Family assessment chpt 5 without questions


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  • Understand where the family is now (at the present moment)Notice the goal is to assess strengths – emphasize this pointAlso we look for where change is neededIt is a collaborative process, we work with the family (this is true across human services in general – we are always working with the client-family etc.
  • This idea goes back to a great deal of what we are learning in the class, the family is a system, not a collection of individuals, stop and think about the difference between a system and a collection of individuals – Do you understand the difference, if not you should stop this lecture and do your own research to answer this question for yourselfOnce you know what the difference is then you will need to draw on your knowledge of this system – how it works, what makes it work. This is a knowledge starting point for you.
  • I have talked a great deal about evidence based practice and I have challenged you to understand the importance of making sure your statements are evidence based.In assessment this means understanding how to gather information (in an organized way), knowing what types of assessment techniques are valid, understanding what the research literature tells about intervention techniques, matching up the right technique for the right problem. In other words you do not take medicine to lower your blood pressure if the assessment says you have high blood sugar. We know from research and evidence that this will not work. It is no different in looking at assessment and intervention in the helping professions.
  • This is what you are trying to understand in the assessment process – Ask yourself why Why am I looking at family structure?Why am I looking at the organization of the family? , etc.Well when there is a problem in the family is supported by these structures and patterns. Patterns have a way of persisting and you need to understand what the patterns are, and in essence how they reinforce one another so we look at these “things”In order to do this you really need to work and see the family as a whole, all the members of the household – if not then you are oftentimes missing the perspective that this person brings and in missing this perspective you can get a “tainted view of the org, structure and transactional pattern”
  • Transactional patterns- I am want to make sure everyone understands this idea, because it is important and can be missed.The slide talks about the idea that a family system operates through these patterns, the patterns establish how the family operates and functions, who is responsible for what, who owns certain roles, who and what the “power structure is in the system”. Who people are in the family system and the role they play. Stop for minute and think about this as you relate it to your own life – note that these transactions as they are referred to here are not isolated interactions, but patterns which reoccur and provide definition within a system.
  • What are you trying to get at, we are being and looking at this from a pragmatic perspective – current problems – these are the current manifestation of what is going on, and then the presenting problem, what got this system here looking for help.
  • Lets look at assessment approaches – in other how do we figure out what we need to know and how do we figure out what the family needs to know in order to develop a plan to function in a more productive manner.Interviews are a basic method , but it is perhaps the most opened ended and least structured of methods in that you are asking questions, and soliciting information, outside of a structured tool.There are formal tools, that we will look at- that are more focused and have a specific purpose, in other words a specific set of things they are gathering information about but these may feel less personal.
  • These standardized approaches have the benefit of being more accurate because they are designed to cover all aspects of a given area, and they have typically been looked at in the research literature as providing information that is valid and reliable. No one approach is an end all and be all – that is important to remember – there is no magic bullet, you still have to understand what the information is telling you and it still makes sense to often times combine what you do -
  • We will look at four tools
  • So the interview - you function as an observer, so it is not just what is being said, but you must watch how things are being said, you must in a sense read between the lines and look at the patterns you see emerging – so how are answers given, how do people talk to and about one another, who seems to have the power in the system, how is decision making done, what is not getting said – there are lots of dynamics to observe – remember this is a system, not a collection of individuals. Also within the frame of the interview you will see strengths things that allow the family to be successful and there are also negative patterns that you see.Not stop for a minute and think about this – think about your own family – every family has patterns, every family has strengths and negative patterns – stop and think about how you might see these in your own family, and what it might look like if your family was being interviewed – think of this as a “Thought Experiment” picture your family being in an interview and what might emerge.
  • OK – Physical, Cognitive and Family Characteristics – this talks about the everything from the families ability to actually be present, their ability to communicate and explain information, the emotional mood that is created in the interviewPay close attention to non-verbal’s this is important as we have learned in the previous learning plan – etc.
