C-Change Capacity to Change Assessment Manual

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C-Change Capacity to Change Assessment Manual

Transcript Of C-Change Capacity to Change Assessment Manual

C-Change Capacity to Change Assessment Manual
Dendy Platt and Katie Riches
© University of Bristol, 2016
Sample chapter (pre-publication draft)
Chapter Two, Outline of the C-Change Assessment
The approach proposed in this manual is a method of assessing parents’ capacities to change their behaviour, in a context where maltreatment is likely, or there are other welfare challenges affecting the children. The key to decisions about a child’s future often involves considering whether parents can make the necessary changes to promote the child’s well-being within a time-frame that meets the child’s needs.
The approach has been designed to support local authority social work practice in England. It builds on existing processes including child and family assessments, parenting assessments, and routine practices of giving parents the opportunity to resolve their difficulties before considering more significant actions such as applications to the family court.
It will be of particular interest in the following circumstances1:
 Assessment of a child and family following a child protection conference.  Using capacity to change information to inform a choice of therapeutic or other
interventions for a family.  Assessment of a child and family following the issuing of a letter before proceedings
under the Public Law Outline 3 4.  Preparation of a parenting assessment for the Family Court prior to or during Care
Proceedings.  Assessment and planning for the potential return of a child from the care system to
its birth family or equivalent carers (reunification).  Identifying the detailed focus of therapeutic interventions.  Planning contact arrangements.  Working with so-called ‘stuck’ cases, where, typically, little progress is being made,
professionals encounter hostile or un-cooperative behaviour from parents, and there is a need to make decisions to secure the children’s futures.
1 It is acknowledged that processes vary between local authorities, and that a list of this kind may not describe precise aspects of standard practice in all authorities.
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Good assessment of parental capacity to change adds an additional dimension to a standard assessment, such as one based on the Framework for the Assessment of Children in Need, Signs of Safety 2, or other similar models. Where these assessments lead to an analysis of a child’s needs in a static sense, at a single point in time, the C-Change assessment introduces a dynamic element, enabling the assessor to consider whether parents can change their situation to meet the child’s needs sufficiently into the future. This type of assessment can potentially lead to improved court reports, better decision-making, and reduced delays in securing children’s futures. In this chapter, we set out key inter-related aspects of the assessment, and conclude by summarising fundamental principles.
Process
The C-Change assessment is not a free-standing process. It is designed to be integrated within an existing assessment, such as a child and family assessment, based, for example, on the Framework for the Assessment of Children in Need 2 or similar approaches. The CChange assessment, thus, requires the following to be in place or planned:
 Assessment of the child’s needs.  Assessment of parenting capacity.  Assessment of family and environmental factors.  Identification of key difficulties that the family should address to ensure the safety /
well-being of the child.  An evolving analysis that will draw together the findings from all aspects of the
assessment.
The model is comprised of two essential practice components. They are:
1) Barriers and facilitators of change. Assessment of what helps and hinders the parents to change their behaviour, and
2) Actual changes. Offer parents an opportunity to resolve key difficulties, via provision of interventions to facilitate the process of change, alongside assessment of the extent to which change has been achieved within an agreed timescale.
The way that these components appear in the overall assessment process is set out diagrammatically below.
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Figure 2.1 Diagrammatic summary of the approach

Concerns regarding child

Single Assessment: child’s needs, parenting,
risk, etc

Target difficulties

Assess barriers / facilitators to change

Interim goals

Intervention

Observe changes

= Capacity to
Change

Overall assessment:
• Can change be achieved within the child’s timescale?
• Does capacity to change outweigh risk to child?

Definitions of key terms
It is important to recognise that parental capacity to change is different from parenting capacity. Parenting capacity refers to
a parent’s overall ability to parent a child, across the range of needs the child may present (i.e. basic care, safety, emotional warmth, stimulation, guidance / boundaries, stability, etc.) 2.
On the other hand, we define parental capacity to change, as
the range of attributes, capabilities, motivations, contextual factors etc. that may enable a parent to make changes for the benefit of the children, and to demonstrate that they can address critical difficulties that would otherwise have a severe impact on the child’s welfare.
There is potential for confusion between parental capacity to change and parental engagement or co-operation. Parental engagement is often a pre-requisite of change, and we define it as:
“The mutual, purposeful, behavioural and interactional participation of parent(s) and/or carers in services and interventions provided by social work and other relevant agencies with the aim of achieving positive outcomes” 5 (p.142).
In the practice context, engagement, typically, is experienced in two ways. First are the observable, behavioural components of engagement, such as keeping appointments, allowing home visits, making sacrifices (e.g. of time, emotional commitment, money), and completing agreed tasks. Second is the working alliance between the parent and practitioner. The working alliance has been described 6 as involving the sense of a working bond between practitioner and parent (trust, respect, etc.), together with a commitment to working together to develop goals, and achieve agreement on and carrying out tasks.
Clearly, the ways in which different parents engage with services, or change their behaviour vary from person to person. And, as always with assessments that have the child’s welfare as paramount, the ability of the parent to make changes must be considered with regard to the child’s timescale.
One importance of these different concepts is understanding that mere engagement with services by a parent should not be mistaken for actual change. Engagement itself can be misunderstood by focusing merely on behavioural indicators, without considering the working alliance, or vice-versa. Similarly, behaviour change is often hard to sustain, and is subject to multiple influences, which may lead to failure to engage with the change process, or to relapses in commitment and failures to achieve the goals of change. Both aspects, barriers/facilitators to change, and the behavioural observation of change, are necessary for the most balanced assessment.
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Fundamental principles of the C-Change assessment
The basic points raised in this chapter can be crystallised into a set of principles that are fundamental to our approach:
1) Capacity to change should be assessed in relation to particular defined behaviours. The reason for this is that an individual’s capacities to change vary between different behaviours. To illustrate this point with a simple example, curbing a tendency of someone to shout at their children may well be more challenging than switching to a cheaper brand of washing powder. Thus, the capacity to change the tendency to shout would be considered weaker than the capacity to change choices of washing powder.
2) A capacity to change assessment should be integrated within existing processes of assessment and analysis. To be able to assess capacity to change, it is necessary to have completed a holistic assessment of the child, parents and environment factors, so that the most significant needs are identified, alongside the parental behaviours that must change to ensure those needs are addressed. The risks to the child must be clear, in order to assess whether the changes will be sufficient to mitigate those risks into the future.
3) All relevant parents or carers should be assessed separately, but with attention to the dynamics between joint carers. The reasons for this are that each parent or carer contributes differently to the parenting, and the changes they may have to make are often different.
4) A capacity to change assessment should incorporate two essential sources of information, namely observable behaviour, and the barriers and facilitators affecting capacity to change. Observing actual change gives the parent a fair, realtime opportunity to demonstrate their capabilities. Assessing barriers and facilitators provides an important layer of understanding of how the parents are approaching the goals they need to address. Taking one or other of these aspects separately leaves the capacity to change assessment incomplete. The use of both together strengthens the information available to the decision-making process. This fits with a well-accepted principle of parenting assessment, that more than one method of collecting information should be used.
5) For the needs of the child to remain central to the assessment, the key consideration is the parents’ capacities to achieve change within the child’s timescales. Clearly, it would be damaging to a child if change were only achievable over such a long period that the child’s needs were significantly unmet whilst that change was taking place.
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ChangeAssessmentChildCapacityParents