Transcript Assessment: Motivation to Change - Florida`s Center for Child Welfare

Session 2
The Screening and
Assessment Process
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Chapter 39: Harm to Children
(g) Exposes a child to a controlled substance or
alcohol. Exposure to a controlled substance or
alcohol is established by:
1. A test, administered at birth, which indicated that the
child's blood, urine, or meconium contained any
amount of alcohol or a controlled substance or
metabolites of such substances, the presence of
which was not the result of medical treatment
administered to the mother or the newborn infant; or
2. Evidence of extensive, abusive, and chronic use of a
controlled substance or alcohol by a parent when
the child is demonstrably adversely affected by such
usage.
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Coding Guidelines
o Caregiver’s drug or alcohol use results in
inadequate food, clothing, shelter, or medical
care for child.
o Caregiver’s drug or alcohol use causes concern
about current ability to provide safe care.
o Adverse effect on child is unknown, but concern
about caregiver’s ability for safe care due to
chronic or severe substance use.
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Initial In Home Safety Assessment
The parent or caregiver(s) apparent
mental, physical or developmental
condition, or drug or alcohol use affects
their ability to adequately care for the
child(ren).
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Trained Eye
You are not responsible for determining that
a family member has a substance abuse
disorder; your job is to suspect that
substance abuse may be present and to
use your skills to engage in useful
conversations.
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Objectives
o Conduct the screening process: historical
information gathering, interviewing,
observations, and standardized screens.
o Summarize the purposes and structure of
assessments.
o Build parent motivation to participate and
team member collaboration.
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Informal Screens
o Children comments/behaviors
o Parental comments/behaviors
o Environmental/person observations
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Seven Effects of an Alcoholic Parent on Kids
Slide Show 1
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Family Centered Approach
o Reduce
– Secrecy
– Isolation
– External denial or minimization
– Internal denial or precontemplation of change
o Increase
– Reflection on actions
– Recognition of strengths
– Sense of responsibility
– Positive change
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UNCOPE Questions
o Have you continued to Use alcohol or drugs longer than
you intended?
o Have you ever Neglected some of your usual
responsibilities because of alcohol or drug use?
o Have you ever wanted to stop using alcohol or drugs, but
couldn’t (Cut down).
o Has your family, a friend, or anyone else ever told you
they Objected to your alcohol or drug use?
o Have you ever found yourself Preoccupied with wanting
to use alcohol or drugs?
o Have you ever used alcohol or drugs to relieve
Emotional discomfort, such as sadness, anger, or
boredom?
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CRAFFT Questions
o Have you ever ridden in a Car driven by someone (including
yourself) who was high or had been using alcohol or drugs?
o Do you ever use alcohol or drugs to Relax, feel better about
yourself, or fit in?
o Do you ever use alcohol or drugs while you are by yourself Alone?
o Do you ever Forget things you did while using alcohol or drugs?
o Do your Family or Friends ever tell you that you should cut down
on your drinking or drug use?
o Have you ever gotten into Trouble while you were using alcohol or
drugs?
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Family Story Process
1.
Listen to the story not to see if it meets the criteria for
maltreatment or to evaluate truthfulness, but to clearly
understand the family’s perspective.
2.
Listen while the story is told. Don’t ask questions
during the story.
3.
At the end, thank the persons for telling it, then
summarize it to show the family you heard what they
were saying.
4.
Then, you may ask questions to clarify the family’s
story. This is the time to check for substance abuse if
it wasn’t mentioned in the story – and for exceptions to
substance use behaviors.
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Assessment
o Diagnosis
o Motivation to Change
o Treatment Structure Decision
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Assessment: Motivation to Change
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Assessment
o Diagnosis
o Motivation to
Change
o Treatment
Structure Decision
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CPI/DCM Goals
o Build support for treatment (motivate).
o Keep parent in treatment (motivate).
o Develop comprehensive/integrated services
plan(s) (collaborate).
o Monitor for child safety (collaborate).
o Maintain on-going communication/case
coordination (collaborate).
o Transition out of service provision (collaborate).
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Change Process
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Motivate/Collaborate
o CPI/DCM
o Parent
o Treatment Professional
o Informal Supports
o What do I need to do to:
– Protect the child during the assessment process?
– Help the family in the precomtemplation and
contemplation stages of change?
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CPI/DCM Actions
o Collaborate
o Motivate
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Informal Supports
o Friends/family
o Peers
o Organizations
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