Cover Page

Table of Contents

Title Page

Copyright

Dedication

Preface

Acknowledgments

About the author

Contributors

Chapter 1: Assessment of Children

Defining Assessment

Historical Background

Evolving Ecological-Systems Perspective

Biopsychosocial Assessment Report

Summary of Current Evidence-Based Assessment of Children

Emerging Trends in Child Assessment

Implications for Social Work on Micro-, Mezzo-, and Macrolevels

Conclusion

Key Terms

Review Questions for Critical Thinking

Online Resources

References

Chapter 2: Intervention With Children

Development of EBPs for Children at Risk for Emotional or Behavioral Problems

Current EBPs With Children

Limitations of the Evidence

Conclusion

Key Terms

Review Questions for Critical Thinking

Online Resources

References

Chapter 3: Assessment of Adolescents

Evidence-Based Assessment With Adolescents

Limitations of Evidence-Based Assessment With Adolescents

Treatment Goals

Implications for Social Work

Conclusion

Key Terms

Review Questions for Critical Thinking

Online Resources

References

Chapter 4: Intervention With Adolescents

Overview of Issues and Problems Facing Adolescents

Promising Programs of Prevention and Intervention

Promoting the Development of Competencies and the Prevention of Disorders

Substance-Abuse-Prevention Programs

Promising Treatment Programs

Ongoing Treatment and Case Management

Considerations in Service Delivery

Motivation for Treatment

Context and Focus of Treatment

Conclusion

Key Terms

Review Questions for Critical Thinking

Online Resources

References

Chapter 5: Assessment of Adults

Historical Background

Summary of Current Evidence-Based Assessment for Individuals

Evidence-Based Assessment

Implications for Social Work on Micro-, Mezzo-, and Macrolevels

Conclusion

Key Terms

Review Questions for Critical Thinking

Online Resources

References

Chapter 6: Intervention With Adults

Historical Background

Summary of Useful Resources

Limitations of the Evidence

Implications for Social Work at the Micro-, Mezzo-, and Macrolevels

Conclusion

Key Terms

Review Questions for Critical Thinking

Online Resources

References

Chapter 7: Assessment of the Elderly

Historical Background

Elements of the Comprehensive Assessment

Mental Status

Functional Assessment

Medical History and Nutritional and Health-Behaviors Assessment

Assessment of Emotional Well-Being

Assessment of Social, Economic, and Environmental Well-Being

The Care Plan

Conclusion

Key Terms

Review Questions for Critical Thinking

Online Resources

References

Chapter 8: Intervention With the Elderly

Historical Background

Summary of Current Evidence-Based Interventions With the Elderly

Limitations of the Evidence

Implications for Social Work at Micro-, Mezzo-, and Macrolevels

Conclusion

Key Terms

Review Questions for Critical Thinking

Online Resources

References

Chapter 9: Assessment of Families

Historical Background

Current Evidence on the Assessment of Families

Limitations to the Evidence on the Assessment of Families

The Assessment Process Within Social Work Practice—Micro-, Mezzo-, and Macrolevels

Conclusion

Key Terms

Review Questions for Critical Thinking

Online Resources

References

Chapter 10: Chapter Chapter 10: Intervention With Families

Historical Background

Summary of Current Evidence-Based Intervention With Families

Cognitive Behavior Therapy With Parent Component

Limitations of Evidence-Based Family Interventions

Implications for Social Work Practice

Conclusion

Key Terms

Review Questions for Critical Thinking

Online Resources

References

Author Index

Subject Index

Title Page

We have many blessings to be thankful for each day of our lives. The extent to which we actually count our blessings and give thanks is less well certain.

I dedicate this volume to my life partner, spiritual anchor, ego-validity checker, and reality-grounded spouse, Deborah Ann Holosko, whose support, love, and inspiration are what drives me to be me. Thank you for being you, Ann.

—Michael J. Holosko

Preface

North American social welfare and social work as we know it today evolved in the United Kingdom from the Elizabethan Poor Laws of 1601, more specifically the Act for the Relief of the Poor. Thus, it was social policy that set the framework for the provision of goods and services doled out to the have-nots of society. Since its inception then, social policy has directed social work practice and from the 19th century onward, social research has informed social work practice.

