

• Cases for which the initial intervention is not successful.• Cases with competing findings.• Cases with repeated reports but no satisfactory

disposition.• Cases with lengthy involvement with the Child Welfare

System.– Should parental rights be terminated?– What kind of plans should be made for children?

• Cases involving multiple types of child maltreatment and other problems.

Goals• The goal is to assess children and their

families historically (over time) and at a particular point in time.

• The goal is to address specific questions posed by the referring professional/agency.

• Often the goal is to obtain consensus among agencies about a plan for children/families.

Comprehensive Family Assessment Process

• Conduct a telephone intake with the referring professional that focuses on issues and questions to be addressed.

• Gather and review background information.– CPS reports, other child welfare records, school records, past

treatment reports, etc.• Interview all children.

– Children in our program receive at least 2 interviews.– Give children more than one chance to talk.

• Caretakers need to be interviewed.– This is a chance for them to tell their story.– Caretakers are interviewed for 2+ hours.– Caretakers may be afraid to tell, too.– Interviewer obtains permission to call the adult with follow-up

questions.

Comprehensive Family Assessment Process

• Psychological testing is conducted separately from the interview.– There is no magic in psychological testing.– Tests must be appropriate to the problems being

assessed.– Testing must be contextualized.

• CBCL, CSBI, & TSCYC or TSC completed on each child.• Parent-child & family interactions as indicated.• Medical exams and consultations as indicated.• Access medical specialties as indicated.

• Educational consultations as indicated.• Collateral contacts add important perspectives with

caretaker’s permission & by phone.– Professionals.– Non-professionals.

• Substance abuse assessment as indicated.– Random drug screens, but they are not a panacea.

• Domestic violence screening as indicated.• Psychiatric consultations as indicated (medication

review and psychiatric diagnosis).

Comprehensive Family Assessment Process

A Team Meeting after data-gathering is complete

• Invite relevant people.• Bring all the information to address

questions relevant to child safety, permanency, and well-being.

• Make specific and feasible recommendations.

• These meetings last about 3 hours.• Produce written reports.

Follow-up

• Meet with family to share summary of findings.

• Testify in court.• Conduct a 6 month follow-up.

Resources• Comprehensive Family Assessment Guidelines

for Child Welfare• http://www.acf.hhs.gov/sites/default/files/cb/famil

y_assessment.pdf• Children’s Bureau website on CFA

https://www.childwelfare.gov/management/funding/funding_sources/familyassessment.cfm

• Faller, K.C., Ortega, M.B., & Pomeranz, E. (2008). Can Early Assessment Make a Difference in Child Protection? Results from a Pilot Study. Journal of Public Child Welfare, 2(1), 71-90.