Social Work Practice with Individuals and Families

Evidence-Informed Assessments and Interventions

Michael J. Holosko, Catherine N. Dulmus, Karen M. Sowers

• Publisher: Wiley
• Year: 2012
• ISBN:
  9781118420911
• Edition: 1
• Topic: Politik & Internationale Beziehungen
• Subtopic: Sozialpolitik

A lifespan approach presenting evidence-informed interventions for working with individuals and families

Social Work Practice with Individuals and Families covers assessment of and intervention with children, adolescents, adults, the elderly, and families. It offers an array of pedagogical features within each chapter, as well as online resources and review questions at the conclusion of each chapter to help guide critical thinking about topics.

Reflecting the current state of evidence-informed social work practice, each chapter's contributors emphasize the incorporation of wider forms of systematically collected data such as case studies, best or promising practices, and consumer-focused data. Reading this book will not only give readers the tools to work effectively with individuals and families, but also develop their skills in evidence informed practice.

Comprehensive and insightful, Social Work Practice with Individuals and Families is a student- and practitioner-friendly text identifying the best assessment tools and strategies available for social workers to successfully serve individuals and families facing a broad range of challenges.

Chapter 1

Assessment of Children

Michael E. Woolley

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Purpose: This chapter details and discusses the historical evolution and current trends in social work in the systematic, ecological, and evidenced-informed assessment of children. It includes the myriad struggles impacting children and the broad range of settings in which social workers serve children and their families.

Rationale: Whether in schools, child protective services, juvenile justice, family or community centers, mental-health agencies, or hospitals, social workers assume many roles in providing services for children. A critical part of providing effective services is a comprehensive assessment informed by social work values, ethics, interfacing with our evolving professional orientation, knowledge, skills, and tools.

How evidence-informed practice is presented: One current trend is the increasing use of quantitative survey instruments in child assessment, and there is an increasing number of such assessment tools being developed by social work researchers. A second trend is the increasingly widespread need for the evaluation of the effects of interventions. In order to offer such evaluations, valid and reliable assessment tools are needed that can show changes in the assessed struggles and targeted outcomes of those interventions.

Overarching questions: Within specific social work practice settings serving children, in order to complete an ecologically oriented and comprehensive assessment of a child and family, what information would be needed, from whom should that information be gathered, and by what means or methods should that information be collected?

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Social workers are vital members of teams delivering services to children across a variety of settings, including, but not limited to, child welfare agencies, family service organizations, schools, health-care providers, and mental-health settings. The struggles and challenges faced by children served by those social workers covers a broad spectrum from day-to-day struggles to life-altering trauma. In all those settings and struggles, beginning the social work intervention process with a systematic and comprehensive effort to gather information about the child, the social contexts of the child, and the presenting struggle or challenge is a critical first step to providing professional, appropriate, and effective services to children who have been impacted by issues ranging from sexual abuse or mental illness to brain tumors or learning disabilities.

Social work has been increasingly called on, from both outside and inside the profession, to demonstrate the effectiveness of its practices. This scrutiny provides the impetus to engage in research to develop evidence-based practice (EBP) strategies and approaches (Gambrill, 1999). The needs for quality assessment tools and strategies as a fundamental task within that effort are twofold. First, all practice activities should start with and be informed by an assessment process. Second, gathering evidence as to the effectiveness of an intervention requires assessing the target of that intervention before and after that intervention is delivered; therefore, reliable and valid assessment measures are a fundamental tool in the pursuit of evidence to support practice.

This chapter first defines what is involved in performing a systematic and comprehensive social work child-assessment process. The accumulated social work practice knowledge in the area of child assessment emerging across the first 100 years of professional social work is discussed. We then outline the current prevailing framework used to gather, organize, and present assessment information about children. More recent developments in the assessment of children are then added to that framework—for example, the necessity of gathering information from multiple informants and using multiple information-gathering tools when assessing children. Within that evolving assessment framework, a growing effort in social work (and other helping professions) is to strive to utilize evidence-based strategies and tools in practice. What is meant by evidence-based practice and how that effort can inform the most effective and efficient assessment of children is explored. The limitations to the evidence in support of our current assessment strategies with children, as well as promising ways to reduce those limitations, are detailed. Finally, current trends and developments in the assessment of children in social work practice settings, including child protection, schools, and mental health, are presented.