Social Work Practice With Individuals and Families: Evidence-Informed Assessments and Interventions reiterates that these two cornerstone principles of social work have never wavered. What has changed, however, are our societies, economies, and the social/political context that shape how social workers deliver services to those in need, or the vulnerable populations who are our clients. Thus, this volume links policy-practice to research and evaluation in each chapter within it.

The point of departure for each chapter is how research and evaluation document, critically appraise, assess, and provide empirical evidence for our day-to-day activities in direct practice—that being face-to-face interactions with individuals and families, or the lifeblood of social work practice. The chapters cut across the life span from children to adults, to the elderly. For each of these cohorts, material is presented that shows how to both assess and use intervention evidence judiciously. This volume shows clearly how our profession has matured, by continually making the aforementioned connections throughout research and evaluation ↔ policy-practice, and assessment ↔ intervention, and the mechanism to achieve these intersecting areas is empirical evidence.

Indeed, our profession's use of evidence has moved from: case wisdom → empirical practice → evidence-based practice → evidence-informed practice. The latter emphasizes the incorporation of wider forms of systemically collected data, for example, case studies; findings from research studies; synthesized reviews of literature; best or promising practices; and data and evidence from the experiences of consumers, service users, professional practitioners, administrators, and policy makers. As such, the evidence-informed practice offered in this volume is an effort to be the first link in a knowledge-sharing chain-of-events system involving: the evidence itself to → assessment of the evidence to → the self-appraisal of how the evidence can be used to → transparency between all stakeholders in this process (i.e., clients, practitioners, administrators, etc.) to → disseminating the evidence to → utilization, or applying the evidence to inform practice decisions. Thus, each chapter in this text is judiciously anchored in this chain of evidence.

In an effort to stylistically address this chain-of-evidence idea, all contributors were asked to first construct succinct text boxes to establish the chapter's overall purpose and rationale, as well as to explain how examples of evidence were used within the chapter. They then presented an overarching question that students could think about while reading the chapter. At the end of each chapter, contributors then identified a set of key chapter terms and three to six field-tested websites that students or practitioners could access for additional readings, as well as five critical thinking questions to further probe the content of the chapter. This uniformity of style to address these important evidence-informed issues are presented consistently in the writing and reading of the chapters. We hope these elements also made the chapters more student and practitioner friendly.

This book is designed as a foundation social work practice text with individuals and families for undergraduate and graduate students in social work programs. The text provides the foundation of skills required for beginning social work practice with individuals and families. This book addresses Council on Social Work Education (CSWE) required competencies for accreditation. Specifically, the book addresses the following required accreditation competencies:

As our profession develops and uses evidence more routinely and effectively, as such, it will not only fare well in this competitive era of legitimacy, but it will be better prepared to more effectively and ethically serve the unique needs of our diverse and marginalized clients.

—MJH, CND, KMS

Acknowledgments

A text of this nature could not have come to fruition without the support of many. This collective group is the real story behind the book, and they need recognition. First, I would like to acknowledge both of my co-editors for pushing this well-conceptualized and well-crafted book forward for publication in our field. Catherine N. Dulmus, one co-editor, spent much appreciated time shepherding, marshalling, and empowering my ability to write, edit, tweak, and freshen-up this well-written set of chapters; I thank you for this, Catherine. In regard to the chapter contributors, thank you for sharing your poignant ideas on evidence-informed assessments and intervention from your practice wisdom and research. Your professionalism and commitment to promoting this leading edge topic in order to advance our practice reality was much appreciated.

At John Wiley, a special acknowledgment goes to Rachel Livsey, Senior Editor for Social Work and Counseling and particularly Amanda Orenstein, Editorial Assistant for supporting this work from A to Z, through numerous phone calls, e-mails, long telephone messages, and edited PDF files. At the University of Georgia, I would like to acknowledge and thank Dr. Israel Berger who endowed my chair in family and child welfare in the School of Social Work. This allowed me to obtain the much needed resources and additional time to dedicate to this project. Finally, I would like to thank Catherine A. Patterson, Tisha Abolt Graduate Assistant, MSW, who not only spent countless hours on this manuscript as a research and editorial assistant, but who also found the time to co-author a chapter in the text itself. I very much appreciated your professionalism, diligence, sense of humor, and student voice in reviewing and working on countless renditions of this manuscript during this past year.

