Session 2 The Screening and Assessment Process 1

Session 2 The Screening and Assessment Process 1

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. 2

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. 3

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). 4

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. 5

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. 6

Informal Screens o Children comments/behaviors o Parental comments/behaviors o Environmental/person observations 7

Seven Effects of an Alcoholic Parent on Kids Slide Show 1 8

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 9

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? 10

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? 11

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. 12

Assessment o Diagnosis o Motivation to Change o Treatment Structure Decision 13

Assessment: Motivation to Change 14

Assessment o Diagnosis o Motivation to Change o Treatment Structure Decision 15

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). 16

Change Process 17

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? 18

CPI/DCM Actions o Collaborate o Motivate 19

Informal Supports o Friends/family o Peers o Organizations 20