Lishman
Lishman
Lishman
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12 Assessment
Janine Bolger and Patrick Walker
Key Themes
●● Assessment is a core activity of social work practices, which should be a process
capable of responding to dynamic factors in the lives of service users.
●● Assessment is underpinned by a series of principles that serve to guide and
direct practice.
●● The legal and policy context of assessment is essential to understand as this
sets a mandate for appropriate social work practice.
●● Models and frameworks for assessment provide guides for practitioners and are
underpinned by the skills and knowledge to inform the ‘what’, ‘how’ and ‘why’ of
assessment.
●● Assessment is founded on partnership with service users, but may be undertaken
in both voluntary and involuntary contexts.
INTRODUCTION
The concept of assessment is generally associated with notions of appraisal, making
judgements, forming opinions or calculating the value of something. Whilst these
provide a helpful starting point, they require much further examination when applied
to a social work context, where assessment is a discrete, core activity and a key skill.
This chapter will introduce you to elements of social work assessment, incorporating
principles, context, models, frameworks, skills and practice issues. It will draw reference
from across the range of service user groups and invites you to reflect on and critically
explore the material.
To begin to understand the meaning of assessment in social work, consider your
understanding of assessment in your day-to-day life. Everyone makes numerous
assessments every day in order to navigate their way through the daily interactions
and situations that they face. In making these day-to-day assessments you will use a
wide variety of perspectives that give meaning to the information that is presented,
or help sift the information that is presented or found. Perhaps personal experience
helps you, or perhaps your own cultural beliefs offer a way of interpreting situations or
environments. Some of these factors will have relevance to assessment in social work
and highlight the importance of being self-aware.
For our purposes we would propose to define assessment in social work as a structured
activity with the characteristics shown in Figure 12.1.
PRINCIPLES OF ASSESSMENT
The purpose of this section is to offer some principles, or core common features, of
assessment. The discussion here cannot be prescriptive, but rather is indicative, for
reasons that will become apparent. Assessments are frequently context-specific and
consequently are shaped by the inclusion of particular elements and influenced by the
manner in which the assessment is undertaken.
Case Study
Consider the following three different types of assessment that may take place
under the auspices of services for children and young people:
As a consequence, we need to be very clear about our role, remit and the context of any
assessment.
Guiding principles help clarify and direct practice in all areas of assessment. They
may be drawn from ethical frameworks, theoretical perspectives, legal obligations and
practice guidance and are important because, although various frameworks can be
Purposeful
and appropriate
Leads to
Dynamic and
planning and
responsive
future action
Involves
judgement to Based on
support engagement
decision-making and inclusion
Assessment
used in assessment, it should be remembered that, as Statham and Kearney point out,
‘social work can never be a purely technical activity based simply on assessment formats,
models or methods’ (2007: 102, emphasis added). This suggests that some underpinning
and orientating principles are required when beginning and undertaking the assessment
process. Five key principles are presented here.
and points the reader towards Bradshaw’s (1972) taxonomy of need, summarized as:
●● Normative need, which is identified according to a norm (or set standard); such
norms are generally set by experts. Benefit levels, for example, or standards of unfit-
ness in houses, have to be determined according to some criterion.
●● Comparative need concerns problems that emerge by comparison with others who
are not in need. One of the most common uses of this approach has been the com-
parison of social problems in different areas in order to determine which areas are
most deprived.
●● Felt need, which is based on the perspective of the people who have it.
●● Expressed need, which is need people say they have. People can feel need that they
do not express and they can express needs they do not feel.
Need, as a principle, can determine what the social worker may require to explore in
assessment. If children need, for example, a secure relationship with their parent or
caregiver, to grow and develop, then the absence of it becomes a risk to them. Similarly,
if an adult with mental health problems needs support and counselling to manage
auditory hallucinations, then an absence of such support may significantly impact on
the person’s health and well-being. By understanding need and drawing on broader
knowledge and theory, the practitioner is able to consider the person’s situation and to
explore approaches to relieving the unmet need.
