Case Study 1: Example of a popular consensus-based assessment instrument
The Strengths and Stressors Tracking Device
The Strength and Stressors Tracking Device (Strengths and Stressors) is a consensus-based assessment instrument that was developed by modifying the North Carolina Family Assessment Scale (NCFAS). According to those who developed Strengths and Stressors, it:
guides new and inexperienced caseworkers to the critical indicators of family well-being, provides the ability to assess a family’s strengths as well as their stressors, incorporates an ecological array of conditions and skills into a contextual assessment, and can be completed at multiple points in time, providing a quick assessment of how well a family is increasing its strengths and reducing its stressors. (Berry, Cash, & Mathiesen, 2003).
As the name of the instrument suggests, it is designed to go beyond simply predicting the immediate danger to the child and the likelihood of the child experiencing maltreatment in the future by also assessing family wellbeing and psychosocial development.
Strengths and Stressors has 55 items, which are divided into four domains:
• environment (17 items);
• social support (7 items);
• family/caregiver (14 items); and
• child wellbeing (17 items).
The child protection practitioner assesses whether each item on the form is affecting the family as a strength or as a stressor (the scale ranges from -2 [serious stressor] to +2 [serious strength]).
The explication by Strengths and Stressors of the different strengths and stressors of a family is designed to assist child protection practitioners in project planning and evaluation. Strengths and Stressors does not, however, offer structured advice as to which interventions should be implemented if specific scores on the instrument are obtained.
Evidence of effectiveness
Only one small-scale study has tested the efficacy of Strengths and Stressors. In this study, which was conducted by the team that developed the instrument, Strengths and Stressors demonstrated high internal consistency, was able to distinguish between different forms of child maltreatment, and appeared to accurately detect changes made by families during the assessment period (Berry et al., 2003). However, this study did not adequately assess the validity of the instrument. As such, more research is needed before Strengths and Stressors can be said to have an adequate evidence base.
Case Study 2: Example of a popular actuarial assessment instrument
Structured Decision Making (SDM)
The Structured Decision Making (SDM) model of child protection comprises a series of actuarial tools developed by the Children Research Center in Wisconsin, USA. As there are distinct issues to be addressed at each stage of the child protection process, different tools or scales are necessary for each decision point. Therefore, SDM is based around eight areas of assessment. In illustrating the use of SDM, this summary will concentrate on those SDM tools directly relevant to risk/strength and needs assessment: the SDM Family Risk Evaluation (Version 3.1), the SDM Child Strengths and Needs Assessment (Version 3.1), and the SDM Family Strengths and Needs Assessment (Version 3.0).
The SDM Family Risk Evaluation comprises two subscales:
• a neglect scale (12 items: e.g., “Primary Parent has criminal history as adult or juvenile – Y/N”); and
• an abuse scale (11 items: e.g., “Two or more incidents of domestic violence in the household in the past year – Y/N”).
Each item is scored with a 0, 1, 2 or 3 (in the example items above the “No” responses scored a 0 and the “Yes” responses scored a 1, 2, or 3 depending on the severity of the risk factor). Based on the subscale with the highest score, families are classified into a low, moderate, high or very high-risk category. Child protection workers can override the risk classification and increase the risk category by one level.
The SDM Family Strengths and Needs Assessment consists of 12 items (e.g., Alcohol and Drug Use, Mental/Emotional Health, Household Resources and Basic Care). According to the scores of these scales, families are classified into one of four “strengths” categories: exceptional strength, good/adequate functioning, some need, or significant need. This measure also helps to identify specific needs to be included in the family case plan (e.g., a low score on the Household Resources and Basic Care item would indicate that assistance in this area should be included in the case plan).
The SDM Child Strengths and Needs Assessment is very similar in structure to the SDM Family Strengths and Needs Assessment. It consists of 12 items (e.g., Alcohol and Drug Use, Emotional Stability, Behaviour).
Evidence of effectiveness
The SDM Family Risk Evaluation has performed well in tests of predictive validity (i.e., it was shown to be able to quite accurately predict which families should be classified into which risk category). This instrument has also shown moderate levels of inter-rater reliability. No studies were found that looked specifically at the efficacy of the SDM Family Strengths and Needs Assessment or the SDM Child Strengths and Needs Assessment. Finally, compared to demographically matched jurisdictions that used other types of risk assessment instruments, those countries that used SDM instruments had lower substantiation rates, re-referral rates and levels of injuries (For a detailed review of this evidence, see Austin et al., 2005). It is worth noting that almost all of the research into the SDM model and tools has been conducted by the Children’s Research Center, the organisation that developed SDM.
Another alternative approach used by some child protection departments is based on the ‘Signs of Safety’ approach which evaluates not only risk factors, but also family competencies, strengths and resources. This approach also attempts to identify the values, beliefs and meanings held by all family members and to determine their willingness and capacity to engage in the child protection progress.
The ‘Signs of Safety’ assessment maps the harm, danger, complicating factors, strengths, existing and required safety and a safety judgment in situations where children are vulnerable or have been maltreated. The framework is set out into four simple domains for inquiry:
1. What are we worried about? (past harm, future harm and complicating factors)
2. What’s working well? (existing strengths and safety)
3. What needs to happen? (Future safety)
4. Where are we on a scale of 0 to 10, where 10 means there is enough safety for child protection authorities to close the case, and 0 means it is certain that the child we be (re) abused (judgment)
In the resources there are copies of the templates used for the Signs of Safety assessment tool.