Defining Assessment

Assessment is used to describe an assortment of activities and processes in the social sciences and human services that involve gathering information about a client(s) and the presenting circumstances leading to an evaluation, determination, or plan of action focused on that client or client system. In social work practice, some aspects of assessment are driven by the practice setting, the population being served, and the practice model being applied by the social worker. However, this chapter offers a framework for social work assessment with children that, although embedded within the evolution of the social work perspective and the current effort to situate social work practice on an evidence base, can be applied by any direct practitioner regardless of setting, population, practice level, or model. In this chapter, a descriptive and evolving definition of assessment in the context of providing social work services to children is offered. As a starting framework, assessment in social work with children is defined as including three key components: (1) collecting data, (2) being informed by a contextual perspective, (3) leading to a prevention or intervention plan.

Data Collection

First, assessment of children is, in large part, defined by a range of activities used to gather information about a child, a struggle or challenge confronting that child, and relevant information about that child's social environments. Those activities can include but are not limited to (a) clinical interviews, (b) structured interviews, (c) self-report instruments, (d) direct observations, and (e) reviews of existing records. Those data-collection activities may elicit information from multiple informants, including the child, parents/guardians, other family members, key individuals in the child's life, and professionals who have direct experience with the child.

Contextual Perspective

The second component is illustrated by an enlightening distinction about assessment in social work practice made by Clifford (1998). He referred to “social assessment,” as opposed to psychological or medical assessment, in that social assessment “is centered on a social explanation—and will draw on social research and social science concepts” in identifying the service needs of an individual, small group, or community. Although social workers clearly also draw on and are informed by psychological and medical aspects of and explanations for client struggles, Clifford's focus on the social aspects of the client and his or her struggles distinguishes assessment in social work from assessment in other disciplines. This focus on contextual factors in social work can be seen in many assessment orientations in social work, such as the person-in-environment perspective, psychosocial models, the widespread use of ecological-systems thinking, and the pervasive structuring of assessment information into a biopsychosocial assessment document.

Prevention or Intervention Planning

Third, child assessment in social work is also defined as having as the central goal in gathering that information to inform the development of a social work prevention or intervention plan to help that child or group of children. Although systematic information about a child and his or her social environments may be gathered for other reasons—such as part of a research endeavor or eligibility evaluation—unless the ultimate goal is a formulation leading to the implementation of a social work service plan, the gathering of that information does not constitute an assessment as it is referred to in this chapter.

Thus, a social work assessment of a child includes (a) data collection, defined as a systematic gathering of information about the child, a struggle or challenge facing that child, and that child's multiple social environments; (b) data pursued from a contextual perspective oriented to how the child's social environments influence the child, the struggle or challenge, and efforts to resolve that struggle or challenge; and (c) development of an intervention plan to assist that child with that struggle or challenge as the primary goal of that data-collection effort.

The application of systemic and comprehensive assessment strategies has become more important given profession-wide efforts to build an evidence-based approach to social work services (Gambrill, 1999). Because service-delivery activities start with and are built on the assessment process, reliable and valid assessment strategies and tools are fundamental to identifying, developing, evaluating, and providing evidence-based interventions. For example, reliable and valid assessments provide a vehicle to evaluate interventions, thereby establishing evidence as to when and with whom such interventions can be effective. Further, the application of interventions with already established bodies of evidence as to their effectiveness should only be utilized after the application of systematic, comprehensive, reliable, and valid assessment strategies and tools to inform the selection of interventions appropriate for a specific child in a specific situation. Additionally, the results of a systematic assessment should influence the provision of the interventions chosen, thereby following long-established social work practice principles, such as starting where the client is, treating each client as an individual, and providing individualized services (Hepworth, Rooney, & Larsen, 2002; Pilsecker, 1994).

The wide variety of settings in which social workers serve children, the larger array of struggles and challenges faced by those children, and the wide range of what and who social workers are actually assessing—for example, the child, a potential home placement, the risk of a caregiver to abuse or neglect, the appropriateness of a classroom setting—all make a truly comprehensive discussion of assessment of children in social work seem daunting. Therefore, one goal of this chapter is to set the current state of assessment of children in social work in a historical context that encompasses our collective professional knowledge informing the assessment of children as a framework on which to add recent advancements.

Historical Background

Mary Richmond, in her seminal book Social Diagnosis (1917), presents the first comprehensive treatise on the assessment process in social work. Although she uses the term diagnosis, which, for most social workers today means something quite different than assessment, what she is referring to as a social diagnosis 90 years ago meets the three criteria for social work assessment offered here. In fact, for those who have not read all or even parts of her book, it is truly worth the time, and you may find it contains surprisingly still-relevant insights on assessment, social casework, and prescient glimpses of things to come. For example, Richmond describes her preparation to write Social Diagnosis as including systematically reviewing social work case records and recording interviews with caseworkers across five different sites over the course of a year “to bring to light the best social work practice that could be found” (p. 7). Is that not a...