Features of a Family Assessment Process - Assignment Example

Family Assessment Name Institution Date Introduction Family assessment is a critical process in the determination of challenges faced by families and in developing interventions that benefit the family as a whole. Nurses now have a critical role to play in family assessment and are therefore, faced with the need to have in depth understanding of the features involved, the tools used and the matching of solutions to identified problems.This paper investigates this subject by first exploring the features in a family assessment process before making analysis of a family assessment tool, and applying this tool on a case study. The paper emphasizes on the principles used in problem identification and the solutions applicable to particular problems. 1. Family assessment Family assessment involves several processes that need to be properly coordinated from the first contact to the decision making stages that will follow. After the first contact, several decisions will be made concerning placement, termination of parental rights, reunification, and closure. Other family assessments will demand decisions that are related to changes in the case goal, formal progress reviews, and independent living decision. But while these decisions are made, the first dominant feature of the assessment processes will usually involve screening and general disposition which is usually done at intake. This stage involves information gathering and provision of support to the people as well as analysis of this information to finding clues about the problem or challenge. Definition of the problem follows where factors that led to the problem are understood and a clear problem statement generated. This stage may include diagnostic assessments or quantification of the severity of the problem. The assessment then goes to the stage where planning, selection and matching of services are done with regard to the identified problems. Possible solutions for specific problems are identified and matched to the corresponding problem as a general solution to the challenge is pursued. After this stage, proper monitoring of the progress of the assessment will be done and an evaluation carried out on the service outcomes. Family assessments are the foundations of good casework practices that can help promote safety, permanency, and the well-being of the children and family. Through these assessments, professionals can partner with families to make decisions, set goals and achieve great results. Since families get to communicate openly about the challenges that face them, these assessments help the families disclose culture, dynamics and personal experiences so as to meet the personal needs of every member of the family and every child (Bray, 2009). But as Bray (2009) further points out, the success of any assessment and treatment will depend on careful diagnosis of the problem and proper matching of the problems to the proposed solutions. 2. Assessment tool - Ecomaps Ecomaps are diagrams used during assessment that depict a given individual or family within the context of a society by revealing the energies, resources and supports that help maintain specific relationships (Rempel, Neufeld & Kushner, 2007). This tool is always used alongside genogram for practitioners to synthesize information and demystify the interactions within the social system and find the tensions and strains between the family and other systems (Carpenter-Aeby, Aeby & Boyd, 2007). Ecomaps are used by professionals to find a variety of reciprocal influences between the individual and the people around him/ her, the relevant institutions within the society and the environmental influences. This tool has great benefits in the assessment of families since relationships are clearly depicted so that problem finding becomes much easier. By portraying an overview of the connections and relationships between the outside system and the family, ecomaps demonstrate the flow or lack of resources and supports. Furthermore, ecomaps provides demonstration of the prevailing relationships to ecological systems and culture. The graphic images as painted by the client are useful since they provide multiple systems an understanding for proper assessment and intervention with clients. Whether oriented to present or past experiences, the ecomap configures the spatially at a given point in time with consideration of significant others and to community organizations and institutions (Iversen, Gergen & Fairbanks, 2005). Assessment Ruth is in a difficult position as she tries to recover from the birth and as she tries to regain her strength. But during this critical time, she gets very little support from her husband. It is revealed that John is largely preoccupied with his job which is very demanding and finds little time to come home and care about what his wife goes through. As seen in the ecomap, John has very relationship with his wife and children. It is also seen that he may have faced difficult time himself while he was young in his father’s house. This has led to very poor relationship between john and his father and may have contributed to his present in-considerations, demands and self centeredness. John’s failure to understand what other people may be going through is also seen in the manner in which he presses his wife to in their sexual life without caring to understand whether or not the wife is fully recovered. Ruth does not get the support she needs from her husband and is left to care for the children when she is the one who should be resting. John expects her to “take care of it” and does not expect that the cries of the Children should wake him up early in the morning. Ruth therefore, feels very lonely in her own home and does not feel supported. She has left her work to find time to care for the babies and regain her strength but John feels that this is reason for them to resume their sexual relationship earlier since she is more rested and relaxed. John also thinks that Ruth should resume fulltime work since the family is facing financial challenges. This shows how John’s rough upbringing may have broken him and caused him to be un-understanding and inconsiderate to his wife. Ruth finds consolation in her sister Sarah who has agreed to come and help her with the babies for 12 months. Sarah must be very caring and understanding to agree to come to her sister’s help at this time while she had her own children to care for. Ruth’s mother is also supportive and is willing to come in and help with the babies. Generally, Ruth’s family proves to be very supportive as opposed to John’s. While both parents in law have gone through a divorce, John’s family shows little willingness to involve in John’s family and to help with the current situation. John’s family has several other issues to deal with and even his brother has not married yet. The family also struggles with their social life in their new home. John, particularly, has very poor social characteristics and is mainly concerned about his personal interests. He goes surfing but has not cared about his wife. He has also failed to make friends at the coast. He plans to take the family at the local Surf Club for lunch hoping that they would meet likeminded people, he doesn’t care about the interests of his wife. The social challenges may also be due to the high demands of their work and the little time that they could get to come down at the coast. 