In sum, I sincerely appreciate all your help with this endeavor and I enjoyed working with all of you on this journey very much.

—MJH

About the author

Michael J. Holosko, PhD, MSW, is the Pauline M. Berger Professor of Family and Child Welfare at the University of Georgia, School of Social Work. He has taught across the undergraduate and graduate curriculum in schools of: social work (primarily), nursing, public administration, and applied social science in Canada, the United States, Hong Kong, Sweden, Australia, and the U.S. Virgin Islands. He has published extensively in the areas of evaluation, health care, gerontology, social policy, research, music intervention, and spirituality. For the past 33 years, he has been a consultant to a variety of large and small health and human service organizations in the areas of: program evaluation, outcomes, accreditation, organizational development, communication, leadership, visioning, organizational alignment, and stress management. He serves on the editorial boards of: Research on Social Work Practice; Journal of Health and Social Policy; Journal of Human Behavior and Social Environment; the Hong Kong Journal of Social Work; Journal of Social Service Research; and the Journal of Evidence-Based Social Work Practice.

Catherine N. Dulmus, PhD, LCSW, is Professor, Associate Dean for Research, and Director of the Buffalo Center for Social Research at the University at Buffalo and Research Director at Hillside Family of Agencies in Rochester, New York. She received her baccalaureate degree in Social Work from Buffalo State College in 1989, the master's degree in Social Work from the University at Buffalo in 1991, and a doctoral degree in Social Welfare from the University at Buffalo in 1999. As a researcher with interests that include community-based research, child and adolescent mental health, evidence-based practice, and university-community partnerships, Dr. Dulmus' recent contributions have focused on fostering interdependent collaborations among practitioners, researchers, schools, and agencies critical in the advancement and dissemination of new and meaningful knowledge. She has authored or co-authored several journal articles and books and has presented her research nationally and internationally. Prior to obtaining the PhD, her social work practice background encompassed almost a decade of experience in the fields of mental health and school social work.

Karen M. Sowers, PhD, is Dean and Beaman Professor in the College of Social Work at University of Tennessee, Knoxville. She is the University of Tennessee Beaman Professor for Outstanding Research and Service. Dr. Sowers received her baccalaureate degree in sociology from the University of Central Florida, and her master's degree and PhD degree in social work from Florida State University. Dr. Sowers serves on several local, national, and international boards. Dr. Sowers is nationally known for her research and scholarship in the areas of international practice, juvenile justice, child welfare, cultural diversity, and culturally effective intervention strategies for social work practice, evidence-based social work practice, and social work education.

Contributors

Paula Allen-Meares, PhD
School of Social Work
University of Michigan
Ann Arbor, Michigan
 
Kimberly A. Brisebois, BSW, MSW
School of Social Work
Wayne State University
Detroit, Michigan
 
Elaine Congress, PhD, DSW, LCSW
Fordham University Graduate School of Social Service
New York, New York
 
Cynthia Franklin, PhD, LCSW, LMFT
School of Social Work
University of Texas–Austin
Austin, Texas
 
Michael J. Holosko, PhD
School of Social Work
University of Georgia
Athens, Georgia
 
Laura Hopson, PhD
School of Social Welfare
University at Albany
Albany, New York
 
Catheleen Jordan, PhD, LCSW
School of Social Work
University of Texas–Arlington
Arlington, Texas
 
Craig Winston LeCroy, PhD
School of Social Work
Arizona State University
Tucson, Arizona
 
Robyn Munford, PhD
School of Health and Social Services
Massey University
Palmerston North, New Zealand
 
Catherine A. Patterson, MSW
School of Social Work
University of Georgia
Athens, Georgia
 
Gregory J. Paveza, MSW, PhD
School of Health and Human Services
Southern Connecticut State University
New Haven, Connecticut
 
Tara M. Powell, MSW, MPH
Austin, Texas
 
Mary C. Ruffolo, PhD, LMSW
School of Social Work
University of Michigan
Ann Arbor, Michigan
 
Jackie Sanders, PhD
School of Health and Social Services
Massey University
Palmerston North, New Zealand
 
Jeffrey F. Skinner, LCSW, MDiv
School of Social Work
University of Georgia
Athens, Georgia
 