Exercise
The word ‘need’ is used commonly by everyone, so the expression ‘needs-led’
should be fairly straightforward. However, think about when you and others use the
word and substitute the word ‘want’ in place of ‘need’. How often is ‘want’ a more
appropriate term, and how often is ‘need’ the correct description of the situation?
Bronfenbrenner later added a fifth level, the chrono-system, this being the dimension of
time relating to an individual’s life events and environment – for example the influence
of time in relation to reactions to the death of a parent, relocation, a relationship
breakdown and so on.
See the article by Hill (2002) on the Companion Website (www.sagepub.co.uk/
SocialWork) which reviews the social network approach to social work assessment.
and capacity for change (Daniel et al., 2010). An assessment that explores strengths
can reveal an individual’s or family’s ability to resolve their difficulties using their own
skills and expertise without becoming disempowered through service involvement. The
very process of assessment can help individuals or families to identify and utilise latent
strengths and thus reduce dependency on professionals.
This principle is relevant when working with all service users and in all domains of social
work, whether the practice base is termed ‘Children and Families’, ‘Learning Disability
Services’, ‘Social Work with Older People’ and so on. Assessments that purely focus on
deficits are not only likely to be demoralising and incomplete, but also run the risk of
being oppressive, result in inappropriate labelling and potentially limit an individual’s (and
their network’s) abilities to resolve their difficulties themselves. Compensatory strengths
need to be explored, identified and added in to the equation whenever they are present.
Exercise
Consider your own situation now. What are the positives and negatives in your own
situation? How do you interact with your family and how does your family interact
with neighbours, friends, work and the wider community? How much of this is relevant
to your current situation?
an effective interpersonal process that facilitates the achievement of goals that can-
not be reached when independent professions act on their own …
●● The Procedural model, often associated with guidance related to legislation, involves
using systems that are devised to ensure consistency and thoroughness in data col-
lection. Consequently, eligibility for and allocation of services is often decided upon
as a result of the collection of such data. This can provide only a snapshot assessment,
directing the assessment away from examining the individual’s strengths and abili-
ties, and can divert from individual rights or concerns over quality of life (Milner and
O’Byrne, 2009). The concern is that such systems can replace rather than support or
inform judgements made by professionals (Barry, 2007 cited in Milner and O’Byrne,
2009), and may be viewed as rigid, time-consuming (lots of forms) and one-way,
in that it meets the needs of the worker and agency rather than that of the service-
user. The difficulty arises when information is collected on an individual by different
professionals with a different focus (i.e., health, housing etc.) but stored separately.
This results in an inadequate understanding of the total experience of any individual
by any one professional. Workers can become caught up in the process of gathering
information rather than in trying to understand what the service user needs. On a
more positive note, this systematic manner of collecting large amounts of data has
also contributed to the evidence base for social work practice.
●● The Questioning model of assessment focuses on the nature of the questions and how
the information is used. Using this approach problems and solutions reside with the
individual and the social worker’s task is to identify the problem and highlight the
most appropriate approach to resolve the issue. A criticism of this model is that it
can be seen as oppressive given that the social worker takes on the role of expert and
makes the final decision. However, if questions are asked in order to try to under-
stand what is impacting on the current situation, and if a range of perspectives are
sought, then this does not have to be the case.
●● When adopting the Exchange model the service user becomes the expert with regard
to their own needs and through their involvement in their own assessment becomes
empowered. It acknowledges that the worker’s expertise lies in their problem-solving
abilities. The aim, through development of trust, is to seek a compromise between
choices and needs through involvement of all parties. The worker takes on responsi-
bility for managing the process of assessment. The focus is on a holistic assessment
of the context in relation to the individual over time (Coulshed and Orme, 2012).
Specific frameworks have been outlined in the Case Study to demonstrate how models of
assessment can support particular frameworks or approaches to information gathering.
