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CASE VIGNETTE: Following the referral to CPS by newborn nursery personnel, Lisa became angry at the hospital and its staff and did not want to bring Timmy back to the hospital for well-child care. She also refused to cooperate with the CPS assessment, and Timmy's father became verbally abusive towards the CPS workers. The maternal grandmother was contacted. Although she was hurt and angry about CPS involvement with her daughter and grandchild, Lisa's mother eventually shared what she knew, describing her daughter's unstable lifestyle and addiction. Upon questioning, she indicated that she would be willing to care for Timmy and encourage her daughter to enter a substance abuse treatment program. Further assessment revealed that the grandmother's home life was stable and that she would be able to provide a safe and nurturing environment for her grandson.

The assessment process for any troubled family that has come to the attention of professionals should involve an inquiry that addresses both the problem of substance abuse and the problem of child maltreatment. In addition to the initial determination of risk of harm to the child, information about family dynamics and the service needs of parents and children needs to be addressed.

Once the initial assessment has revealed a family problem related to alcohol and/or other drug use, a more comprehensive assessment of the chemically involved family's functioning is critical to the overall intervention process. Such an assessment lays the groundwork for building on family strengths and selecting services to meet the complex needs of both parents and children. Because parental abuse of alcohol and other drugs impacts all family members and all aspects of their life together, it is essential that the assessment process be family focused. Furthermore, since the circumstances within chemically involved families, especially those with special needs children, can change rapidly (sometimes in ways that can be dangerous to children) the process of assessment must be ongoing. A comprehensive, culturally sensitive, and continuing assessment is pivotal to the development of a realistic service plan and provides a framework for evaluating the effectiveness of intervention whether the assessor works in CPS, health care, education, substance abuse treatment, mental health, or the juvenile justice system.

This chapter begins with a discussion of how to gather family assessment data and then details the types of information professionals should explore during the assessment process. The reader should remain aware that the comprehensive assessment is a process that takes time. As professionals become more experienced with the general areas of the comprehensive assessment, and as they become more familiar with individual families, the assessment questions will become more evident, often becoming part of the intervention process itself.

Gathering Information

To gather sufficient information regarding the chemically involved family's functioning, professionals need to:

• Conduct interviews with parents and other family members.
• Make a series of visits to evaluate the home environment, family dynamics, and interactions among family members.
• Contact other service providers and agency representatives who have been, or are currently, involved with the family.
• Obtain or arrange for a variety of standardized evaluations for the parents as well as for the children.

Interviews With Family Members

Interviewing all family members is important. Alcohol and other drug problems affect every member of the family, and it is important for professionals to assess how a parent's substance abuse has affected the health, schooling, and social life of each individual within the immediate and extended family.

Professionals should not rely solely on interviews to gather information. Observation of nonverbal behavior, appearance, and environment may substantiate or contradict information gained during the interview process. For example, a parent may deny substance abuse but exhibit behavior that is suggestive of drug or alcohol use such as slurred speech, staggering gait, and/or drowsiness.

Home Visits

Home visits are critical because the home environment can reveal a great deal about a family's day-to-day functioning, cultural beliefs and affiliations, strengths, and problems. Compared with a clinic or office interview, a home visit provides less structure, and families may present themselves quite differently. Further, many families feel more comfortable being interviewed in their own homes.

Collateral Contacts

Denial of alcohol or other drug abuse is common in chemically involved families. Moreover, parents may minimize the extent of their drug and/or alcohol use or deny any relapses because of fears that their children will be removed from their custody. Thus, to make an accurate assessment, it is important to obtain information from knowledgeable sources outside the family system. These sources may include physicians, nurses, social workers, teachers, members of the clergy, employers, neighbors, child care providers, mental health professionals, substance abuse counselors, parole and probation officers, and CPS caseworkers. In gathering information from these sources, the interviewer should be familiar with the guidelines for confidentiality that govern individual and agency practice with respect to the sharing of information. Federal Law 42 CFR, Part 2, for example, governs the release and exchange of confidential information about an individual's use of alcohol and other drugs.

Standardized Evaluations

Standardized assessment tools are used to monitor a child's developmental progress and to help identify developmental and educational service needs. Use of standardized evaluations with parents, as well, can be helpful in identifying developmental disabilities and underlying psychiatric problems.

Tags: Child Abuse, Addictions

About the Author

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Formerly the National Clearinghouse on Child Abuse and Neglect Information and the National Adoption Information Clearinghouse, Child Welfare Information Gateway provides access to information and resources to help protect children and strengthen families. A service of the Children's Bureau, Administration for Children and Families, U.S. Department of Health and Human Services.