Family assessment chpt 5 without questions

Assessment Aims

• Process of Collecting Data– Determine family system functioning– Assess strengths– Analyze area for change– Collaborate in decision making with families

Your Preparation

• Requires reflection on the family as a system&

• Knowledge of family systems

Evidence based Practice

• Assessment is guided by evidence based practice– Individualized assessment (strengths, needs,

values, preferences of client)– Well-formulated question (database query)– Well-executed search of research literature– Deciding its applicability to clients – Considering the evidence together with the values

and preferences of the client.(Sackett et al., 1997; Gibbs, 2003)

During the Assessment

• Practitioner elicits information about– Family structure– Organization– Transactional Patterns

Transactional Pattern

• As defined by Minuchin (1974), “family structure is the invisible set of functional demands that organizes the ways in which family members interact.

• A family is a system that operates through transactional patterns. Repeated transactions establish patterns of how, when, and with whom to relate, and these patterns underpin the system.”

• For example, a mother tells her child to pick up his socks and he obeys. This interaction defines who she is in relation to him and who he is in relation to her. Repeated interactions constitute a transactional pattern. (H. Charles Fishman, M. D,. 2011)

Emphasis

• 0n Current Problems• Including the Presenting Problem

Assessment Approaches

• Interviews are the most common but least systematic

• Use of Formal Tools and Instruments are more efficient, but have the drawback of being less personal

• Select methods you and family are most comfortable with

Standardized Approaches

• More Accurate• Grounded in Research• Used in combination with non-standardized

tools

4 Tools

• The Family Interview• Mapping and Graphing Tools• Teaching, Observation and Role Play

Tools• Self Report Tools

Family Interview

• Primary Task– Observe family interactions• Which will reveal family patterns• Along with the systems strengths and negative patterns

• To be successful you must– Communicate clearly– And possess the ability to understand the ability of

family members

Interview Impacted By:

• Practitioner and Family Characteristics– Physical, Cognitive and Effective Factors

• Message Components– Language, non-verbal cues, sensory cues

• Interview Environment or Climate– Physical, Social, Temporal or Psychological

Environmental Factors

• Be aware of surroundings

Listening

• Listening skills lead to informed impressions– Do not become preoccupied with what you will

say next– Ebb and flow will modify your impressions as the

interview progresses– Do not jump to conclusions

Listen to Yourself

• Be attuned to your own – Thoughts – Feelings– Actions– Biases

– Read about Confirmation Bias and think about it’s relation to assessment.

Body Language• Body language conveys meaning– Supportive and accepting body language will put

everyone at ease– Be aware of what you convey with your body

language

Observe Family Language and Behavior

• Observe words and behavior of each family member throughout– Pay attention to what is going on• Verbal language• Non-verbal language• Responses of family members to each other • Listen to inflection, tone speech

Stop and Read this Short Article

• Family Assessment Model - Short Article

Mapping and Graphic Tools

• Genogram – pictorial chart of people involved in a 3-genrational relationship system

• Ecomap – shows the interactions outside the family environment

• Social Network Map – Capture family behavior in the context of it’s social network

The Genogram

• Draw 3 Generations• Idea is to gain a picture of the family for the

family, so they are the creators, and the practitioner acts as the recorder

• Example of drawing one using a simple paint program: http://www.screencast.com/t/UxBJcs2B

Ecomap

• Depicts systems which the family interacts with

• Indicates where changes may be needed in the environment systems to provide improved interactions and support

Ecomap

• Practitioner can see– Supportive relationships exist– Deficiencies and areas of conflict exist

• Are there– Missing connections that need changing?– Is social isolation a problem

• Can indicate the flow of resources between family and others

Ecomap

• Ecomap Video

Social Network Map

• Social networks are patterns depicting personal relationships that sustain each individual– Help us cope with the usual demands of daily

living and stressful situations

Social Network Mapping

• Draw a map or a grid• For each member of the family describe

1. The kind of support provided1. Emotional, concrete or informational

2. The degree to which the support is critical3. The direction of the help provided4. The degree of perceived closeness5. Frequency of contact and length of relationship

Self Report Tools

• You are attempting to measure and issue or problem and whether it changes over time

• 2 types– Standardized self report• Example – Click here

– Pragmatic self report