Case Study
1. The Common Assessment Framework (CAF) in England and Wales, the
UNOCINI Assessment Framework in Northern Ireland and the GIRFEC (Getting it Right
for Every Child) approach in Scotland focus on how practitioners across all services
for children and adults can work together to ensure that children and young people
have their needs met with reference to a range of outcomes and indicators that
can be applied in any setting and circumstance. The approach is underpinned by
a set of common values and principles. The success of such approaches depends
on a standardised assessment and the application of shared tools and models. All
approaches require a lead professional.
The five outcomes of CAF concern being healthy, staying safe, enjoying and
achieving, making a positive contribution and achieving economic well-being
(Children’s Workforce Development Council, 2009). It consists of a pre-assessment
checklist to decide who would benefit from an assessment (focusing on the
development of the child/young person, parents and carers, and family and
environment); a standard recording format; and a process to enable practitioners in
the children and young people’s workforce to undertake a common assessment and
to move forward on the result through the development of an action plan.
In sharing information with other professionals, recording information on a single
system, identifying needs and services, establishing a plan and reviewing both the
plan and provision, it would appear that a Procedural model is being employed.
2. The Single Shared Assessment (SSA) in Scotland, the Single Assessment Process
(SAP) for older people in England, the Unified Assessment in Wales and the
Northern Ireland Single Assessment Tool (NISAT) combine elements of both
Procedural and Questioning models. SSA is the ‘streamlining of the assessment
process to enable the needs and outcomes for the individual to be identified and
subsequent interventions and services put in place’ (Scottish Government, 2009b: 1).
(Continued)
(Continued)
The sharing of information across agencies is crucial and so the process encourages
joint working.
In a SSA a ‘lead professional’ coordinates the gathering of information for the
assessment and ensures that a plan is made and reviewed and that the identified
services are delivered. Care Management is the name for this process, and it is
focused on the needs of individuals with complex or changing needs. Three different
types of assessment (Simple, Comprehensive or Specialist) can be carried out,
depending on the needs of the service user, and assessment is undertaken by
different professionals depending on their levels of training and expertise. The legal
context for Care Management is provided through the National Health Service and
Community Care Act 1990 and in Scotland is augmented by the Regulation of Care
(Scotland) Act 2001 and the Community Care and Health (Scotland) Act 2002. The
process of a SSA involves service users and carers and is intended to be person-
centred. However, for older people information is also gathered through an Indicator
of Relative Need questionnaire which consists of 12 multiple choice questions under
section headings: activities of daily living; personal care; food/drink preparation;
mental well-being and behaviour; and bowel management. The answers to each
question are scored and the totals for each section are calculated. The scores are
intended for planning purposes and not to determine eligibility for services.
3. Motivational interviewing (see Chapter 23), used in substance misuse counselling,
is both client-centred and semi-directive. The approach attempts to increase the
service user’s awareness of the consequences of their behaviour and to encourage
reflection on the benefits that might be achieved through change. The approach is
non-judgemental, non-adversarial and non-confrontational. The eight key interviewing
techniques: asking leading questions; reflecting resistance; acknowledging the
advantages of behaviours; raising awareness of discrepancy between the present
and the desired situation; elaborating on self-motivational statements; offering non-
dogmatic information; voicing the service user’s doubts and summarising selectively
(Miller and Rollnick, 1991) fit well with the Exchange model of assessment.
Having chosen a specific model and framework for assessment the social worker must
also consider the knowledge that underpins assessment. The range of knowledge used
to support the assessment should include an awareness of developmental theories,
social systems theories, policies, organisational knowledge and knowledge of research.
The point is to bring together information and resources in order to personalise the
provision (Statham and Kearney, 2007).
support the service user to draw on their own resources to examine alternative ways to
improve their situation and to build their confidence. As previously outlined, assessments
focusing on deficits may serve only to disempower the service user and reinforce
inequalities between them and the social worker. The social worker’s role is to develop
the service users’ capability to assist themselves. This is known as empowerment.