  • Environment – sets a tone – always best to see a family in their own environment it can give you information about the family – always try to set up a comfortable and trusting environment, that makes people feel safe
  • Remember from your interviewing class what you learned about listening skills – listening is a skill and you want to use what you have learnedMaintain eye contact Focus on content, not delivery.Avoid emotional involvement. When you are too emotionally involved in listening, you tend to hear what you want to hear--not what is actually being said. Try to remain objective and open-minded.Avoid distractions. Don't let your mind wander or be distracted Treat listening as a challenging mental task. Listening is not a passive act--at least it shouldn't be. You need to concentrate on what is said so that you can process the information Stay active by asking mental questions. Active listening keeps you on your toes.Use the gap between the rate of speech and your rate of thought. You can think faster than the family can talk to you.That's one reason your mind may tend to wander. All the above suggestions will help you keep your mind occupied and focused on what being said.
  • This is about how you are processing the information – We have spent an great deal of time examining our own biases, our own perspective – understand where you are coming from and make sure you neutralize these issues so you can be objective and get what you need from the interview and not confirm your own preconceived notions.Talk about the notion of confirmation biasConfirmation bias is a phenomenon wherein decision makers have been shown to actively seek out and assign more weight to evidence that confirms their hypothesis, and ignore or under weigh evidence that could disconfirm their hypothesis.As such, it can be thought of as a form of selection bias in collecting evidence.
  • Again think about non-verbal communication as a whole and be aware of what you are saying, with your posture and body language. Complete this little research project as you go through the day. As you interact with people, be aware of what they are saying with their bodies – how do you interpet these messages, are the congruent with the verbal communication, are they impacting communication more than what is being said – what do you think.
  • Review these three tools -
  • This is a graphical or pictorial representation of three generations of family. It helps you see the family or this segment of the family in a way that is different than the family is used to looking at itself. It takes advantage of the fact that when we perceive things using different sense we may see and understand relationships or processes or behavior differently. Note there is a short video that outlines what this looks like -
  • Here we are looking at social networks that the family interacts with, so this is not about the family interacting with each other but other social systems, work, religious organizations, community agencies, etc.It looks at our attitudes and the type of relationship we have – strength, stressor, conflictual –etc.
  • These are the types of things we are looking at.
  • This looks at our social support network. It can be seen when we need help where do we get it form, when we need support, where to we get it from, who comes to us when they need help, Nobody lives in isolated existence, everyone needs support – here we are looking at where we get it and where we give and the strength of those networks.
  • Standardized self reporting tools include questionaries‘ – You can click to an example of one such toolPragmatic self report – rely on family self statement – So think journal – logs. When I am asking you to write reflectively in class, which you have doen over the past couple of LP’s I am actually engaging you in a pragmatic self report.Now these types of assessments are more prone to bias as they are in a sense unfiltered information about ones perspective, but they can give us good or important qualitative information about family functioningAn example of qualitative is:Here is her example of qualitative data.Have you felt sad or depressed at all lately, or have you generally been in good spirits? (Subject 1) Well, I’ve been in pretty rough shape lately, to tell you the truth. I mean, I haven’t felt suicidal or anything like that, but I just can’t seem to shake the blues. I just don’t see anything to feel hopeful about in my future. I haven’t really had anybody to talk to about my problems since my husband died last year. it provides context and the person perception of what is happening
  • Family assessment chpt 5 without questions

    1. 1. Assessment Aims<br />Process of Collecting Data<br />Determine family system functioning<br />Assess strengths<br />Analyze area for change<br />Collaborate in decision making with families<br />
    2. 2. Your Preparation<br />Requires reflection on the family as a system<br />&<br />Knowledge of family systems<br />
