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Gathering information about a young person's family background and the state of their current relationships with immediate and extended family members will help you to understand their story and will assist you in helping them to build a positive support network. Explain to your client that talking about their family history and relationships will help the two of you to address past family issues that may be impacting on them and focus on building a positive support network for the future.
An effective assessment of a young person's circumstances, problems, needs, strengths and capacities usually takes some time and may take three or four interviews to complete. The following assessment tools and methods are suggested to assist you to implement a family aware practice approach in your work and would normally be used during the course of a number of interviews over the first few weeks of contact. |
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Always clarify your role during the assessment process and be clear about what services you can offer. |
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When completing an assessment it is important to focus on family strengths and coping capacities, in addition to identifying problems and deficits in relationships. |
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Be sensitive to and respectful of the different experiences of culturally and linguistically diverse families. |
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Genograms and ecomaps are useful tools to assist assessment of family relationships and support networks |
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Assessing complex needs can be complicated. Seek a second opinion if necessary. |
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If a young person is at serious risk, take preventative action.
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When meeting with the young person for the first time, it is important to establish the boundaries and limitations of confidentiality and consent as outlined in the Worker sheet: Confidentiality and Duty of Care Issues. This is so both of you are clear about these matters right from the outset.
It is also important in the first meeting that you clarify what your role is at your agency and any limitations on your role and on the services that your agency can provide. Young people should leave the first interview with a clear understanding of what services you can realistically offer them.
Explain from the outset whether it is within the scope of your role at your agency to work with the families of your clients and why you think that it is sometimes helpful to have contact with family members.
In later interviews when you and your client have had an opportunity to discuss whether contact with immediate or extended family members would be helpful, clarify with them the type and level of contact that you are proposing and your skills in family work. Let them know whether you have professional training in family counselling and you feel that you may be able to work with the young person and their family to help them address unresolved relationship issues that may still be impacting on the young person. Or whether you simply want to speak with significant family members to explore their knowledge and understanding of the young person's situation and assess whether they are able to offer the young person support and assistance in the future if this is appropriate.
Sometimes when working with young people with complex needs, relationships with the young person's immediate family have broken down. Family members may not feel they can offer the young person support at the present time or family contact may be inappropriate. In these cases explore whether there are extended family members or significant others (such as family friends, teachers, coaches, mentors, parents of a close friend) who may be able to be a positive role model in the young person's life and provide them with consistent support.
Try not to be judgmental when family relationships break down. It is easy to blame parents for a young person's difficulties but it is important to look more broadly at the family situation. Consider the structural factors that may be impacting on the family's life. Families that are experiencing poverty, unemployment and homelessness, are usually under extreme stress. Other factors may also be impacting on a family's ability to function well such as mental illness, physical disability or substance abuse. It is important to identify all the factors that may be contributing to a breakdown in family relationships.
Do not just focus on family problems and deficits. It is important to recognize that all families have strengths and capacities and to try and identify these in your assessment. Ask questions about the young person's positive experiences in their family and whether there are particular family relationships that they value and cherish.
Sometimes it may be difficult to identify family strengths but even in situations where family relationships have broken down, the family's strength may lie in the fact that they have been able to identify their limited ability to provide support at this time and that 'time out' is needed.
Explore with your clients the impact of their cultural or religious background on their family life and on them as individuals. If you are working with young people from culturally and linguistically diverse families don't make assumptions about the young person's background based on cultural stereotypes. Explore with the young person their family values and traditions. Acknowledge the complexities migrant and refugee families face settling into a new country and different cultural environment. Young people in culturally and linguistically diverse families often struggle with strong expectations from family members to maintain their cultural values, whilst trying to fit into mainstream Australian culture (see Centre for Multicultural Youth website).
In completing your assessment consider asking the young person: Did your family have any cultural or religious traditions? What cultural influences or religious traditions enhanced your family life? Were there any cultural or religious differences that made it difficult for you or your family?
Caring for a young person with complex needs is demanding and stressful - young people and their families need information, advice and support to find better ways to cope and to explore their potential. Some families have struggled for years to cope with a young person's behaviour. Getting a clear diagnosis of a young person's problems can sometimes be difficult - different professionals say different things. A young person with a personality disorder or a dual diagnosis can be challenging to diagnose and treat. Sometimes families might need assistance to ascertain the best clinical services available so that questions they have been asking for many years about a young person's disposition can finally be answered.
Don't be afraid to ask for a second opinion if required. For example, if you are unsure whether a young person has a personality disorder, a borderline intellectual disability or bipolar disorder, consult with a psychologist of psychiatrist who has expertise in working with adolescents. If necessary discuss with the young person, the benefit of having another professional undertake an assessment with them to provide you both with further information that will help you to set in place a realistic case management plan.
Young people with a dual diagnosis of mental illness and substance abuse are frequently turned away from services where staff do not feel they are adequately trained to deal with both issues. Family members may be at their 'wit's end' trying to get help for a young person who does not fit easily into one service system - whether that be the mental health system, the drug treatment system or the disability system. It is important to support the family by acknowledging their frustrations and the complexity of the situation they are experiencing. Try not to exacerbate the situation by turning them away from your service as well. At the very minimum provide appropriate referrals and follow up on the outcome.
If in the course of your assessment you feel that the young person you are interviewing may be at serious risk, it is imperative that you take preventative action. It is easy to become desensitized or blasé when you have been working with young people with complex needs for some time due to the chaotic nature of the lives that many young people lead who are involved in the welfare system. Nonetheless you have a duty of care to respond to risk situations. Remember it is better to be cautious, than sorry.
For concerns that are life-threatening call the police. For concerns about the immediate safety of a child ring the Child Protection service in your state. For contact details of your local regional child protection service in Victoria see the following website: office-for-children.vic.gov.au. The After Hours Child Protection Crisis Line is 131 278. If a young person is suicidal call the Crisis Assessment Team at the nearest hospital for advice or intervention.
The following questions may help you to explore the young person's family background and family dynamics:
- Who is important to you in your life? Why are these particular people important?
- Who provides the most support in your life?
- How have members of your family reacted to the problems that you are currently experiencing?
- Are members of your extended family aware of what you have been experiencing?
- What was it like growing up in your family?
- Perhaps you could talk about some of the memories, both good and not so good.
- What is it like for you right now - living in your family?
- How do you think your family might describe you? What qualities or strengths might they say you have?
- Are there members of your extended family that you feel close to or feel that you have something in common with?
- Did you feel safe in your family?
- How does your family handle disagreements?
- Is it okay to express your emotions in your family? To feel happy, sad, frustrated, angry, content etc?
- Tell me about your different family members and the ways in which they express their emotions.
- Were there times when you were worried about any of your family members? Why were you worried? How were these concerns handled?
- What qualities do you bring to your family that are special or unique?
- Were there any special activities that you did together?
- Did your family mix with other families?
- What other information would you like me to know about your family that will be helpful during our time together?
The genogram is a useful tool that is used widely in family therapy but it can be adapted for use with individual young people. The genogram provides a visual representation of three to four generations. Clients are encouraged to identify whether relationships in the family have been close, conflictual or distant. The genogram can help young people to identify patterns or themes within their families that may be influencing their behaviour (see: Simple Guide to Genograms).
An eco-map is another assessment tool that is particularly useful in work with young people with complex needs. It is a visual representation of current family relationships and also community and social networks. Clients are encouraged to identify whether their relationships with their peers, school, social clubs, professionals are strong, weak or stressful (see: Queensland Government Interview Resource - Ecomap).
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