Presentation on theme: "Assessing motivation and willingness to change"— Presentation transcript:
1Assessing motivation and willingness to change P18
2To assess parents’ capacity to respond to the child’s needs
3Central to assessment Assessment of parenting capacity. Assessment of parent-child interaction.Assessment of parental readiness and capacity to change.
4A goal of assessment‘to identify the extent to which parents have the capacity to see the experience from the child’s point of view and to realistically appraise what might need to change for the child to thrive in their care.’(Donald and Jereidini 2004, quoted in Barlow with Scott 2010)
5Assessment of parenting capacity Recognition of the child’s needs.Awareness of the potential effects of relationships.Ability to take responsibility for own behaviour.Capacity to avoid dangerous, impulsive acts.Acceptance by the abusive parent(s) of their responsibility.Awareness by the parent(s) of the effect of their own experience.Provision of physical and emotional care appropriate to child’s developmental status.
6Assessment of parenting capacity Confirm the evidence of harm to the child due to neglect.Establish the level of acceptance of, and responsibility taken by the parents for the harm.Record the assessed parenting capacity and the parents’ response.Draw out parents’ responses to negative aspects of parenting capacity.Plan to address the child’s future safety, therapeutic needs and, where appropriate, reunification.
7Assessment of parent-child interaction Sensitivity of parent towards the child.Control of parent’s emotions, for example, covert or overt hostility.Responsiveness of the adult towards the child.The infant’s cooperativeness.The infant’s compulsivity.The infant’s ‘difficultness’ and passivity.
8Assessment of willingness to change Capacity has two elements: ability and motivation.Each parent is an individual with different motivation and ability to change. It is crucial that assessment involves both, as one parent could negatively influence and undermine change in the other.Intentions to change are complex and should not be confused with willingness to work with a particular practitioner or particular programme.Professionals need to recognise the changing context in which assessment takes place. It is only by assessing the family over time that it is possible to discover the parental and familial capacity to change.
9Steps in assessmentAssessment of parents’ functioning including an assessment of their interaction and relationship with their child(ren).Specification of targets for change that should include the unique problems facing the family.Implementation of interventions that addresses all aspects of family functioning with goals tailored to address specific areas of family functioning.Objective measures of changes over time including standardised tests pre- and post-intervention and evaluation of parents’ willingness to change.
10Comprehensive Model of Change Useful tool for child and family assessment. Change is a matter of balance.For effective change, professionals should assess and work with the parent or carer at the stage the parent has reached in their readiness to accept or deny the need to change.(Prochaska and DiClimente 1982)5Model contains five stages of change2Model identifies two blocks to change
115 2 Change model stages of change Blocks to change contemplation determinationactionmaintenancelapse.pre-contemplationrelapse.
12Information processing This model evolved from research on neglectful parents to develop theory on how and why neglectful behavior occurs.Identifies 4 stages at which parents could fail to respond to signals of children's needs.Failure at each stage represents a different type of neglect.(Crittenden 1993)
13Information processing Parents could fail to respond to children's need for care because:did not perceive the signalinterpreted the signal as not requiring a parental responseknew that a response was needed but did not have a response available orselected a response but failed to implement it.
14In practice: disorganised neglect Implications for engagement:develop trust, express empathy, be predictablemirror feelingsintroduce alternative strategieslong-term.Families where there are multiple problems, disorganisation and frequent crises.Mother or parent appears to need or want help, and professionals are made welcome.Parental care is inconsistent and unpredictable.Children become more demanding to get attention – behaviour can be increasingly dramatic.
15In practice: emotional neglect Opposite of ‘disorganised’ families.Materially advantaged but failure to connect emotionally.Children know their roles, respond to clear rules, often do well at school - physical needs are met but not emotional needs.Absence of feelings - lack of empathic responses from parents.Results in children learning to block expression of feelings and awareness of feelings .Children may appear falsely bright, self-reliant but have poor social relationships.Children may become carers - role reversal.
16In practice: emotional neglect Implications for engagement:Families appear superficially successful – but do not require less professional involvement.Help parents learn to use other sources of support.Teach parents to engage with children emotionally.Provide structured support with clear rules and roles.
17In practice: depressed neglect Classic neglect: parents appear withdrawn with dull affect.Uninterested in professionals, appear unable to understand and unmotivated.Love their children - but do not perceive their needs or believe anything will change.Present as passive and helpless.Parents have shut down both cognition and affect.Parents may feed, change and move children but rarely respond to signals from the them.Children may give up when there are no responses - become silent, limp, dull and depressed.
18In practice: depressed neglect Implications for engagement:Children benefit from access to responsive and stimulating environments, for example, day care.Parents need to learn to express feelings - practice smiling, laughing, soothing.Parent education unlikely to be successful if backed by threats or punitive strategies.Medication may help but beware side-effects.Needs a longer term, supportive approach.
19In practice: tools to support assessments CARE Index (Crittenden 1981)HOME Inventory (Cox and Walker 2000)The Family Assessment Pack of Questionnaires and Scales (Department of Health 2000)
20Assessing parents’ response to change Four categories are identified:genuine commitmenttokenismavoidance and/or dissentcompliance(Howarth 2000; 2009)
21Further ReadingCrittenden, P.M. (1993) ‘An information-processing perspective on the behavior of neglectful parents’. Criminal Justice and Behavior 20(1): 27–48.Donald, T. and Jureidini, J. (2004) ‘Parenting Capacity.’ Child Abuse Review 13(1): 5-17.Horwath, J. & Morrison, M. (2000) ‘Assessment of Parental Motivation to Change.’ In J. Horwath (ed) The Child's World: Assessing Children in Need and Their Families, pp London: Department of Health, NSPCC and University of Sheffield.Horwath, J. (ed) (2009) The Child's World The Comprehensive Guide to Assessing Children in Need Assessing Children in Need. London: Jessica Kingsley Publishers.McGhee, J. & Hunter, S. (2011) SCCPN Briefing - Involving parents in assessment and decision-making. Stirling: Scottish Child Care and Protection Network.