David W. Springer, PhD, LCSW
School of Social Work
Portland State University
Portland, Oregon
 
Bruce A. Thyer, PhD
College of Social Work
Florida State University
Tallahassee, Florida
 
Lela Rankin Williams, PhD
School of Social Work
Arizona State University
Tucson, Arizona
 
Michael E. Woolley, MSW, DCSW, PhD
School of Social Work
University of Maryland
Baltimore, Maryland

Chapter 1

Assessment of Children

Michael E. Woolley


Purpose: This chapter details and discusses the historical evolution and current trends in social work in the systematic, ecological, and evidenced-informed assessment of children. It includes the myriad struggles impacting children and the broad range of settings in which social workers serve children and their families.

Rationale: Whether in schools, child protective services, juvenile justice, family or community centers, mental-health agencies, or hospitals, social workers assume many roles in providing services for children. A critical part of providing effective services is a comprehensive assessment informed by social work values, ethics, interfacing with our evolving professional orientation, knowledge, skills, and tools.

How evidence-informed practice is presented: One current trend is the increasing use of quantitative survey instruments in child assessment, and there is an increasing number of such assessment tools being developed by social work researchers. A second trend is the increasingly widespread need for the evaluation of the effects of interventions. In order to offer such evaluations, valid and reliable assessment tools are needed that can show changes in the assessed struggles and targeted outcomes of those interventions.

Overarching questions: Within specific social work practice settings serving children, in order to complete an ecologically oriented and comprehensive assessment of a child and family, what information would be needed, from whom should that information be gathered, and by what means or methods should that information be collected?


Social workers are vital members of teams delivering services to children across a variety of settings, including, but not limited to, child welfare agencies, family service organizations, schools, health-care providers, and mental-health settings. The struggles and challenges faced by children served by those social workers covers a broad spectrum from day-to-day struggles to life-altering trauma. In all those settings and struggles, beginning the social work intervention process with a systematic and comprehensive effort to gather information about the child, the social contexts of the child, and the presenting struggle or challenge is a critical first step to providing professional, appropriate, and effective services to children who have been impacted by issues ranging from sexual abuse or mental illness to brain tumors or learning disabilities.

Social work has been increasingly called on, from both outside and inside the profession, to demonstrate the effectiveness of its practices. This scrutiny provides the impetus to engage in research to develop evidence-based practice (EBP) strategies and approaches (Gambrill, 1999). The needs for quality assessment tools and strategies as a fundamental task within that effort are twofold. First, all practice activities should start with and be informed by an assessment process. Second, gathering evidence as to the effectiveness of an intervention requires assessing the target of that intervention before and after that intervention is delivered; therefore, reliable and valid assessment measures are a fundamental tool in the pursuit of evidence to support practice.

This chapter first defines what is involved in performing a systematic and comprehensive social work child-assessment process. The accumulated social work practice knowledge in the area of child assessment emerging across the first 100 years of professional social work is discussed. We then outline the current prevailing framework used to gather, organize, and present assessment information about children. More recent developments in the assessment of children are then added to that framework—for example, the necessity of gathering information from multiple informants and using multiple information-gathering tools when assessing children. Within that evolving assessment framework, a growing effort in social work (and other helping professions) is to strive to utilize evidence-based strategies and tools in practice. What is meant by evidence-based practice and how that effort can inform the most effective and efficient assessment of children is explored. The limitations to the evidence in support of our current assessment strategies with children, as well as promising ways to reduce those limitations, are detailed. Finally, current trends and developments in the assessment of children in social work practice settings, including child protection, schools, and mental health, are presented.

Defining Assessment

Assessment is used to describe an assortment of activities and processes in the social sciences and human services that involve gathering information about a client(s) and the presenting circumstances leading to an evaluation, determination, or plan of action focused on that client or client system. In social work practice, some aspects of assessment are driven by the practice setting, the population being served, and the practice model being applied by the social worker. However, this chapter offers a framework for social work assessment with children that, although embedded within the evolution of the social work perspective and the current effort to situate social work practice on an evidence base, can be applied by any direct practitioner regardless of setting, population, practice level, or model. In this chapter, a descriptive and evolving definition of assessment in the context of providing social work services to children is offered. As a starting framework, assessment in social work with children is defined as including three key components: (1) collecting data, (2) being informed by a contextual perspective, (3) leading to a prevention or intervention plan.