A good assessment relationship involves the social worker in:
●● examining the personal and environmental strengths of the service user and carrying
out a multidimensional assessment of such strengths
●● utilising meaningful and appropriate language
●● negotiating mutual agreement over the assessment
●● apportioning no blame. (Cowager, 1994)
Any attempt to form a genuine partnership will involve good skills of listening and
interviewing and will focus on the individual rather than the procedure.
are made by the service user without the facilitation of a social worker (this is the highest
level of involvement). Decisions might be service user life decisions, decisions to protect
others, or decisions about resources or service delivery. Unless an individual’s capacity is
in question or there is a concern that the safety of others might be compromised, service
users should have control over decisions about their own lives. The reason to choose a
lower rather than a higher level of involvement must be justified and limits should be
placed on the type of involvement only if there are grounds to do so (O’Sullivan, 2011).
Exercise
Read Chapter 15 and try to identify situations where service user involvement might
be problematic.
●● There is an expectation that violence will be rewarded, i.e. by influencing the decision
or withdrawal of the worker.
●● There is a belief that no other action is possible, e.g. where there is evidence that
violence has been used frequently as a coping mechanism. (Breakwell, 1989)
In conclusion, resistance may be seen as a way in which service users attempt to regain
some of their ‘perceived’ loss of power and control by refusing to recognise risks to self or
others, not accepting the need for change, or being unwilling to accept options presented
to them. The concept of principled negotiation might assist in finding a way forward.
By focusing on the interests rather than the attitudes of those involved, separating the
people from the problem and trying to find options for mutual interest before agreeing
criteria for evaluating the result of the negotiations, a resolution to any stalemate might
be found. However, legal and policy requirements might mean that negotiation is not
an option (e.g. because of protection issues) or that due to their personal values and
principles an individual might be unwilling to negotiate on certain matters (e.g. around
the use of alcohol). In planning a response discussions should take place with colleagues
and relevant agencies, involving the service user wherever possible. Any response should
recognise that safe practice is beneficial for both the worker and the service user.
Critical Thinking
In assessment work, collaborative approaches building on service users’ expertise are
vital. The current practice agenda, especially personalisation and self-directed support,
emphasises the role of self-assessment. Gardner (2011: 43) notes that there has been much
professional resistance to the concept and she highlights that we mistakenly assume that
self-assessment involves only the service user. In self-assessment, however, service users
are major participants because, quite simply, they know themselves best. The social worker
participates too, supporting, offering information and assistance. Gardner’s interpretation
of self-assessment is interesting and provides a useful point for you to consider.
During, or after your most recent period of practice learning, critically appraise your
practice in respect of a collaborative assessment.
To read about the findings of pilot projects focusing on self-assessment in adult social
work settings, visit the Companion Website (www.sagepub.co.uk/SocialWork) and see
the article by Abendstern et al. (2013).
CONCLUSION
This chapter has offered particular frameworks, methodologies and supporting
theoretical concepts which are integral in good social work assessment. The following
central themes should be borne in mind when undertaking assessment in work with
service users:
Reflective Questions
1 Considering the concepts of need and Bronfenbrenner’s Ecological Systems
Theory identify what a person requires from their immediate caregivers or family
in order to develop or progress. Go on to consider how a person’s development
or progress may be influenced by the wider world and what difference being
part of a supportive community environment can make.
2 What questions might you ask during the assessment process in order to
explore ‘strengths’? Consider how the questions you ask interface with the
model of assessment being used.
3 As part of preparing for one of your social work placements or practice oppor-
tunities spend time researching the legal and policy context of the field you
will be working in. During placement, reflect on how legislation and policy
shape the work that your placement agency undertakes. Does working in dif-
ferent settings impact on the extent to which social work practice is statutorily
driven?
RECOMMENDED READING
Milner, J. and O’Byrne, P. (2009) Assessment in Social Work. Basingstoke: Palgrave
MacMillan.
Parker, J. and Bradley, G. (2010) Social Work Practice: Assessment, Planning, Intervention
and Review (Transforming Social Work Practice), 3rd edn. Exeter: Learning Matters.
Walker, S. and Beckett, C. (2010) Social Work Assessment and Intervention. Lyme Regis:
Russell House Publications.