3. Two family issues a. Parent-Child relationships It is clear from the case that John’s childhood experiences may have greatly contributed to his personality and his unfair treatment of his wife. His relationship with his own children is not good either. Researchers have found out that physically abused children are likely to exhibit externalizing symptoms, aggression and increased rates of disruptive behaviour disorders compared to non-abused children. Such abuse has been associated with high risk of depression and other internalizing spectrum symptoms and disorders (Lau et al, 2006). Other findings indicate that positive parent-child relationships are the basis for children’s learning. Parents who are sensitive and responsive and those who provide predictable care greatly help children to develop important skills that they will need in life. Early parent-child relationships greatly influence the emotional well-being of children, their basic coping and problem solving capabilities as well as future capacity to get into healthy interpersonal relationships. These interactions help children learn skills that teach them how to engage with others and to succeed in different environments. These relationships help children learn how to manage their own emotions and establish good relationships with adults and peers. Research also indicates that when parents are able to establish warm, reliable and trusting relationships with peers, community members, family and service providers, they are highly likely to establish positive relationships with their own children. Tronick & Beengly (2011) add that these relationships help children develop a sense of self so that they can be able to model various emotional expressions and emotional regulations. Parents are also encouraged to engage in every day learning activities with children even at an early age since this wilL help them develop lifetime motivation, love for learning and persistence (Dunst, Bruder, Trivette & Hamby, 2006; Cook, Roggman & Boyce, 2011). Most importantly, as Hess, Teti & Hussey-Gardner (2004) point out, children’s development could be thrown out of track if parents are highly stressed, lack the support of the society or when they find their children’s temperament as difficult. This may be the likely outcome of the newly born twins. They get very little attention from their father while their mother is stressed with John’s sexual demands and pressures to resume work even before she recovers well. John’s behaviour is also a direct consequence of his treatment when he was a child and there are fears that the same might happen to John if efforts are not put towards treatment of the problem. Nursing Goal: counselling and help laying ground for John’s understanding of his roles as a father b. Social isolation John’s family has just moved into Gold Coast and they have not managed to make any friends yet. The nature of their work has made it difficult to find time for social interactions with other people in the area and the family remains very isolated. John has managed to join the local club but has not managed to make friends. He has managed to greet a few people when he goes surfing but has not established any solid relationships. Out of desperation and the fear of the loneliness, John hopes to find “likeminded” people when he takes his family for lunch at the club. Social isolation may be described as the absence of relationships with family or friends on the personal level, and with the society of the broader level (Mental health Foundation, 2010). While John’s family struggles with isolation from the society, it is highly likely that Ruth feels lonely within the family and does not feel loved and cared for. John comes out as a tough and commanding husband that does not care much about other people’s interests and convenience. Individuals become part of one or more of networks that are different depending on the composition. At the family level there are local family networks that provide support during decision making and at any other time, for companionship and comfort. This type of companionship is evidently lacking from Ruth’s house. Ruth also wants to break away from this isolation by joining the local group for new mothers. She seems to have very little to do for free time and is lonely, despaired, sad and maybe frustrated. Relationships like the one for John and Ruth may turn out to be cold, unsupportive and neglectful. Such characteristics will lead to vulnerabilities and/or interact with vulnerabilities based on genetics in offspring that create disruptions in the psychological functioning, and health behaviours. Children should begin by learning from their environment and acquire emotional security and physical safety, as well as behaviours that will help them maintain their own emotional and physical health. Nursing Goal: explain the characteristics and consequences isolation and advise on necessary adjustments. Conclusion As seen in the discussion above, the ecomap provides great visual presentation of the circumstances that surrounding the situation at hand, thereby making easy to identify particular problems in the system. The tool reveals critical issues that must be addressed in time to prevent their effects from affecting the development of the young children as they begin to interact with their environment. These problems could also result to breakage of the family in separation or divorce. The goals identified above will greatly assist in the improvement of relationships within the family as well as between the family and the external environment. References Bray, J. H. (2009). Couple and family assessment. The Wiley‐Blackwell Handbook of Family Psychology, 151-164. Iversen R.R., Gergen K.J. & Fairbanks R.P. (2005). Assessment and Social Construction: Conflict or C0-Creating? British Journal of Social Work. Vol. 35, No. 5, pp. 689 – 708 Carpenter-Aeby T. Aeby V.G. & Boyd J.S. (2007). Reciprocal Influences: Triage with Disruptive Students at an Alternative School. The School Community Journal. Vol. 17, No. 2, pp. 45 - 72 Hess, C. R., Teti, D. M., & Hussey-Gardner, B. (2004). Self-efficacy and parenting of high-risk infants: The moderating role of parent knowledge of infant development. Journal of Applied Developmental Psychology, 25 (4), 423-437 Mental health Foundation. (2010). The lonely Society? Mental Health foundation Lau A.S., Valeri S.M., McCarthy C.A. & Weisz J.R. (2006). Abusive parent’s reports of child behaviour problems: Relationship to observed parent-child interactions. Child Abuse & Neglect. Vol. 30, pp. 639 – 655 Tronick, E. Z. & Beeghly, M. (2011). Infants’ meaning-making and the development of mental health problems. American Psychologist. Vol. 66, No. 2, pp. 107-119. Cook, G. A., Roggman, L. A., & Boyce, L. K. (2011). Fathers’ and mothers’ cognitive stimulation in early play with toddlers: Predictors of 5th grade reading and math. Family Science. Vol. 2, No. 2, pp. 131-145 Dunst, C. J., Bruder, M. B., Trivette, C. M., & Hamby, D. W. (2006). Everyday activity settings, natural learning environments, and early intervention practices. Journal of Policy and Practice in Intellectual Disabilities. Vol. 3, No. 1, pp. 3-10. Rempel G.R., Neufeld A. & Kushner K.E. (2007). Interactive Use of Genograms and Ecomaps in Family Caregiving Reaseach. Journal of Family Nursing. Vol. 13, No 4, pp. 403-419. Appendix Strong Weak Demanding Stressful Understanding Fig: Ecomap for case 1 Read More