Data Collection

First, assessment of children is, in large part, defined by a range of activities used to gather information about a child, a struggle or challenge confronting that child, and relevant information about that child's social environments. Those activities can include but are not limited to (a) clinical interviews, (b) structured interviews, (c) self-report instruments, (d) direct observations, and (e) reviews of existing records. Those data-collection activities may elicit information from multiple informants, including the child, parents/guardians, other family members, key individuals in the child's life, and professionals who have direct experience with the child.

Contextual Perspective

The second component is illustrated by an enlightening distinction about assessment in social work practice made by Clifford (1998). He referred to “social assessment,” as opposed to psychological or medical assessment, in that social assessment “is centered on a social explanation—and will draw on social research and social science concepts” in identifying the service needs of an individual, small group, or community. Although social workers clearly also draw on and are informed by psychological and medical aspects of and explanations for client struggles, Clifford's focus on the social aspects of the client and his or her struggles distinguishes assessment in social work from assessment in other disciplines. This focus on contextual factors in social work can be seen in many assessment orientations in social work, such as the person-in-environment perspective, psychosocial models, the widespread use of ecological-systems thinking, and the pervasive structuring of assessment information into a biopsychosocial assessment document.

Prevention or Intervention Planning

Third, child assessment in social work is also defined as having as the central goal in gathering that information to inform the development of a social work prevention or intervention plan to help that child or group of children. Although systematic information about a child and his or her social environments may be gathered for other reasons—such as part of a research endeavor or eligibility evaluation—unless the ultimate goal is a formulation leading to the implementation of a social work service plan, the gathering of that information does not constitute an assessment as it is referred to in this chapter.

Thus, a social work assessment of a child includes (a) data collection, defined as a systematic gathering of information about the child, a struggle or challenge facing that child, and that child's multiple social environments; (b) data pursued from a contextual perspective oriented to how the child's social environments influence the child, the struggle or challenge, and efforts to resolve that struggle or challenge; and (c) development of an intervention plan to assist that child with that struggle or challenge as the primary goal of that data-collection effort.

The application of systemic and comprehensive assessment strategies has become more important given profession-wide efforts to build an evidence-based approach to social work services (Gambrill, 1999). Because service-delivery activities start with and are built on the assessment process, reliable and valid assessment strategies and tools are fundamental to identifying, developing, evaluating, and providing evidence-based interventions. For example, reliable and valid assessments provide a vehicle to evaluate interventions, thereby establishing evidence as to when and with whom such interventions can be effective. Further, the application of interventions with already established bodies of evidence as to their effectiveness should only be utilized after the application of systematic, comprehensive, reliable, and valid assessment strategies and tools to inform the selection of interventions appropriate for a specific child in a specific situation. Additionally, the results of a systematic assessment should influence the provision of the interventions chosen, thereby following long-established social work practice principles, such as starting where the client is, treating each client as an individual, and providing individualized services (Hepworth, Rooney, & Larsen, 2002; Pilsecker, 1994).

The wide variety of settings in which social workers serve children, the larger array of struggles and challenges faced by those children, and the wide range of what and who social workers are actually assessing—for example, the child, a potential home placement, the risk of a caregiver to abuse or neglect, the appropriateness of a classroom setting—all make a truly comprehensive discussion of assessment of children in social work seem daunting. Therefore, one goal of this chapter is to set the current state of assessment of children in social work in a historical context that encompasses our collective professional knowledge informing the assessment of children as a framework on which to add recent advancements.

Historical Background

Mary Richmond, in her seminal book Social Diagnosis (1917), presents the first comprehensive treatise on the assessment process in social work. Although she uses the term diagnosis, which, for most social workers today means something quite different than assessment, what she is referring to as a social diagnosis 90 years ago meets the three criteria for social work assessment offered here. In fact, for those who have not read all or even parts of her book, it is truly worth the time, and you may find it contains surprisingly still-relevant insights on assessment, social casework, and prescient glimpses of things to come. For example, Richmond describes her preparation to write Social Diagnosis as including systematically reviewing social work case records and recording interviews with caseworkers across five different sites over the course of a year “to bring to light the best social work practice that could be found” (p. 7). Is that not an effort to build a body of evidence about what works? Richmond further says of her efforts in the preparation of the book, “the most difficult of all my problems has been to make a presentation on the handling of evidence” (p. 9) in the assessment process. Richmond's book culminates in a series of structured interview protocols for the assessment of various clients and situations.

