Comprehensive family assessment as a prerequisite of individualized planning, monitoring and evaluation of family-visitation program in Croatia

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Comprehensive family assessment as a prerequisite
of individualized planning, monitoring and
evaluation of family-visitation program in
Croatia Professor Marina Ajdukovic, Ph.D,
psychologistProfessor Antonia Žižak, Ph.D,
special educator University of
Zagreband UNICEF Croatia
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Background Deinstitution
alization of public care for children is among
the most important priorities in Croatia in the
area of social care for children.  Among the
total of 3.148 children in alternative care due
to insufficient parental care 54,5 are placed in
foster families and 46,5 live in children
homes. Goal 80 of children in alternative
care placed in foster families.
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Paths of deinstitutionalization of the
out-of-home care for
children Efficient early ?
Deinstitutionalization ? Good quality
fostering in interventions families
  ?  Work with parents while child is in
out-of-home care  
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Early interventions in families The
Family Law provides two measures for the
protection of the rights and well-being of the
child(1) Warning the parents about
shortcomings in their care for and upbringing of
a child and helping them to remedy the
shortcomings through counseling and parent
training (2) Monitoring and supervision of
parental care through home visitation in cases
when shortcomings in care for the child are
multiple and frequent or when the parents need
particular care in the upbringing of the child.
The centre for social work determine the
monitoring/supervision program for the child and
the parents, and appoints the person who will
carry out this program (family supervisor).
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Monitoring/supervision of parental care through
home visitationOverview

• Number of cases of monitoring/supervision of
  parental care in the period of last five years
  was between 2.344 and 2.261.
• Family supervisors (N81) reported that greatest
  obstacles in implementation of monitoring/supervis
  ion program were
• lack of cooperation by parents and their poor
  motivation for change (23)
• resistance to the measure (21)
• lack of insight into own problems and behaviors
  (13)
• breech of agreements (11).

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Monitoring/supervision of parental care through
home visitationObstacles

• Standardized procedures and instruments are not
  used for needs assessment
• Monitoring/supervision programs are typically
  too general, not individualized nor developed
  based on the good assessment they are directed
  primarily to risks and failures without review of
  parents' strengths
• Programs are made without participation and
  cooperation of the parents
• The change is/was needed

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Project cooperating institutions

• Ministry of Health and Social Welfare
•  
• Department of Social Work, Faculty of Law
•  
• UNICEF Croatia project implementing agency

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Framework of project values

• Every child has the right that his/her family
  gets high quality, focused, multidimensional and
  timely assistance, in order to avoid placement in
  alternative care.
• If the child has to be placed in alternative
  care for her/his best interests, to provide
  adequate assistance for strengthening parental
  capacities and to provide adequate circumstances
  for return of the child into the family.

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Project goals

• Develop criteria for assessing and monitoring
  competencies and potential for change of parents
  whose children are at risk to be taken out of the
  family and for parents whose children are already
  placed in alternative care.
• Advance the concept (contents) and
  implementation (methods) of monitoring/supervision
  of parental care.
• Expand the range of early interventions for
  families under risk for placing children into
  alternative care, such as day care for children,
  group work with parents, one-time workshops with
  parents, modeling of parental behaviors, etc.

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Project dimensions

• Action project direct work with families and
  children under risk for placement in public care
  and families where the children have already been
  taken out of families.
• Developmental project development of a model
  of more effective work in the area of early
  and/or targeted interventions with families with
  children at risk.
• Community project working towards development
  of a local community as a context for social
  interventions with families at risk, including
  development of a local team of professionals

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Project implementation

• The project was carried out in four centres for
  social work during 12 months through
• First three-day educational seminar followed
  by
• Practical assignments related to the content of
  the training
• Two supervision sessions
• Second two-day educational seminar followed by
• Practical assignments related to the content of
  the training
• Three supervision sessions
• Third two-day educational seminar followed by
• Practical assignments related to the content of
  the training
• Three supervision sessions
• One-day consultation with the project team
•  External evaluation

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New professional concepts

•   Concept of early interventions for family at
  risk for child/children separation
• Comprehensive family assessment
• Family empowerment and collaborative approach

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Expected outcomes

• Guidelines for comprehensive family assessment,
  including child risk assessment
• Development of a set of assessment tools
• Guidelines for planning and carrying out
  family-visitation program based on
• Comprehensive family assessment
• Development of individualized program of change
  
• Criteria for monitoring and evaluation
• ?Skilled professionals providing better quality
  services for families in need

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Comprehensive family assessment (1)

• Comprehensive family assessment (CFA) is the
  process of identifying, gathering, and assessing
  the importance of information to understand the
  significant factors affecting the child's safety,
  permanency planning, and well-being, the parental
  protective capacities, and family availability to
  assure the safety and well-being of their
  children.
•  
• The purpose of CFA 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.

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Comprehensive family assessment (2)

• Begins with the first contact with a family and
  continues until the "case" is closed
• Must be completed in partnership with families,
  children and youth and in collaboration with
  other community partners the staff must be
  trained to engage family in that work
• Must identify individual and family strengths
  and protective factors
• Is a process and has to be updated whenever
  major changes in family circumstances occur and
  at the points of key decision-making on a case.

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Areas of assessment - Parents

• Background and history of the parents or
  caregivers including history of abuse and neglect
• Problems in accessing basic necessities such as
  employment, housing, income, child care
• Ability to recognize problems and accept
  responsibility, motivation for change
• Patterns of social interactions, including the
  characteristics of social support networks
• Parenting practices (understanding of child
  development and/or emotional needs of children,
  methods of disciplining and supervising children)
• Behaviors/conditions associated with domestic
  violence, mental illness, physical health,
  disabilities, alcohol and drug abuse.

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Areas of assessment Children

• Information relevant for assessment of child
  safety and well-being.
• Depending on specific context information can be
  related to
• Health
• Intellectual and cognitive functioning
• Academic achievements
• Emotional and social functioning
• Attachment patterns
• Vulnerability/ability to communicate and
  protect themselves
• Developmental needs.

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List of assessment tools

• 16 assessment tools identified as a part of CFA
  guidelines
• Three of them are locally developed and other
  were translated international instruments
• The assessment tools cover broader spectrum -
  from assessment for family stress, parental
  stress, risk for child abuse, family strengths,
  level of meeting child's needs, attachment
  patterns family embeddedness in community, etc.
• Important!!!
• When using instruments the risk of "social
  technology" should be avoided.

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Internal evaluation (1)

• The project had positive effects on increase of
  professional competency of participants, their
  understanding of family in crisis improved, and
  they started to involve parents as collaborative
  partners more often.
• Most important changes in their practice
• Use of comprehensive family assessment
• Collaborative work with parents as active
  participants in all phases from needs assessment
  to evaluation of each activity
• Development of plans according jointly defined
  priorities
• Use of concrete short term action plans
•  

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Internal evaluation (2)

• 95,2 of the trainees were very satisfied with
  having participated in the project and suggest
  dissemination of the project outcomes to the
  whole professional community.