    3. 3. Evidence based Practice<br />Assessment is guided by evidence based practice<br />Individualized assessment (strengths, needs, values, preferences of client)<br />Well-formulated question (database query)<br />Well-executed search of research literature<br />Deciding its applicability to clients <br />Considering the evidence together with the values and preferences of the client.<br />(Sackettet al., 1997; Gibbs, 2003)<br />
    4. 4. During the Assessment <br />Practitioner elicits information about<br />Family structure<br />Organization<br />Transactional Patterns<br />
    5. 5. Transactional Pattern<br />As defined by Minuchin (1974), “family structure is the invisible set of functional demands that organizes the ways in which family members interact. <br />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.” <br />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)<br />
    6. 6. Emphasis<br />0n Current Problems<br />Including the Presenting Problem<br />
    7. 7. Assessment Approaches<br />Interviews are the most common but least systematic<br />Use of Formal Tools and Instruments are more efficient, but have the drawback of being less personal<br />Select methods you and family are most comfortable with<br />
    8. 8. Standardized Approaches<br />More Accurate<br />Grounded in Research<br />Used in combination with non-standardized tools<br />
    9. 9. 4 Tools<br />The Family Interview<br />Mapping and Graphing Tools<br />Teaching, Observation and Role Play Tools<br />Self Report Tools<br />
    10. 10. Family Interview<br />Primary Task<br />Observe family interactions<br />Which will reveal family patterns<br />Along with the systems strengths and negative patterns<br />To be successful you must<br />Communicate clearly<br />And possess the ability to understand the ability of family members<br />
    11. 11. Interview Impacted By:<br />Practitioner and Family Characteristics<br />Physical, Cognitive and Effective Factors<br />Message Components<br />Language, non-verbal cues, sensory cues<br />Interview Environment or Climate<br />Physical, Social, Temporal or Psychological<br />
    12. 12. Environmental Factors<br />Be aware of surroundings<br />
    13. 13. Listening<br />Listening skills lead to informed impressions<br />Do not become preoccupied with what you will say next<br />Ebb and flow will modify your impressions as the interview progresses<br />Do not jump to conclusions<br />
    14. 14. Listen to Yourself<br />Be attuned to your own <br />Thoughts <br />Feelings<br />Actions<br />Biases<br />Read about Confirmation Bias and think about it’s relation to assessment.<br />
    15. 15. Body Language<br />Body language conveys meaning<br />Supportive and accepting body language will put everyone at ease<br />Be aware of what you convey with your body language<br />
    16. 16. Observe Family Language and Behavior<br />Observe words and behavior of each family member throughout<br />Pay attention to what is going on<br />Verbal language<br />Non-verbal language<br />Responses of family members to each other <br />Listen to inflection, tone speech<br />
    17. 17. Stop and Read this Short Article<br />Family Assessment Model - Short Article<br />
    18. 18. Mapping and Graphic Tools<br />Genogram – pictorial chart of people involved in a 3-genrational relationship system<br />Ecomap– shows the interactions outside the family environment<br />Social Network Map – Capture family behavior in the context of it’s social network<br />
    19. 19. The Genogram<br />Draw 3 Generations<br />Idea is to gain a picture of the family for the family, so they are the creators, and the practitioner acts as the recorder<br />Example of drawing one using a simple paint program:<br />
    20. 20. Ecomap<br />Depicts systems which the family interacts with<br />Indicates where changes may be needed in the environment systems to provide improved interactions and support<br />
    21. 21. Ecomap<br />Practitioner can see<br />Supportive relationships exist<br />Deficiencies and areas of conflict exist<br />Are there<br />Missing connections that need changing?<br />Is social isolation a problem<br />Can indicate the flow of resources between family and others<br />
    22. 22. Ecomap<br />Ecomap Video<br />
    23. 23. Social Network Map<br />Social networks are patterns depicting personal relationships that sustain each individual<br />Help us cope with the usual demands of daily living and stressful situations<br />
    24. 24. Social Network Mapping<br />Draw a map or a grid<br />For each member of the family describe<br />The kind of support provided<br />Emotional, concrete or informational<br />The degree to which the support is critical<br />The direction of the help provided<br />The degree of perceived closeness<br />Frequency of contact and length of relationship<br />
    25. 25. Self Report Tools<br />You are attempting to measure and issue or problem and whether it changes over time<br />2 types<br />Standardized self report<br />Example – Click here<br />Pragmatic self report<br />