Assessment Informing Best and Evidence-Based Practices

The pursuit of providing clients with the best possible social work services available at a given point in time, basing assessment on gathering the best evidence possible, and collecting that evidence in a systematic manner are distinctly not new endeavors in the social work profession. In fact, social work has a rich history of professional knowledge development in the area of assessment.

Central to that accumulation of knowledge in the assessment of children has been the conceptual perspective of a child as embedded in a set of social contexts. Mary Richmond articulated that fundamental perspective 90 years ago. That perspective also guided Jane Addams and the Hull House staff. For example, in the area of juvenile delinquency, Hull House rejected dominant theories based on heredity and instead asserted that the most important factors leading to juvenile delinquency were environmental (Hart, 1990). With respect to assessment, that clearly means the gathering of information about, and analysis of, the social environment that a child inhabits in an effort to understand that child's development, struggles, and behavior.

The history of that perspective can be traced to today by examining social work textbooks over the decades detailing the state of the art and science of casework practices. For example, Hamilton (1951) states that assessment is an attempt to understand the client, the problem, and the situation; and such authors as Perlman (1957), Hollis (1964), and Pincus and Minahan (1973) iterate that triad of assessment. Hollis states this perspective succinctly when she points out that, in assessment, “strengths as well as weaknesses in both the person and the situation are important considerations” (p. 261). Hepworth et al. (2002) offer a similar triad. Assessment, they suggest, is a process “to gather information and formulation of that information into a coherent picture of the client and his or her circumstances,” leading to “our inferences about the nature and causes of the client's difficulties” (p. 187). They do, however, describe a meaningful shift in one aspect of that triad in that they stress the assessment of the needs and the strengths of the client as much as the difficulties of the client. This strengths perspective continues to guide the development of structured assessment instruments for practice, such as a strength-based and culturally informed reliable and valid assessment tool for practice with Native American youth, their families, and communities (Gilgun, 2004). This sort of melding of the long-evolving social work ecological strengths and culturally informed orientation to helping clients with more recent and rigorous assessment methodology seems like a promising trajectory in social work assessment with children.

The focus on strengths has grown in part from the long-standing fundamental humanistic perspective in social work that all clients are doing their best and have resources and that, when clients struggle, it is because of a deficit in those available resources. Such resources can be both internal and environmental, and clients can call on those resources—social workers can likewise call on those resources in the assessment process—to help meet challenges and struggles clients face (McQuaide & Ehrenreich, 1997). Such a strengths perspective grows out of social work's values and ethical orientation to clients (a) as persons of worth, (b) as persons who have a fundamental right to choose their goals in the helping process and how they go about working on those goals, and (c) as persons who are capable of solving their own problems with appropriate support (Loewenberger & Dolgoff, 1985). The strengths perspective also stands in contrast to the still-pervasive medical model of diagnosing and labeling limitations, which is particularly prevalent in mental-health practice (Cox, 2006). The strengths perspective and the focus on the social environments of a client are reflected in the ubiquitous development of an ecological-systems orientation in social work practice.

Evolving Ecological-Systems Perspective

A seminal application of the ecological perspective in social work is the introduction of the life model of practice by Germain and Gitterman in 1980. As they put it, “the social purpose [of social work] calls for a practice method that is designed to engage people's strengths and the forces pushing them toward growth, and to influence organizational structures, other social systems, and physical settings so they will be more responsive to people's needs” (p. 2). In the 1980s, the ecological perspective was increasingly used to articulate the social work approach to assessment and service delivery. Further, some authors started adding concepts from the general systems theory to that ecological perspective to create what was termed the ecosystems perspective (Greif & Lynch, 1983).

The adaptation of systems theory to practice endeavors introduced several helpful theoretical concepts into social work thinking. Those concepts are especially helpful in assessment, as they offer insights into how social systems—the interactions between a client and his or her environment—work. For example, equilibrium is a concept that states that human systems (read families) tend toward establishing a balance that can be maintained, whether that balance is good or not so good for the members of the system. Boundaries, such as between members of the family or between the family and other systems, such as the school or neighborhood, are critical in the flow of information, resources, and support within and among systems. Social work has long asserted that assessing and attending to these dynamic processes are critical to effective assessment of a child and his or her social systems (Germain & Gitterman, 1980).

Another notable step in the evolution of the contextual orientation to assessment in social work is the person-in-environment (PIE) system, introduced by Karls and Wandrei (1992). The PIE system offers a common language and structure for social workers to use in formulating assessments from the unique orientation of social work. One goal in the development of the PIE system was to design an assessment structure that focuses on the “social well-being” of a client, which is identified as “different than physical or mental well-being” (p. 81), that assertion being supported by research about those three domains. The PIE assessment approach is systematic and comprehensive and includes information about the client, the problem, and the client's social environment, therefore possessing many of the characteristics described earlier for an effective assessment. It also introduces a coding system for client problems, with codes for duration, severity, and coping, as a way to quantify assessment information. The basic structure of the PIE system includes four factors: Factor 1–social role problems, Factor 2–environmental problems, Factor 3–mental disorders, and Factor 4–physical disorders. This system shares some structural characteristics with and foreshadows the multiaxial format of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2000) diagnostic format, and, although not widely used today, the PIE system represents an important development in social work's quest to build a professionally unique and uniform structure to assessment. Additionally, the PIE perspective continues to evolve; for example, the person-environment practice approach, as described by Kemp, Whittaker, and Tracy (1997), offers an ecological competence-oriented practice model that stresses the importance of ongoing assessment, social support, empowerment, and collective action.

Other developments in social assessment have also yielded systematic formats to gather and organize information. For example, there are two diagrammatic assessment tools that have seen widespread use in social work practice with children and families: the eco-map and the genogram (Hartman, 1995). Both tools grew out of the ecological-systems perspective and gained popularity in social work practice in the 1980s. Either or both can be drawn by a social worker in concert with a child and family during the assessment process and used as tools to elicit and synthesize information from the child and family as they help complete each diagram. Either can then be used to analyze family dynamics, gain a comprehensive picture of the family circumstances related to the struggle or challenge, or used to search for strengths, possible resources, and the ongoing collection of assessment information.

Hartman (1995), a social worker, first developed the eco-map for use in child welfare practice. An eco-map has, at its center, the child and family drawn as a circle (Figure 1.1). Then, surrounding the family and child is a system of circles representing other important people, resources, or activities, such as extended family; friends of the child and parents/guardians; activities, such as recreation, sports, or hobbies; organizations, such as schools, churches, neighborhood groups, or workplaces; or other agencies, such as health-care providers, mental-health providers, or juvenile court. Care should be taken to include not just circles related to the presenting challenge or struggle but also those that represent strengths and resources to the child and family and other struggles or possible barriers to solving the presenting issue. Once all the needed circles have been drawn, various types of lines are drawn between the circles to represent the nature of the connection between the child and family and each particular circle. For example, a solid line depicts a strong relationship, and a dashed line represents a tenuous connection, whereas a line with hash marks across it suggests a stressful connection. Arrows are drawn along the connections to indicate the direction of flow of support, resources, and energy.

Figure 1.1 Example of an eco-map for Eddie, a 10-year-old boy with behavior problems

c01f001

Murray Bowen (1978), a psychiatrist who was a pioneer in the field of family therapy, developed the genogram as an assessment tool. Carter and McGoldrick (1980), social workers who have been at the forefront of the evolution of family therapy over the past 25 years, particularly with respect to gender and ethnicity issues, introduced the use of genograms in social work. In drawing a genogram, three or even four generations of the family are depicted (Figure 1.2). Males are drawn as squares and females as circles, and a system of lines is utilized to connect family members and indicate the nature of their kinship. A genogram has levels for each generation, such that family members in the same generation are on the same level across the page. Once all the multigenerational members of the family are included and kinship lines are drawn, other aspects of the family dynamics and circumstances can be included, such as marriages and divorces, deaths and illnesses, alcohol or drug use, significant events in the family history, religion, occupation, education, mental-health problems, or any important events or family dynamics. Similar to the eco-map, various types of lines can also be added that characterize the nature of the relationships between family members. A genogram is used in practice not just as an assessment tool to identify family patterns, strengths and resources, and unresolved issues but also as an ongoing tool to identify strengths and resources in intervention planning and implementation. A comprehensive discussion of the use of genograms as an assessment and intervention tool is beyond this chapter; for more detail, see McGoldrick, Gerson, and Shellenberger (1999).

Figure 1.2 Example of a genogram for Eddie, a 10-year-old boy with behavior problems

c01f002

Another important step in the evolution of the ecological perspective in social work is the incorporation of a focus on risk and protective factors and the vulnerability or resilience to the impact of environmental stressors that such factors may offer (Fraser, Richman, & Galinsky, 1999). From this perspective, the characteristics of the physical environment and social relationships may act as risk or protective factors with respect to child and family functioning. Risk factors are environmental characteristics that predict undesirable developmental outcomes, whereas protective factors are promotive of positive developmental outcomes or may compensate for the negative impact of certain risk factors (Richman, Bowen, & Woolley, 2004). Central to this perspective is the concept of resilience, which has been defined as the dynamic interplay of environmental, social, and individual protective factors in the context of risk exposure, leading to positive adaptation and desirable developmental outcomes for youth (Luthar, Cicchetti, & Becker, 2000).

Related to the concept of resilience, it has become foundational in any assessment process in social work practice to assess client and client-system strengths (Saleebey, 2006). In the assessment of children, that means gathering information about the strengths of the child and the resources available to the child from his or her social environments. For example, Gleason (2007) details a strengths-based approach to completing a social developmental study in a school setting. That approach includes strategies for how to query children about strengths (for example, What are some things you have done that you are proud of?) and how to ask assessment interview questions from a strengths perspective (for example, When things are going well, what does that look like for you?). Then, the social worker frames intervention goals and objectives in positive ways and calls on assessed strengths and resources to achieve those objectives. Finally, a strengths perspective supports social workers striving to give children a voice in school meetings about their school service plans by preparing each child to speak and advocate for him- or herself in such meetings and making certain that time and space are made for the child to make those contributions to the process.

Bringing many of these concepts together in a manner that makes them applicable to assessment with children is the eco-interactional developmental (EID) perspective, as described by Richman et al. (2004). This framework is informed by (a) the ecological-systems perspective in terms of the centrality of the social environment, and (b) the risk and resilience perspective in how that environment influences children, all within (c) a developmental orientation whereby child functioning can only be meaningfully interpreted in the context of that child's developmental trajectory and current developmental level, needs, and struggles. Within this ecological framework, there are three key environmental contexts that must be assessed in social work practice with children: family, neighborhood, and school. As described by Bronfenbrenner (2005), these microsystems are the environmental settings that directly influence a child, whereas mezzosystems represent the connections among those key microsystems. Examples of mezzosystems include the nature of the relationship between a child's family and a teacher or the relationships between the family and neighborhood residents and organizations. The larger social, cultural, and political environments that children and their families inhabit and the characteristics of those systems constitute the macrosystem.

Social work also has a rich history of stressing issues of cultural and ethnic diversity and historic and current forms of discrimination and oppression that emerge within a family's macrosystem and the various microsystems and mezzosystems surrounding a child and his or her family. Building on the ecological- and strengths-oriented PIE assessment system described earlier, Appleby, Colon, and Hamilton (2007) have comprehensively approached the effects of race, culture, and social class in the dynamics of oppression and discrimination (including racism, sexism, homophobia, ableism, and religious bigotry) on healthy development and social functioning. Because a fundamental goal in social work assessment is to take a contextual perspective, it seems imperative to attend to the impact of such issues with respect to child clients and their families who may be members of currently or historically oppressed or discriminated groups. For example, the authors point out that culture is often seen as static, when, in fact, it is dynamic, changing as it develops, much like an individual develops and changes as the result of interactions with the environment and other cultures. Therefore, the culture in which the child client and his or her family are members is changing, as are the other cultures that child is surrounded by, and the dominant or majority culture, if that is different from the child's culture. Those multiple changing cultural contexts can at once serve as developmental settings for the child and family, sources of strengths and resources, mediators of struggles and challenges, or sources of oppression and discrimination, all potentially profoundly impacting child and family adaptation and functioning.

The pursuit of social justice